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OK, sorry. So good evening, everybody. Um Welcome to our Color in the Clinic Series. Um This is a part of Black History Month and it's brought to you by Black Medics UK. Um Before we start, just a bit of a reminder that there will be a feedback form after the session. Um And that's gonna allow you to get your certificate at the end. So if you're wondering about certificates, you have to fill, fill out the feedback form first. Um This is really helpful for us to improve future sessions um as well as for Asia as well to get some feedback on her session as well. So a bit about me, I'm a male, I'm the education and membership lead for uh Black Medics UK. We are a network dedicated to supporting and amplifying the voices of Black medical students and trainees across the UK. But our mission is to bridge the gap in medical education and create a more inclusive healthcare workforce. Um So today, um we're excited to kick off the series with our fantastic speaker at Asia. Um She's the founder of Anatomy and she's an acclaimed medical student, a fellow um university of Nottingham final year student um in this series. Um she'll be shedding light on enriching the anatomical and medical curriculum with diversity. Um And she will provide considerable insights. Um and hopefully this will be an insightful uh talk for you all and please welcome Asia. Um Any questions in the chat, I'll be reading them out for Asia. So put them in the chat. Thank you, everyone. I'll start sharing my slide. Now, you have to let me know. You can see, you can everyone see that. Okie Dokie. So um yeah, if you can go to mental.com, I've also put the link in the chat as well, but you can type in the code and then what does inclusivity mean to you? If you can just put it might be a word, it might be a few words, a phrase, just share what you think inclusivity means because anatomy and what we do in our work is all about inclusivity and educational resources. So it would be nice to see what you all think. And if anyone's having a problem joining the mentee, um if you can just pop in the chat, then let me know. Yeah. So people saying representation definitely particularly pertinent to anatomy and our work diversity, including everyone. Definitely equity is great because I know we talk about equality, diversity, diversity and inclusion. But I think a lot of times it's probably be equity, diversity and inclusion being welcoming. Definitely equality. Yeah, equal opportunities, including everyone. Our population. Definitely. And when I talk about anatomy in our project, the population does come into that quite a lot belonging. Yeah, definitely. So, lots of, and it's nice to see they all fit the same theme, but everyone has a different opinion of what inclusivity is. So, thank you. I'll move on to the rest of the presentation but feel free to continue putting your words and things into the word cloud because it's really nice to see. So, like I may have said, I'm as I'm a final year medic at the University of Nottingham. And this presentation is going to be talking about not only anatomy as a case study for approaching inclusivity and diversity in the curriculum, but I'm also going to be discussing some other things such as implicit biases and how that impacts healthcare professionals too. So first, we're gonna start off by understanding some of the historical context behind implicit biases that healthcare professionals have, what an implicit vice is and how to challenge them introducing anatomy and how anatomy develops the curriculum and how you can integrate inclusivity into the medical curriculum as well. So hopefully there should be some tangible takeaways for you from this talk as well. And I just want to say at the top, a special thanks to all of these people who have made anatomy possible and who have meant that we've had funding and been able to develop anatomy into the project that it is today because without all of these people, this work would just not be possible at all. And we wouldn't have the amazing images that we've got and we wouldn't have got the extra funding that we've received this year to develop our project further. So when we talk about implicit biases, I think Carlin Aus is a really important person to talk about because he's kind of known as the father of the human race and of Homo Sapiens because he was the one who gave humans that name, he called us Homo Sapiens. And just as animals were classified into different species, Carlius decided to do the same thing with people. But you might see and if you have a look at the table on the right there, this is um an adaptation of what he said. But essentially it is a translation of how he made a hierarchy of Homo Sapiens. And as you'll see, black people or Africanist are at the very bottom of the hierarchy. So the problem with this classification is two fold. So firstly, from research, we now know that race is a social construct rather than a biological one. And research has actually shown that there is a greater difference within racial groups than there is between racial groups. So by classifying humans based on their race is not only biologically incorrect, but also we can see that the descriptions that Linnaeus has given to Africanus are derogatory and also you'll notice that in part, the descriptions are the most lengthy as well and providing afrikaners or black people with this derogatory description set the stage for future racial hierarchy that we see perpetuated in the transatlantic slave trade. And even as we see today, where black people consistently have poorer health care outcomes. We've seen that recently with the embrace report where black women are four times more likely to die as a complication or a result of being pregnant. So you can see here just looking at the descriptions Europaeus was described as being cheerful, muscular and inventor. Whereas Africanus is phlegmatic