Creating Belonging

Purpose: Medical schools have been called to create welcoming environments for learners who are Black, Indigenous, and People of Color (BIPOC).1 There is no known tool that measures the level of inclusiveness and antiracism in medical school learning facilities. We created, piloted, and implemented a survey tool that assessed the level of inclusiveness and antiracism within the University of Wisconsin School of Medicine and Public Health (UWSMPH) physical learning space through the lens of UWSMPH students, faculty, and staff. Method: A literature review determined how other sectors evaluate and develop inclusive and antiracist spaces.2–5 From this, a crowdsourcing Qualtrics survey tool was piloted by UWSMPH students. Qualitative analysis led to a final survey grading the level of inclusivity and antiracism within UWSMPH’s learning space. The tool was divided into structural, visual, and social/cultural categories, totaling 19 yes/no/unsure questions, and was distributed to UWSMPH students, faculty, and staff via listservs. Each “yes” was given 1 point, and “no” and “unsure” were given 0 points with a maximum possible score of 19. The higher the score, the more inclusiveness and antiracism the space promoted. Percent of yes responses for each question was also determined. Total survey tool scores were averaged for students (n = 113) and faculty/staff (n = 113), which were combined (faculty n = 20, staff n = 93). Student and faculty/staff groups were further divided into White, BIPOC, and unspecified subgroups based on respondent answers to a demographic question. Total survey tool scores were averaged for each subgroup. Percent of yes responses was analyzed by subgroup. Results: There was general agreement on the level of antiracism within our physical learning space, with total average scores of 8.25 for White students/faculty/staff and 8.16 for BIPOC students/faculty/staff (P = .43, both subgroups reported yes to approximately 43% of the survey questions). Structural category scored highest, averaging 64% yes responses for students and 62% for faculty/staff. Some of the highest percent yes responses were regarding diversity in artwork, being acknowledged or greeted by others while in the building, and access to public transportation. Two of the least percent yes questions were regarding affordable parking and welcome signage in the main common area. The most unsure responses were regarding if the security officers were unbiased. Most questions showed concordance between demographic groups. However, when asked, “Do you see individuals of diverse backgrounds while you are physically present in the building?” White students (P < .001) and faculty/staff (P = .01) were more likely to respond yes than their BIPOC contemporaries. Ninety-eight percent of White students responded yes, while only 67% of BIPOC students responded yes. Similarly, 94% of White faculty/staff responded yes, and only 60% of BIPOC faculty/staff responded yes. Discussion: It is feasible to assess inclusiveness and antiracism in a physical space using a standardized survey and to measure differences in perceptions between demographic groups. Survey results illustrate how our learning space is perceived and offers specific strategies for improvement as well as a way to measure inclusive and antiracist dimensions over time and physical space upgrades. Further work in psychometric validation of this tool is planned. Significance: Creating inclusive learning environments for BIPOC students requires more than increasing the number of BIPOC students in the cohort. Physical space is one aspect of inclusive and antiracist learning environments that should be considered. This novel survey tool can assess medical schools’ learning spaces for inclusiveness, provide a road map for improvements, and be used to document change.

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