Extending "Beyond Diversity": Culturally Responsive Universal Design Principles for Medical Education.

This commentary follows up on Maduakolam et al. (2020) "Beyond Diversity: Envisioning Inclusion in Medical Education Research and Practice," which introduced Culturally Responsive Universal Design for Learning (CRUDL) as an approach to accounting for learner diversity in educational theory development and curriculum design. We flesh out the principles of CRUDL, using publications in this issue of Teaching and Learning in Medicine as case examples for how the principles work in action. With this scholarly thought exercise, we seek to demonstrate the feasibility and promise of curriculum that is accountable to diverse learners and the impact of historical trauma. We also explore how research inclusive of diverse social identities could inform curriculum design by identifying how social identity, learning environment, educational activities, and learner engagement interact to produce diverse learning experiences and performance. Scholarly thought exercises such as this one may help bridge the gap between professed ideals and action with respect to inclusive medical education; CRUDL principles provide a helpful framework for planning and evaluating accountable curriculum design.

Beyond Diversity: Envisioning Inclusion in Medical Education Research and Practice.

This commentary examines the publications in Teaching and Learning in Medicine's Issue 32(5) from the perspectives of Black, female medical trainees. Its purpose is to demonstrate how including diverse perspectives in general medical education scholarship could prompt reconsideration of basic concepts and the development of richer, more nuanced, and practicable understanding of who medical learners are. An inclusive concept of medical education is a first step toward "culturally responsive universal design for learning," an approach to educational design that views barriers to learning as a systems problem, recognizes racism as a learning barrier, and offers learners multiple means to achieve academic success. Augmenting studies that explicitly target the experiences of trainees and faculty from marginalized racial groups, this commentary aims to establish a vision for what to do educationally with the knowledge that people bring diverse backgrounds and perspectives to their learning.

Problem-Based Learning About Problem-Based Learning: Lessons Learned from a Student-Led Initiative to Improve Tutor Group Interaction.

This article summarizes a student-led effort to improve tutor group interactions among second-year medical students in a hybrid problem-based learning (PBL) curriculum. Dissatisfaction with PBL had led to superficial tutorial discussions that students escaped to study for board certification exams. Following the PBL principle of using intrinsically motivating problems, the student investigators created board-style questions with accompanying facilitation guides for tutors to present as 'mini-problems' to stimulate case-related discussion. Tutor groups used and enjoyed the questions, but interaction quality did not improve. Like the hybrid curriculum itself, the intervention embodied conflicting educational philosophies; implementation challenges reflected the tension between them.