and lazy. And you'll also notice that Africanus is the only one whose physical traits make um reference to genitalia and breast. And this is also going into what I'll talk about later, how black people have often been hyper sexualized. And once again, this was a way of exerting control over black people, particularly in the slave trade. And this hierarchy continued to be perpetuated by Francis Galton, who spoke about hereditary genius, essentially once again, putting white people at the top of the totem pole and black people at the bottom. So there's plenty of things that I could talk about when we talk about systemic racism and the factors that influence this. But when we're talking about implicit bias and how people innately have biases towards certain people based on the information they received and their experience in life and in the world some of these topics are really important and I think some of the examples I picked for you today should be hopefully eye opening and also give a better understanding about why some healthcare professionals have biases against people of darker skin tones without even knowing it. So firstly, in this image, we have Otto Bega and Otta Bega was from the um was from Africa and he was brought over to the er to America and he was displayed in the Bronx Zoo. So he was taken from his home in the Belgian Congo and he was brought to the Bronx Zoo in 1906. And OAB Bega is a sad story, but he also exemplifies something that happened throughout history where black people have consistently been seen as inferior but also in some ways supposed to be superior or marvels. So black people are particularly enslaved. Women were seen as medical marvels and we'll talk a little bit more about that later. But as I said, Otto Bega was captured and taken from his home and sold into slavery. And when he was displayed in the Bronx, he was displayed in the monkey house. And when they displayed him, despite taking him from his home in Congo, they displayed him with the same scant clothing that he would have worn in his home country, which was warm. Whereas in the Bronx, it definitely was not. So whatever the weather conditions they displayed him with little to no clothing. And this was another method used by the white cos at the time to show themselves as superior. And for the patrons who went and viewed Otto Bega at the zoo, it was to leer at him and show how he was how they were superior and he was inferior. And that's also coupled with the fact that they put him in the monkey house as well. Now, unfortunately, I wish I could tell you that Otter Beger had a happy ending in that he was freed from his enslavement at the Bronx Zoo. And even though he was unfortunately, 10 years after he was displayed at the zoo, Otta Ben sadly, committed suicide. So next, as I alluded to, we'll talk about enslaved people and medical super bodies. So medical super bodies is a term often used to describe a lot of the times black people. And it's this notion that black people simultaneously inferior and superior. And we see this in stereotypes such as black people having thicker skin or a higher pain tolerance simultaneously about people are inferior to their white counterparts. Often when we're referring to traits such as intelligence. But when we have physical traits, black people are superior. And it's these beliefs that perpetuated the slave trade because this term of medical super bodies was used to justify slavery. For example, slaves could endure worse treatment because they were physically stronger and superior, yet still inferior enough to be enslaved and to be treated poorly. So we see this as well when we're talking about gynecology and other gynecological discoveries. But as the stereotype goes, black women were thought to have a higher pain tolerance than their white counterparts. And in slavery, this is especially important because in order to make the page economically viable, black women needed to have Children to perpetuate the slave trade and allow it to continue. So even though black women had Children in slavery, it did not exempt them from being treated poorly. But an example of this is how a black woman was fed food that killed a dog. But they thought that it wouldn't kill her because black women had stronger stomachs. So it's once again, you're starting to see probably a similar theme that whilst black people were seen as inferior enough to endure such treatment. They thought that they would survive these treatments. And another example of how being pregnant did not um exclude enslaved women from being abused and tortured. There's a story in um by and all my references are at the end. So if you do want to go read them, you can do where a enslaved woman was told to dig a hole and lie down flat with her belly in the hole while she was whipped. So as to protect the fetus as to protect the thing that made the slave trade economically viable. But once again, still exerting that control and that abuse over enslaved women. And I also hope you notice that I'm using the term enslaved rather than slaves because black people were not historically slaves, they were enslaved by white people. So it just changes the action of that terminology. And it's the same when I refer to ethnically minor people rather than ethnic minorities because someone is only made an ethnic minority by the country in which or the place in which they reside. Some of you may recognize this. I know that I recognize this having recently been on my obs and gynae placement, but this is called the Sims speculum. And we still use the word Sims, even though Doctor James Marion Sims has just a horrible history behind him even though he is hailed as the founder of modern surgical gynecology. So we still hold him in quite high regard in the medical field despite him abusing and taking advantage of enslaved women. So, Doctor Sims was credited with creating the first successful operation for