Teaching poverty and health: importing transformative learning into the structures and paradigms of medical education

Carrie Cartmill; Cynthia Whitehead; Esther Ihekwoaba; Ritika Goel; Samantha Green; Mona Haidar; Dawnmarie Harriott; Sarah Wright

doi:10.36834/cmej.72841

Authors

Carrie Cartmill University of Toronto https://orcid.org/0000-0001-6996-7293
Cynthia Whitehead University of Toronto https://orcid.org/0000-0002-0134-9074
Esther Ihekwoaba University of Toronto
Ritika Goel University of Toronto
Samantha Green University of Toronto
Mona Haidar St. Michael's Hospital
Dawnmarie Harriott Voices from the Street speakers bureau; Working for Change
Sarah Wright University of Toronto https://orcid.org/0000-0002-6636-4822

DOI:

https://doi.org/10.36834/cmej.72841

Abstract

Background: As a paradigm of education that emphasizes equity and social justice, transformative education aims to improve societal structures by inspiring learners to become agents of social change. In an attempt to contribute to transformative education, the University of Toronto MD program implemented a workshop on poverty and health that included tutors with lived experience of poverty. This research aimed to examine how tutors, as members of a group that faces structural oppression, understood their participation in the workshop.

Methods: This research drew on qualitative case study methodology and interview data, using the concept of transformative education to direct data analysis and interpretation.

Results: Our findings centred around two broad themes: misalignments between transformative learning and the structures of medical education; and unintended consequences of transformative education within the dominant paradigms of medical education. These misalignments and unintended consequences provided insight into how courses operating within the structures, hierarchies and paradigms of medical education may be limited in their potential to contribute to transformative education.

Conclusions: To be truly transformative, medical education must be willing to try to modify structures that reinforce oppression rather than integrating marginalized persons into educational processes that maintain social inequity.

Author Biographies

Carrie Cartmill, University of Toronto

Carrie Cartmill, MHSc is research assistant at the Wilson Centre, University Health Network, University of Toronto. 200 Elizabeth Street, 1ES-559, Toronto, ON, M5G 2C4.

Cynthia Whitehead, University of Toronto

Cynthia Whitehead, MD, PhD is professor in the Department of Family & Community Medicine, University of Toronto, director of the Wilson Centre, University Health Network, University of Toronto, and family physician at Women’s College Hospital. 200 Elizabeth Street, 1ES-559, Toronto, ON, M5G 2C4.

Esther Ihekwoaba, University of Toronto

Esther Ihekwoaba, MD is family physician at St. Michael’s Hospital Family Health Team within the Department of Family & Community Medicine, University of Toronto. Unit 3, 140 The Esplanade, Toronto, ON, M5A 4P5.

Ritika Goel, University of Toronto

Ritika Goel, MD is lecturer in the Department of Family & Community Medicine, University of Toronto, and family physician at St. Michael’s Hospital. 73 Regent Park Blvd, Toronto, ON, M5A 2B7.

Samantha Green, University of Toronto

Samantha Green, MD is assistant professor in the Department of Family & Community Medicine, University of Toronto, and family physician at St. Michael’s Hospital. 73 Regent Park Blvd, Toronto, ON, M5A 2B7.

Mona Haidar, St. Michael's Hospital

Mona Haidar, MD, MPH is staff physician at Inner City Health Associates, St. Michael’s Hospital. Second Floor, 59 Adelaide Street East, Toronto, ON, M5C 1K6.

Dawnmarie Harriott, Voices from the Street speakers bureau; Working for Change

Dawnmarie Harriott is program coordinator for Voices from the Street speakers bureau at Working for Change. 1499 Queen Street West, Toronto, ON, M6R 1A3.

Sarah Wright, University of Toronto

Sarah Wright, MBA, PhD is assistant professor, Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, and scientist, Michael Garron Hospital and Wilson Centre, University of Toronto, Toronto, Ontario, Canada