Dr. Elsa Vazquez-Melendez

Dr. Vasquez-Melendez

“In diversity there is beauty and there is strength.”

I think about Dr. Maya Angelou’s insightful words of wisdom whenever I witness acts of defiance and courage in the name of social justice and equality. Maya Angelou died in 2014. Her loss was felt deeply but I’m actually grateful that she did not live to see the end of the first score of the new millennium. We have so much work ahead of us to bring equality and justice to our community and society at large.

In my first five years as Assistant Dean of Diversity, Equity, and Inclusion, I focused primarily on education. I worked to sow seeds of awareness and create situations, opportunities and safe spaces to foster the necessary, but uncomfortable, conversations that our community, particularly our medical community, had been avoiding. I did this work on three fronts: 1) the Immersion Week for second year medical students was dedicated to topics of social determinants of health; 2) creation and integration of our healthcare disparities seminar within the Family Medicine clerkship; 3) development and delivery of implicit bias training for fourth year medical students and medical staff. The third “spoke in the wheel” was designed to meet our cultural stereotypes head on. It became the impetus for another endeavor to give our students a voice within our medical community: the M4 program known as “Crucial Conversations”. This last session equips our students with the problem-solving skills required to navigate conflicts in the work environment while maintaining inclusive and open communication. The students have been active participants in the curriculum design and evolution of Crucial Conversations.

The changes we implemented have resulted in significant improvements in the dynamics for students rotating through third- and fourth-year clerkships and have challenged the status quo. This has reminded everyone in our community that “In diversity there is beauty and there is strength.”

Speak Up EducateTwo years ago, I engaged the leaders at UICOMP, UnityPoint Health, and OSF Saint Francis Medical Center to develop a real-time program to address gaps in education and awareness of both institutional and individual implicit bias. From these meetings and discussions Speak Up. Educate! was born. Speak up. Educate! is an educational program that teaches health care professionals and caregivers to “speak up” if they hear others make statements that reflect bias (implicit or explicit). Expressions of bias are discussed and clarified openly.

Reoccurring instances of bias encountered by our medical, as well as nursing students, residents, nurses, technicians, and therapists led hospital leadership, college administration and faculty to support our efforts to meet the implicit bias education in our community head on. None of us should tolerate or abide by disrespectful treatment of any member of the healthcare team, most of all our future caregivers and leaders, i.e., our students! Implicit bias causes people to unintentionally favor some groups — often ones like them — over others. Speak up. Educate! provides all caregivers and stakeholders the tools to address expressions of bias and empowers all members of the care team to speak up and educate others when a member of the team expresses unconscious bias (which by definition may be occurring without an awareness of the implications). Between 2018 and 2019, we held more than 30 two-hour workshops with more than 350 participants. The participants were a cross-section of healthcare providers, and the workshops blended everyone together without any notion of hierarchy. The outcome was a much more inclusive community. Speak Up. Educate! sessions are currently on hold, but will resume once the SARS CoV-2 synthetic mRNA Spike protein vaccine is widely available and allows us to hold in-person workshops.

Just before the COVID-19 pandemic arose, we created our Diversity, Equity and Inclusion Task Force. The task force is composed of students, residents, faculty and staff from every subspecialty and UICOMP department. While the group started planning and organizing our local initiatives, the local healthcare community was also engaged in responding to the unanticipated global pandemic that resulted from the emergence of SARSCoV2. Meanwhile, the deaths of George Floyd, Breonna Taylor, and Ahmaud Arbery at the hands of local law enforcement in Minneapolis, Louisville, and self-appointed neighborhood watchers, respectively, were transformative in terms of general awareness of the implicit bias not just within fringe elements of society, but within our rank and file law enforcement as well. During the summer of 2020, we all witnessed the national protests, as well as the peaceful marches with people from all racial, cultural and socioeconomic backgrounds coming together despite the pandemic (with protective masks in place), walking hand-in-hand to raise awareness of the persistent racism and cultural injustice that is so pervasive in our country today.

Tim Killeen and Barb Wilson, the University of Illinois System President and the Executive Vice President and Vice President for Academic Affairs, respectively, shared the charge: “Let us make this outrageous act of aggression a pivotal point in history that begins to reverse generations of systemic racism and discrimination. Let it start here and let it start now.” This was a call to action, and the University of Illinois College of Medicine established the Anti-Racism Urgent Action Committee, led by Dr. Gloria Elam, Associate Dean of Diversity and Inclusion. The committee was charged to use the following months to establish an immediate action plan for mitigating the impacts of racism and/or reducing systemic inequities facing people of color”. The urgent action committee includes students, staff, and faculty from all culture, religious, and ethnic backgrounds. It has jurisdiction across all campuses and collaborates with all the campus-wide subcommittees.

In Peoria, the Diversity, Equity, and Inclusion Task Force has been reinvigorated, and two subcommittees have been created to address our local needs: the Recruitment, Retention and Concerns Subcommittee will work on improving the recruitment of black and underrepresented minority students, residents, fellows, staff and faculty. This subcommittee will provide recommendations for a holistic approach to recruitment and retention as well as the development of processes and protocols to address concerns raised by our underrepresented minorities. Our Learning and Work Environment Subcommittee will focus on improving all aspects of the black (and other underrepresented minorities) student, resident, faculty and staff experience with specific action plans for academic, research and career support.

Our goal is not only to create a more diverse and inclusive environment within our college of medicine, but to prepare individuals who can reach out to all communities and engage them strategically in addressing their needs. An educational program for communities of color about the new COVID vaccine is a great example for community engagement. The process of inclusion could be daunting as there is always the possibility of missing someone. It is important to look at who are sitting at the table making decisions and to ensure that all voices are heard.

This column is part of the Winter 2021 edition of PathwaysRead the full issue.

About the Author

Elsa L. Vazquez Melendez, M.D., FAAP, FACP, is Assistant Dean for Diversity and Inclusion and Assistant Professor of Clinical Medicine at the University of Illinois College of Medicine Peoria.