vesicovaginal fistulas, which is a fistula between the bladder and the vagina, which can occur after childbirth. And it can be very debilitating for a woman to whom this happens to because it means that they're constantly leaking urine and not incontinent. So this was a common complication of childbirth back in the 18 100s. And whilst he created this successful operation, it was not without the struggle and the harm to enslaved women. So on one enslaved woman in particular, Sims carried out more than 30 operations before fixing her Vesico vaginal and her rectovaginal fistula. So a rectovaginal fistula is a fistula between the rectum and the vagina. And also when he operated on black women, sims did not use analgesia or anesthesia. But when he later carried out operations, once he'd affected them on white women, he did use analgesia and anesthesia. So once again, this work emphasizes how people believing that there is a biological difference between black people and white people and their pain tolerance shows that how we hale black women as these inferior yet superior medical super bodies. And that's something that perpetuates today, which is why it's important that we reject the notion that race is a biological construct when it's not, it is a social one because taking that belief and believing it and perpetuating it, particularly when we're looking at medical investments just further emphasizes a divide that should not exist. I know many of you will be from a medical background and you'll probably know in different investigations, we still use race as a determining factor. And I really think we should start moving away from that. And that's not to say that people of different races, they make things that make them more reactive to certain drugs or less reactive to certain drugs. But it's not because of their race. It's because of environmental and social factors that occur to people of different races that makes things different rather than their race itself. So moving on, looking at hair. So hair has long been used as a tool for discrimination against people of the black community. I'm sure many of you in the audience would, may have gone to a job interview worried that someone might see your natural hair as emp or me. I know that I definitely have and hair was used once again during the safe trade to make black women seem inferior and the hair of enslaved women was viewed as unattractive as unmanageable. And we see this racial bias still today, constantly across the world when people are discriminated on the basis of their hair. So for example, in America, a black employee was stripped of a job offer because they refused to cut their locks in accordance with the company's grooming policy. And that's something that's still happening very recently today. And it's a form of implicit bias and it's a form of racism and black hair styles. Historically, black hair styles, the importance of which cannot be understated is because cornrows and hair braiding was used during the era of the slave trade as a method to represent escape routes for enslaved people from the plantations on which they were imprisoned. So these hairstyles have huge historical significance and cultural significance as well. And then there comes the assumption that people with natural hair have bad hair and that straight hair is good hair. And once again, this is another method used by white slave traders to make black people seem inferior. And this is a myth that is still perpetuated today in pop culture. We hear it all the time that um thicker curlier hair, oily hair is described as being nappy or once again being seen as messy and even in a popular Beyonce lyric that I'm sure you're all familiar with. She says you better go and call Becky with the good hair because once again, that stereotype is to today, then I'm gonna go on to talk about sexuality as I showed you earlier with Linnaeus's classification of and it was only reference to genitalia describing black women as having elongated la breasts that lactated properly. And this description led contempt for believing that black people had an over sexual. And as there's many themes in what I'm talking about today, that was once again used to perpetuate the slave trade. And we actually do see, unfortunately, this stereotype and this misbelief is once again, is in our health care system and we see it in dermatological textbooks. We know as I'm sure many of, you know, darker skin tones are poorly represented in dermatological images as they are in anatomical images. However, the only place that people with darker skin tones are overrepresented in medical imagery is in images displaying S ti s or sexually transmitted infection. Once again, a form of implicit bias that impacts how healthcare professionals treat black people and the way that that implicit bias manifest itself is that black people are seen as being increasingly promiscuous and that can lead to black people have having lower prescriptions of preexposure prophylaxis or prep because practitioners believe that it will make them more sexually promiscuous. And even back during the slave trade as well. You may have heard of three stereotypes of black women. There's the mammy who was for a lack of a laor described as being the perfect slave, someone who was docile who kept the household running. Then you had the matriarch who was used as a way to pit black women and black men against each other by being described as overly masculine and emasculating her black male counterpart. And then finally, we have the Jezebel or as known at the time, the Hare and the Jezebel was known as being sexually promiscuous. And the reason that's important is because this Jezebel nature of black women was used to justify rape and sexual assault of enslaved women because the white slave traders believed that a black woman could not be raped because she always wanted it because she was wasn't overtly sexual. And