Images

Antoinette Leonard-Jean Charles Ed.D., is a 2025 graduate of the Ed.D. program in Educational and Professional Practice at Antioch University.

Dissertation Committee:

Tony Kashani, Ph.D., Committee Chair

Cristy Sugarman, Ph.D., Committee Member

Lauren Mitchell, Ph.D., Committee Member

Keywords

epistemology of race in medicine, health disparities and inequities, Critical Race Theory (CRT), Social Cognitive Theory (SCT), Social Capital Theory (ScT), medical education reform, systemic racism in healthcare, race and ethnicity in medicine, healthcare equity and policy, intersectionality in medicine, racial bias in clinical practice

Document Type

Dissertation

Publication Date

2025

Abstract

The persistent health disparities faced by Black, Indigenous, and People of Color (BIPOC) in the United States are deeply rooted in systemic racism embedded within medical education and clinical practice. Historical acceptance of racial supremacy in the United States has shaped both the foundations and continued practices of medical education, leading to entrenched biases that affect healthcare delivery and patient outcomes. This dissertation critically examines the intersection of race, education, and health by analyzing how historical and contemporary understandings of race and ethnicity shape medical curricula, healthcare practices, and patient care. Through the integration of Critical Race Theory (CRT), Social Cognitive Theory (SCT), and ScT, this study deconstructs racialized knowledge systems in medicine and examines their impact on health equity. CRT provides a lens to analyze how systemic racism is embedded within medical education and practice, illuminating the ways racial bias is institutionalized and perpetuated in healthcare structures. SCT contributes by exploring how individuals internalize societal norms and beliefs, which influence the attitudes and behaviors of both medical practitioners and patients. Finally, ScT emphasizes the role of social networks and relationships, highlighting how disparities in access to healthcare resources and support systems affect health outcomes in marginalized communities. Together, these theories offer a comprehensive framework for understanding the layered and interconnected influences of race, education, and healthcare, guiding the study’s aim to challenge and dismantle biased practices within medical training and clinical care. Chapters I and II introduce the research problem and establish a comprehensive foundation, outlining key theoretical frameworks—CRT, SCT, and ScT—while exploring the historical roots of racialized practices in medicine, including the legacy of unethical experimentation and the Flexner Report. Chapter III details the mixed-methods approach used to investigate how racialized knowledge systems shape medical education and clinical practices. Chapter IV presents findings that reveal structural biases within medical curricula, underscoring the need for reform. Finally, Chapter V synthesizes these insights, offering actionable recommendations for dismantling systemic racism in medical training and identifying directions for future research to further advance health equity. This study employs a mixed-methods approach, combining literature analysis with empirical data gathered through qualitative interviews, surveys, and case studies, alongside quantitative analysis of health outcomes. Together, these data sources are used to deconstruct the racialized knowledge systems that shape medical education, clinical practices, and healthcare outcomes. By critically examining how these systems perpetuate health disparities and racial biases, this research provides a foundation for reforming medical education and advancing equitable healthcare practices. By exploring the roles of race and ethnicity in health, the study offers recommendations for revising medical curricula to address inequities, reduce health disparities, and promote healthcare equity for marginalized populations. The findings aim to inform policies and practices that dismantle systemic racism in medicine, ultimately fostering a more just and inclusive healthcare system. Key recommendations include implementing structured anti-racism training within medical curricula to address implicit bias, equipping future healthcare providers with the skills to recognize and counteract racial biases in clinical practice. Additionally, revising clinical standards to eliminate race-based diagnostic tools, such as race-adjusted algorithms, is essential to ensure care decisions are based on individualized patient needs rather than racial assumptions. By incorporating these reforms, medical education can foster a healthcare environment that prioritizes equity, cultivates cultural competency, and advances patient-centered care for all populations. This dissertation is available in open access at AURA ( https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu).

Comments

ORCID No. 0009-0002-6283-7730

Publications:

Johnson, C. D., Mike, E. V., & Jean-Charles, A. L. (2024). Mitigating microaggressions in medical education through the TRAUMA framework. Academic medicine: Journal of the Association of American Medical Colleges, 99(6), 599–604. https://doi.org/10.1097/ACM.0000000000005676

Leonard-Jean Charles, A. (2014). The role of transcription factor TFEB in T cell memory (Order No. 1525589). Available from ProQuest Dissertations & Theses Global.

Download

Share

COinS