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Christen Johnson, Ed.D., M.D., M.P.H., F.A.A.F.P., is a 2023 graduate of the Ed.D program in Educational and Professional Practice at Antioch University.

Dissertation Committee:

  • Lesley Jackson, Ph.D., Chairperson
  • Tony Kashani, Ph.D., Committee Member
  • Warren Jones, M.D., F.A.A.F.P., Committee Member

Keywords

physician cultural responsibility, health equity, race in medicine, medical education, social categorization of medicine, healthcare diversity, microaggressions, physician identity

Document Type

Dissertation

Publication Date

2023

Abstract

Many forms of oppression create barriers for health care, further health disparities, and impact the wellness of physicians. As health disparities, caused by the social determinants of health, complicate the practice of medicine, physicians’ risk of burnout increases. The practice of Physician Cultural Responsibility provides a means to overcome health disparities and support physicians while embracing the intersectionality of the populations they serve. Incorporation of Physician Cultural Responsibility into physician professional identity is essential for the practice to be life-long. As there is no standardized curriculum to address teaching the practice of Physician Cultural Responsibility, this study aims to evaluate a proposed curriculum for the adoption of Physician Cultural Responsibility into students’ physician professional identity, student experience, and knowledge transfer. Through the transformative research paradigm and transformative learning theory, a mixed-methods study of deidentified qualitative and quantitative data was performed using MaxQDA and SPSS (a = 0.05) analytical software. Results suggest successful adoption of Physician Cultural Responsibility in physician identity development, successful knowledge transfer, as well as improvements in collaboration, belonging, and support in student experiences with within in first year medical students. This curriculum offers best practices for a methodology to address the inequities of practice in cultural competency education requirements within medical education. This includes inclusive and culturally responsive pedagogy aimed at supporting the students’ development of skills that improve the patient-physician connection with all patients, limit the impact of personal biases on medical practice, and dismantle the social categorization of medicine. The practice of Physician Cultural Responsibility and it’s adoption in physician professional identity yields an opportunity to create the culture change necessary within medicine to improve equitable patient-centered care for all patients, overcome health disparities, and support physicians through the challenges of medical practice. This dissertation is available in open access at AURA (https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu).

Comments

ORCID No: 0000-0001-8752-0030

Bio:

Christen D. Johnson, MD, EdD, MPH, FAAFP (She/Hers) is a champion for health equity, scholar-practitioner, and board-certified family physician. She attended Wright State University where she acquired a B.A. in Biological Sciences and M.D. and MPH from Wright State University Boonshoft School of Medicine, followed by residency in the Urban Track at The Ohio State University Family Medicine Residency Program in Columbus, Ohio. Her clinical practice in family medicine is rooted in equitable practice, lifestyle medicine, and seeking system interventions that bring healing to patients, their families, and communities. She lives the phrase “To whom much is given, much is required” through her career in leadership and dedication to serving the most vulnerable communities and educating others to do the same.

Dr. Johnson has been honored in the 2017 NBC Black 28 under 28, the 2020 National Minority Quality Forum 40 Under 40 Leaders in Health and as a scholar within the National Health Service Corps and Gates Millennium Scholar Program among other recognition. She has served in leadership positions within the American Academy of Family Physicians, National Medical Association, and the Student National Medical Association. Her research interests include health disparities, medical education, and antiracist medicine and have facilitated numerous local, regional, and national research presentations, and publications in peer-reviewed journals, textbooks, and grants.

Publications:

Christen Johnson, MD, MPH, FAAFP, Elise Mike, MD, PhD, and Antoinette Leonard Jean-Charles. Trauma in Training: Mitigating the silent assault on Physician Workforce Diversity and Health Equity. Accepted for publication in Academic Medicine. 2023.

Christen Johnson, MD, MPH, FAAFP.Cultivating Wellness and Cultural Humility through Self-Awareness and Self-Reflection: The Practice of Physician Cultural Responsibility. Cases on Diversity, Equity, and Inclusion for the Health Professions Educator. 2023.

Christen Johnson, MD, MPH, FAAFP The Model: Best Practices for Teaching Cultural Humility in Family Medicine. The Ohio Family Physician, Winter 2022; 3. 2022.

Kupiri Ackerman-Barger, PhD, Philippe Goldin, PhD, Negar Nicole Jacobs, PhD, Maya London, Christen Johnson, MD, MPH, Dowin Boatright, MD, MBA. Microaggressions, Depression, and Dissatisfaction with Residency Training: A National Survey of Medical Residents in the USA. Journal of Best Practices in Health Professions Diversity: Research, Education, and Policy. 15;1. 2022.