I think understanding these contexts are really important, particularly when we're dealing with sexual health of black people and understanding these things and challenging our own implicit vices. And we even see some of these things perpetuated today in hip hop music videos and like I said, with Beyonce, and I don't think that all of these people obviously, you know, the historic these stereotypes come from. But it's really important that we understand this particularly as healthcare professionals when we're giving medications and when we're explaining things to individuals and then finally looking at medical distrust. So for good reason, black people don't trust healthcare professionals as much as we'd like them to. Like I said earlier with the embrace report, black women being four times more likely to die. We also see that black people consistently have poor healthcare outcomes and their older parts. We saw it in the COVID pandemic where Black people and South Asian people were less likely to uptake the COVID vaccine despite being the most likely to end up hospitalized or dead from COVID. And where does all of this start? Obviously, the slave trade has a massive impact on that. But this image actually shows something called the Tuskegee experiment. Now, the Tuskegee experiment was launched in 1932 and was titled the Tuskegee study of Syphilis in the Negro male and it was held in Tuskegee, Alabama. And what this study aimed to do was to investigate the progression of syphilis in 600 black men, 399 of whom had syphilis and 201 did not. However, before this trial took place, the patients were not adequately informed of what it would involve. Instead, they were told about the advantages that they'd get such as free medical examinations, free meals and burial insurance things that were really important to them and important to their families. This study lasted for 40 years and the treatment for syphilis. Now, we know it as penicillin was introduced in 1943 11 years after the study began. However, like I said before 399 men in this trial had syphilis, not a single one of these men were treated for their syphilis. And this led to participants experiencing some of the really negative effects of advanced syphilis. And I'm not sure how many of you are familiar with this. But some of the symptoms of someone having an advanced syphilis infection include blindness, neurological changes, dementia paralysis and hearing loss. Also, the wives and the Children of infected men in the study were impacted too. And some of these um relatives and descendants of those involved in the Tuskegee study are still alive today and receiving compensation from the United States government. Now, obviously, this is an absolutely horrific experiment that many of us couldn't imagine happening now with how we deal with clinical trials and how we consent individuals. But the fact that this study went up until 1972 when some of you may have been born, some of your parents may have been born and these men were dying and you know, becoming really, really ill in front of these people who knew what the treatment was and still decided to withhold it for them in the name of scientific curiosity. Now there was an apology for the Tuskegee experiment. So former President, Bill Clinton apologized for the wrongdoings of the US government during the study and this was in 1997. So still 25 years after the study actually concluded was in a formal apology given. But that didn't do anything to stop physician mistrust of black people in the United States. And we still see even in the UK that black people are underrepresented, underrepresented in a lot of research and a lot of clinical trials. And this didn't just impact the black community as well. But even people from other ethnic identities, including white people said that they would be less likely to engage with the clinical trial or be involved in the clinical trial because of what they'd heard about the Tuskegee experiment, lots of people at this time thought that, that the government, you know, would do good for them. But here we see that black people were treated really, really poorly and it is no coincidence that all of the study participants were black people. I couldn't imagine that the same thing would have happened to a group of white men and then talking about BM. So our bodies and when we view people's bodies are not without judgment, even though we think bodies are made of flesh, they are so much more than that, your bodies are opinions too. And when we're talking about people's bodies and people's BMI, it's heavily influenced by the media and celebrities. I mean, we've seen it time and time again how women's bodies get absolutely picked part in the tabloids and on social media. And in her book, fearing the black body, the racial Phobia Sabrina Strings discusses the impact that colonialism has on our perceptions of bodies and particularly black ones that permeate through our culture as we see it today. And you might be kind of surprised to hear about this. Obviously, we hear a lot about how BM I measurements aren't really accurate for ethnically minor people because the parameters for which we use BM I were developed from studies of predominantly white populations. Well, actually fat phobia can be seen to be rooted in racism because thinness was seen as a tool once again to display European superiority and restraint and fatness was associated with gluttony and a lack of restraint, not only amongst Africans, but also amongst Turkish women too. And you might remember if you think back to your school history days that historically, fatness was actually seen as being morally superior when we think back to the likes of Henry the eighth and it was a symbol of power because it showed that you could afford food. However, in the era of slavery, once again, European and white people had to find a way to make themselves feel and seem morally superior to