511 - "Above and Beyond": A Qualitative Study to Understand the Experience of Racial Concordance between Medical Residents and Patients During Pediatric Patient Encounters

Poster Number: 511
Publication Number: 511.1

Background: Children of color experience significant health disparities related to racism. The social constructionist framework suggests this is reflective of the meaning assigned to race by humans, rather than biological differences. A potential strategy to disrupt health inequities is offering racially concordant care. However, research on this topic is minimal and has not queried health professionals.

Objective: The objective of this study is to understand how medical providers perceive the relational aspect of race and more specifically, racial concordance during clinical encounters.

Design/Methods: Authors conducted a qualitative study using convenience sampling of pediatric residents at an urban, tertiary care center between June 2019 to December 2020. Interviews elicited self-reported demographic characteristics and narrative responses to a semi-structured interview guide. Transcripts were transcribed and iteratively coded until thematic saturation.

Results: Forty-seven interviews were completed with 5 (10.6%) participants self-identifying as part of a group traditionally under-represented in medicine. Analysis revealed three themes: (1) Racism influences health, (2) Racial discordance creates discomfort during many patient encounters, but racial concordance is a source of comfort for patients and providers of color and (3) Racially discordant clinical encounters may result in a change in clinical practice.

Conclusion(s): Because medical residents were the study subjects, interviews primarily represented the perspective of historically racially and socioeconomically privileged groups. While participants expressed awareness that racism, not race, drives health disparities, they often expressed limited understanding of structural racism. Strategies to address this deficit should 1) emphasize supporting anti-racism competencies in medical education to increase fund of knowledge for trainees who will inevitably participate in racially discordant care and 2) increase workforce diversity to create opportunities for patients of color to experience racially concordant care.