Christen Johnson, MD, MPH. Burning from Both Ends: The Impact of the COVID Pandemic. The Ohio Family Physician, Spring 2022; 3. 2022.

Christen Johnson, MD, MPH, Mark Rastetter, MD, J. Nwando Olayiwola, MD, MPH, FAAFP. Pathways to Equity: Implementing a Health Equity Leadership Curriculum in Residency Education as an Antidote to Systemic Racism. Journal of the National Medical Association. Jan 22,2022.

Christen Johnson, MD, MPH. Conquering the Health Disparities of Structural Racism. Journal of Public Health Management and Practice. January/February 2022;28, 2022.

Christen Johnson, MD, MPH. Infographic: Conquering the Health Disparities of Structural Racism: Best practices for Public Health Practitioners. JPHMP Direct. November 2021.

Christen Johnson, MD, MPH. History Speaks: Historical Biases, Current Circumstances, and Proposed Solutions. The Ohio Family Physician, Spring 2021; 3. 2021.

Nientara Anderson, MD, MHS; Elle Lett, MBiostat; Emmanuella Ngozi Asabor, MPhil; Amanda Hernandez, MD, PhD; Max Jordan Nguemeni Tiako, MS; Christen Johnson, MD, MPH; Tara M. Rizzo, MPH; Darin Latimore, MD; Marcella Nunez-Smith, MD, MHS; Dowin Boatright, MD, MBA. The Association of Microaggressions with Depressive Symptoms and Institutional Satisfaction Among a National Cohort of Medical Students. Journal of General Internal Medicine, 2021.

Faraz Ahmad, MD, MPH, Christen Johnson, MD, MPH. (2021). Hypothyroidism. In Domino FJ (Ed), The 5 Minute Clinical Consult 2021, Philadelphia: Wolters Kluwer.

Mark Rastetter, MD, J. Nwando Olayiwola, MD, MPH, FAAFP, and Christen Johnson, MD, MPH. Advancing Health Equity by Enhancing Family Medicine Resident Training. The Ohio Family Physician, Spring 2020; 3. 2020.

Christen Johnson. Opportunity and Life-Long Health Outcomes: A review of the effects and solutions of hypersegregation on health disparities. Core Scholar, Wright State University, 2017; 1-43. 2017.

Christen Johnson. A Cultural Exchange: The Challenges of Overcoming Elevated Adolescent Pregnancy Rates in Native American Adolescents. Journal of the Student National Medical Association, Winter 2017; 51-52. 2017.

Christen Johnson. Adolescent Empowerment: Improving the Lives of Teen Parents through Project Parenthood. Journal of the Student National Medical Association, Fall 2016; 46-49. 2016.

Christen Johnson. Five Things No One Told Me Before Medical School. MAPS Minutes, Spring 2016. 3;31. 2016.

Christen Johnson. Improving Hepatitis A and B Immunization in Hepatitis C Positive Patients: Recommendations based upon a Quality Improvement Study. Journal of the Student National Medical Association, Spring 2016; 59-60. 2016.

Christen Johnson. The Role of Student Leadership in the Preservation Mental Health in Minority Medical Students, A Literature Review. Journal of the Student National Medical Association, Spring 2016;.8-11. 2016.

Christen Johnson, Dr. Terese Zink. Trailblazers: Resources for First Generation Students. Salem Health: Adolescent Health & Wellness, 3; 856-858, 2015.

Dr. Therese Zink, Christen Johnson, Maggie Rechel. Yes, Virginia, Sex and Human Trafficking are Problems in Ohio. The Ohio Family Physician, Spring 2015; 26-27,35. 2015.

Christen Johnson. Yá’át’ééh: Realizations on the Reservation. Journal of the Student National Medical Association, Summer 2014;14-17. 2014.

Presentations, Oral:

Christen Johnson, MD, EdD, MPH, FAAFP. Family Medicine’s Role in Striving for Health Equity, American Academy of Family Physicians, Virtual 2023. Oral.

Christen Johnson, MD, MPH, FAAFP. Zip Codes or Sick Codes: Creating Solutions to Health Disparities, Ohio Association of Community Health Centers, Virtual 2023. Oral

Christen Johnson, MD, MPH, FAAFP. The Next Level: What Comes After Cultural Humility, Ohio Association of Community Health Centers 2023 Annual Conference. Oral

Ohio Association of Community Health Centers, Scott Leads, Christen Johnson, MD, MPH, FAAFP. Cultural Humility Video Series. 2023.