their Black counterparts. And therefore w was another weapon to beat down enslaved people and deem them morally inferior due to their lack of control for having a higher body mass index. Not only this, but being fat was identified as being syno synonymous with black femininity once again, seem as simultaneously excessive, yet inferior. So next time when you think of BM, I think about how the origins of how we interpret BM I, how we interpret people's bodies and the way that they look might be rooted in colonial history. And then finally, in my little bit about the historical context, I want to talk a little bit about intersectionality and one thing that I really want you to take away from this talk. Despite the fact that I'm speaking mainly about black history and the traumas that black people have endured. Colonialism does not start and end with race. Colonialism is so much wider reaching than that. And it does permeate into gender, it permeates into sexuality, gender identity culture class throughout all of these things. And that's known as intersectionality, how identity and change your standing in the social hierarchy. And it's it intersectionality is the theory that having marginalized sexual ident um gender or sexual identities or class identities, religious identities, different ages, different cultures, different levels of disability can compound the amount of disparity that an individual receives. For, for example, an example of this is that black transgender women are 2.73 times more likely to die than other black transgender people. And that's an example of personality at play. And we must be aware of intersectionality to provide well rounded and inclusive care to our patients. And white colonialism reaches beyond race and ethnicity. In present day countries that belong to the commonwealth disproportionately make up 50% of the countries that still criminalize homosexuality despite making up 25% of the world's population. And the reasoning for this lies in the legal enforcing of homophobia that we saw by colonial administrations in the 19 100s. So I've spoken a lot about implicit bias. What is implicit bias? Well, implicit bias is something that we all have and in and of itself, implicit bias is not necessarily a negative thing because like I said, it's a reflex, essentially, it's something that we all have and it's a bias that we have that leads to a knee jerk negative opinion about someone. So due to characteristics such as their race or such as their gender, we can't do anything to stop people from having implicit biases, all of you in the audience will have implicit biases. But what the important thing is is to recognize your implicit bias, address it and try to change the way that you reflect on that implicit bias and not allow it to affect patient care. So, as we see in textbooks, the archetypal white cisgender male, thin li muscular is what we see and that becomes our normal, which can lead to the formation of an implicit bias that anyone who does not fit that archetype is abnormal and that's wrong because people come in all shapes and sizes, people look differently and that's the beautiful diversity of our population. But because we're presented with something and increasingly told that it's the norm, eventually our brains come to accept that. And it's the reaction that you have to, these implicit biases that are the important thing. Like I said, you will have implicit biases because of society because of who you speak to the interactions that you have the stereotypes that you hear. But when you have that knee jerk negative reaction, it's important to sit back. Think why did I think that way and and cast that view aside and we need to give students a safe space to do that. So an example of the impacts of implicit bias is through stereotype acceptance. So for example, black people have a higher pain tolerance. Black people have thicker skin, black individuals inherently lack sexual control. Having that implicit bias will impact how you engage with a patient and how how you treat a patient and it can lead to lower prescriptions of pain medications as well for patients. And they already spoke about the example about preexposure prophylaxis. Another example is that black people have low prescription of thrombolytic drugs, which can be life saving. We still use race in medical scoring systems and algorithms and we are trying to move away from this. But many of you will know that in the nice hypertension guidelines, race is still used as a factor between prescribing a patient, a calcium channel in inhibitor and prescribing them an ace inhibitor. Whereas internationally race is not used in any hypertension guidelines or in the World Health Organization hypertension guidelines. And A was recently removed from the guidelines for chronic kidney disease. It implicit vices can mean we accept the medical super body model and that we have lower paying prescriptions. So an example of this in the USA black people were less likely to be prescribed opioids because they were considered more likely to abuse opioids, which actually means that there's higher levels of opioid abuse in white populations because they are over prescribed opioids. And it also leads to poor satisfaction rates with healthcare professionals too. So it's just really important that we address this implicit bias, give students safe spaces to discuss their thoughts and their feelings. And we also need to up skill students to be able to deal with conditions of increased cognitive load because that's when it's most likely that implicit biases will impact people's treatment and their prescriptions for patients. And we all know that the NHS is under a lot of time, pressure is under huge amounts of pressure. And so it's doctors and healthcare professionals. So they need to have the tools to be able to deal with that increased cognitive load and to be able to cast aside them as devices and give