Table 3 Constructs from the logic framework for addressing racism matched to interventions identified in the literature and through discussion with experts that are hypothesized to address the underlying gap in logic

Understand racism

EDI Moments

Build literacy and understanding of EDI-related concepts.

Modelled after ‘Safety Minutes’ used in industry to build safety literacy and culture [37], EDI Moments are 5–15 minute presentation on a single EDI-related concept held at the beginning of leadership meetings.

Recognizing racism

Peer Support

Provide opportunity to share experiences and receive validation from trained peers.

Peer support programs use shared lived experience and empathetic listening to validate experiences. In medicine, peer support programs reduce distress from adverse events [40].

Race & Racism Teaching Rounds

Provide real examples of how structural and interpersonal racism influence patient care.

Modelled after “Morbidity and Mortality Rounds”, Race and Racism Rounds apply a just culture approach to improving patient care by identifying contributors to adverse outcomes [41].

Story Telling

Share the experiences of physicians from marginalized groups [42,43,44] to build empathy.

Narrative reflections may demonstrate how racism and other forms of discrimination manifest for people from marginalized groups.⁶¹

Implicit Bias Training⁶²

Teach physicians to recognize and mitigate the effects of unconscious beliefs.

Implicit Bias Training workshops have increased hiring of underrepresented groups in academic settings.⁶³

Naming racism

Local guidelines for patient originating harassment

Address social norms that prevent physicians from naming racism.

Systems-level algorithms for an organizational response to patient requests for white physicians, microaggressions, or other forms of explicit interpersonal harassment shifts from the individual judgements and penalties for action to a collective strategy for these issues.

Support Networks

Provide a safe space to talk about racism.

Modelled after Women in Medicine groups to create a space for sharing removed of judgement and bias.

Disclosure training

Develop skills among medical leadership to receive disclosures of harassment and discrimination.⁶⁴

Lack of support or dismissal by leadership when reporting an experience of racism, sexism, harassment, or discrimination is a central barrier to harassment reporting [18].

Confronting racism

Bystander Intervention Training

Build skills to address racism in the moment it occurs.

Confronting racism is a skillset that must be learned and practiced [45].

Harassment Reporting Mechanisms

Address known barriers to reporting harassment.

Most harassment reporting mechanisms for physicians are not transparent, anonymous, confidential, or safe for those reporting, which contributes to underreporting of harassment among physicians.⁶⁵

Many physicians do not know how to report workplace harassment [18].

Remediation-Based Approaches to Harassment.

Use a report of racism as an opportunity to improve.

Adopting a ‘just culture’ and/or restorative justice approach (when applicable) to racism allows for improvement and growth rather than defensiveness.