them the time to address them before they impact patient care. And reflection is a key part of that. So here are some methods of overcoming implicit biases. So having an education and awareness of implicit biases in the first place is really important because if you don't know about it, you can't do anything to overcome it or address it, allow students to reflect openly and honestly and give them a safe space to do so, challenging those stereotypical beliefs that students hold. And once again, I stress that this is in a safe space because implicit biases, it's not because you are, you know, going out of your way to believe those things. It's just the society that you've engaged with that lead to the acceptance of these stereotypical beliefs, providing students and healthcare professionals with skills to cope under increased cognitive load and integrating reflective practices into the curriculum. And we all talk about reflection. We all do reflect but actively reflecting doesn't necessarily have to be writing out a paragraph. It can just be taking a moment, reflect on what you, you've thought about a patient initially and challenge that initial thought and that initial implicit biases. And all of this is just so important when I come on to my project anatomy because there's a really lovely quote um from um once again, it's in the references, but from Peterson who says the body as well, we know is never simply matter. It is never divorced from perception and interpretation. And because of that diverse representation is how we can improve the perceptions of students. So now I come on to my anatomy. So anatomy is a project aimed at diversifying the anatomical and medical curriculum through the following methods. So what you'll see here is some images of our surface anatomical imagery with that's diverse, with respect to ethnicity, gender, identity, weight, disability and age. So you'll see our three models here. You've got tint in the top right. You've got as in sorry TNO in the top left as in the top, right and high in the bottom, right. We also produce educational blog posts. We have some student developed anatomy revision resources and also a podcast that I hosted over this last year, interviewing those involved in ian education in healthcare and uplifting those voices. And if you want to learn more about anatomy, our website and our Instagram are both at in the top corners of the slides. So what has anatomy done? So I founded Anatomy in April of last year. So I'm very proud of where our project is and how far we've come in that year. So as part of that, I won, I was awarded being one of the runner ups in the Student Woman of the Year competition by uni days. I've also presented at lots of different conferences, showcasing anatomy work and trying to get our voice out there, trying to get people knowing about us so that they can sign up when they want to use our resources in teaching. I was accepted to the Healthcare Leadership Academy to help develop anatomy and grow it in the future. I've won a vice chancellor's medal showcasing my awards and my contribution to medical education. And this year most excitingly, we were successful in getting cascade funding at the university and we've just, we've received just under 9000 lbs to develop the project further over this year and last week and over the weekend and today, I've been hurriedly organizing things for the photo shoots that we have coming up over the next couple of weeks, which is really exciting. So part of what anatomy does, obviously, we are increasing the amount of inclusive resources and inclusive images that we have available at our discretion to use in teaching resources. And we're hoping to distribute these images further soon. But using inclusive images is not the only way that you can integrate inclusivity. And when I talk about inclusivity, it's really important that we integrate it in an active way. So we want to be in the top left hand corner of this um grid active integration is the way that you can be sure that students are going to engage with the changes that you make. Say for example, some things that are passive and disintegrated is mandatory, online training, reading list updates. A problem reporting form is always open, those sorts of things they're not integrated into the curriculum. They look into what the student is studying at the moment and you can't actually even be sure they're going to engage with it. And also we know I'm sure many of you have done lots of online training. A lot of the time. You don't even really take in the information. You just want to get the certificate at the end to say that you did it integrated But passive is recognizing that there's diversity but not explaining it or not providing examples. So an example of this is in dermatology, someone saying this looks different on darker skin tones but not providing an image of what it actually looks like. And part of the problem is that there's not really many resources that actually show that. But if that's the case, then you need to highlight that to students because otherwise it just looks like you haven't gone out of your way to look monthly feedback collection, having an open door policy is integrated because it's monthly rather than just being open all the time. But once again, it's quite passive because it's not really doing anything. And once again, like I said, mentioning but not including diverse resources. So an example of that would be if you mention that anatomy exists, but you didn't use any of our images in your teaching an active way, but disintegrated way of integrating inclusivity is having keynote speakers and one off lectures about diverse topics. It's really great to do that. But for example, if you have a pediatrician talking, everyone who's not on their pediatric placement might not engage with that talk because it's not relevant to them at that time, at that specific moment, workshops and collaborating with students once again, very active but just not integrated. So you might be missing a key demographic of students, optional workshops for students, student positions on policy boards. All of these things are really active, but once they're not integrated into the curriculum that forces students to engage with them a better way to do this is applying diversity to the spiral curriculum that we see in medicine is to include references to diverse topics in key lectures. So lectures that students definitely will be engaging with workshops are relevant and useful to student learning. So maybe that means running the same workshop four or five times a year, but it means that students are actually engaging with it, which is what you want to happen, including diverse and inclusive resources and having patient experience videos and talks within lectures as well. So now I'll um let you go back to ment. So I'll just need to change the slide. And do you have any examples of inclusive practices at your institution that you've recognized? And it might be that, you know, you put a little bit on the menting, you might want to explain further in the chat, but I'd be really interested in seeing if there's any good practices happening at your institutions. Yeah. So you might even want to share if there's some not very great examples as well. So ethnicity just being mentioned here or there, that's not what you want to hear. But I'm also quite a big advocate. So even when there isn't differences between ethnicities, it's still important to say that because then at least students say that you've thought about it. That's very good. So that's a great example of active integration showing how different skin cancers appear on different skin tones with images and explanations. Great and some diversification of scenarios for simulation work but not enough. So I feel like that's how a lot of us feel we're making some positive steps in the right direction but things just aren't there yet. That's really good. So we talk about inclusivity in terms of sexual orientation and having it done by members of the community, which you're talking about is even better but often not really very good, which yeah, I think that's kind of the sentiment for lots of people unfortunately, but it is nice to see we're seeing some positive things. Please carry on adding them. I'm going to move forward in the talk, but it's really great to see um all of your responses. So please feel free to continue adding them cos I think people will like to see that too. Video showing discrimination against different minorities. I think that's really helpful. I know this isn't related to diversity. But for me personally, we had a video when we were doing called geriatrics placement showing AP OV of what it's like for someone who has dementia and I think things like that are really striking because it forces you to put yourself in someone else's shoes and see what they experience on the day to day. So videos like that can be really great. So here is just an example of how you might want to integrate inclusivity and some examples of each type of integration. So updating the reading list to include references to diverse resources. It is good but you can't be. Most students aren't gonna engage with a reading list depending on the course I know in medicine, people are so inundated with content and things to learn that people just don't have time to go out of their way to engage with a reading list. One sort of studied that here. So when you are talking about dermatological conditions mentioning that they look different on dark skin tones but not show an example is quite passive, but you move it to being active if you give those examples and those explanations, once again, having a one off optional workshop highlighting that of colonialism or current health care inequity. So that's kind of what I'm doing today and it's really great to have all of you here. But there's thousands of students who would probably benefit from learning about these things, but they're not the captive audience right now because it's not actually integrated into their curriculum. So integrating or talk into the curriculum would move it into being active and integrated. And then finally, a good example here is when you're discussing asthma and spirometry, consider how race used to be used in calculations based on the historical belief that black people had less lung capacity once again, perpetuated by slave owners. That's a really great way of integrating inclusivity. It might just seem like a sentence but it weaves in that narrative that how implicit biases can form. Because when we see that race is used in a lot of these calculations, many people don't even question why we just accept it. But we need to be questioning why we need to understand why. And oftentimes there's not really a good reason as to why. So where is anatomy going from here? Like I said, we've just received quite a substantial amount of funding. So we're using that to develop more images for photos sheets planned at the moment with 1/5 in the works as well, we hope to expand the committee in the future. So if that's something that you're interested in, if you're interested in becoming involved in anatomy, then keep an eye on AOC because that's where the announcements will be going out, having workshops and conversations with students and staff. Just like this one about the topics that I've been talking about to raise awareness. We're gonna be distributing our images soon for use, teaching resources and collecting feedback on these to see how we can improve them in the future expansion of our image repertoire. So we do have 300 images already. But like I said, we've got kind of five photo sheets that are coming. So we're gonna expand that quite considerably. And then also the anatomy surface anatomical textbook, which is going to cover not only this anatomy but underpinned by the history of healthcare disparities, a lot of which that I've spoken about today, I've lifted a lot of my references and a lot of the topics that I've talked about from what I've written in this textbook and this textbook goes beyond ethnicity, it goes into weight, it goes into religion, it goes into culture, it into investigations, intersectionality so called conversion therapy. It covers lots and lots of topics that hopefully give a bit of an insight as to why healthcare disparities exist. And I hope with the knowledge of why these healthcare disparities exist that we can start educating each other and educating others to start getting rid of them and challenging the implicit biases that we have. So the key takeaways I have you take from this talk is that decolonization, like I said, it's more than ethnicity and race. It's so much more than that. And we need to be facing all those different things when you want to redesign a curriculum. Make sure you're getting students involved. If you think that is important, includes it actively and your resources. Otherwise you can't be sure that students are gonna engage with it. Reflect on your positionality and use it for good. So reflect on your privilege, your position, your education and use it to try to challenge these healthcare disparities, challenge, implicit vices and educate people. So that is it from me? I'm happy to take any questions that anyone might have. If you do scan this QR code, you can sign up to our mail. I'm hoping to um launch a newsletter in the next couple of months where we'll be updating you on what's going on with anatomy. Um That website there is actually a bit out. So it's an Thank you. Oh, thank you so much Asia. That was really insightful. Um There are a few questions in the chart. Um But I'll just um let everyone know again that the feedback form comes after. So after we're doing this Q and A, um the feedback form will come after you can then get your certificate after that. Um So let's have a look at the questions that we've got so far. Um So someone says, um we are taught that patients of African descent tend to produce less renin, which is why calcium channel blockers are used first over other hy um anti hypertensives, I guess is what they're trying to say. So, would this not be a valid reason to have race in the guidelines. I'll just go back, I'll stop sharing my screen now. Hopefully you will scan that if you wanted to. So yeah, there is some evidence. Um Sorry, II think I'm getting feedback off. Do you mind? Sorry. Can you, do you want me to read out again or can you see the chart? Um I can see the chart. So yeah, because I've stopped sharing my screen that I can get them. OK. Um So regarding Ring and CTB, I think obviously different places have different discussions and different points that they discuss. But um in my research, I found that a lot of studies have kind of shown this to be a really negligible difference. And actually even in our highs or anti hypertensive guidelines, eventually you can use an ace inhibitor with patients of African descent. And the problem is when it's not even just patients of African descent, because what most clinicians take to mean by that is someone that is black and someone that has um a black uh racial phenotype that people typically associate with black people. And actually, are we even asking people if they are of African descent when we're prescribing these medications or are we just going off what we think somewhat looks like? And that's a part of the challenge. And another part of the challenge is when someone has, you know, dual heritage high, mixed race, which one do I get prescribed that sort of thing. So, and it everywhere has their different guidelines. The fact that it's not included in international guidelines to me points that we should probably be following the international consensus, but maybe that is something that's gonna change in the next few years we'll have to see. But I don't consider myself to be an expert pharmacist to say I couldn't comment too much. Um um I know Jenny is coming to talk and she definitely has a lot to say about those guidelines as well. So if you're interested in that, definitely come to her talk because she has a lot of insights um because she is has a background in pharmacology. Um Yeah, I've spoken to Jenny and she's great. So definitely come to that talk, Sonia. Yes, I definitely um love to work with you. Um You can drop me an email, you can just find me on. If you search on the directory, you can type my name in and please drop me an email. I'd love to work with you and integrate some of those resources. Um Davina, we haven't, the textbook is not out yet. So once it does come out, you'll see it on our social media. I think it's probably gonna be released early 2025 now. But if you follow Anatomy on Instagram and if you sign up to our mailing list as well and go on our website, then you'll see when the textbook gets released and I've never heard of Joel. So I'm, I'll have to have a look at their resources, but yeah, I definitely will. Thank you. I think that's all the questions so far. Uh Yeah. Does it, is that it in terms of questions? Does anyone else have any quick questions for you in the chat before we close the session um at all. No, just people thanking you. Um It was really great Asia. Thank you so much for um speaking uh for Black credit UK, speaking for our being the first person for our Black in season and really setting off the bang. Um I hope everyone found it very valuable. Um And, and it sounds like everyone's uh I find it really helpful and engaging too. Um Finally I wanna let you all know that we have our next uh session next week on Tuesday with Doctor Klia, which is about dermatological conditions across diverse populations. Um So at the same time, 7 p.m. and we hope to see you there. Thank you again, everyone for joining and enjoy the rest of your evening. Bye guys. Bye.