Christen Johnson, MD, MPH, FAAFP. Bridging the Gap by Breaking the Barriers: Overcoming Racism in Medical Practice, American Academy of Family Physicians, Virtual 2023. Oral.

Christen Johnson, MD, MPH, FAAFP. Keys to Inclusive Spaces. HRACO Diversity and Inclusion Roundtable Virtual, 2022. Oral

Christen Johnson, MD, MPH. The Intersection of Health Disparities, SDOH and Race. Project ECHO, American Academy of Family Physicians, Virtual 2022. Oral.

Christen Johnson, MD, MPH. Anti-racism Overview & Application to Medicine. Project ECHO, American Academy of Family Physicians, Virtual 2022. Oral.

Gabriel Felix, MD, Christen Johnson, MD, MPH, and NMA Postgraduate Section Board. SNMA to NMA: A Path to Continued Service. Conference Session. Student National Medical Association Annual Medical Education Conference, Virtual, 2022, Oral.

Kristen Huntoon, MD, PHD, and Christen Johnson, MD, MPH. Racial Justice and Advocating for the Underserved Communities in Health Care. Boonshoft SNMAXAMSA Collaboration. Virtual, 2022, Oral.

Dr. Christen Johnson, Dr.Mike Sevilla. Teaching Antiracism In Medicine, The Ohio Academy of Family Physicians, Virtual 2022. Oral.

Christen Johnson, MD, MPH. Being the Change: Cultivating Your Antiracist Identity and Fostering a Culture of Inclusion. HRACO Diversity and Inclusion Conference., Virtual, 2022. Oral

Teresa Zryd, MD, MSPH, FAAFP, Warren Jones, MD, FAAFP, Danielle Jones, PhD, MPH, Gary LeRoy, MD, FAAFP, Mark McLoney, MD, Christen Johnson, MD, MPH, Ryan Kauffman, MD, FAAFP. Limiting Implicit Bias Training. The Ohio Academy of Family Physicians, Live, 2021. Oral

Christen Johnson, MD, MPH. Equitable Medicine: Fighting the Effects of Social Injustice on Health Disparities. American Academy of Family Physicians National Conference of Students and Residents. American Academy of Family Physicians, Virtual, 2021. Oral

Drs. Sean Cupp, Christen Johnson, Anna McMaster, Mark McLoney, Tejal Patel. Family Medicine Scope of Practice. Preceptorship Webinar Series, The Ohio Academy of Family Physicians, Virtual 2021. Oral.

J. Nwando Olayiwola, MD, MPH, FAAFP, Mark Rastetter, MD, Christen Johnson, MD, MPH, Candy Magaña and Hiten Patel, MD. Championing Equity: Strategies to Build and Expand a Residency Based Health Equity Curriculum and Leadership Program. Conference Workshop. Beyond Flexner 2021. Beyond Flexner Alliance, Virtual, 2021. Oral.

Representative Thomas West, Christen Johnson, MD, MPH, Emlah Tubuo PharmD, Ezra Bradshaw, PharmD. Covid 19 Vaccine Panel. Partnership to Fight Infectious Disease, Virtual, 2021. Oral

Christen Johnson, MD, MPH. Vaccine Equity: No Joking Matter. Community Shelter Board- Columbus, OH, Virtual, 2021. Oral

Michael Harrell, MD, Christen Johnson, MD, MPH, and Brandi Freeman, MD, MS. SNMA to NMA: A Path to Continued Service. Conference Session. Student National Medical Association Annual Medical Education Conference, Virtual, 2021, Oral.

The Honorable Judge Terri Jamison, Amber Scott, Dr. Christen Johnson, Diona Clark, Bishop Jonathan Sanders, and Sergeant James Fuqua. Domestic Violence During COVID-19: A Hidden Epidemic, Iota Nu Sigma Chapter, Sigma Gamma Rho Sorority Incorporated, October 29, 2020, Oral.

Drs. Rachel Villanueva, Christen Johnson, Fiyin Fawole, Oyetewa Oyerinde, and Monique Gary. Black Women in Medicine Leadership Chat, Student National Medical Association National Leadership Institute, September 19, 2020, Oral

Danielle Jones, MPH, Ashley Bentley, MBA, Deanna Gonzalez, Christen Johnson, MD, MPH, Mikaela Moore, Marie Ramas, MD. Resident and Student Underrepresented in Medicine Networking. American Academy of Family Physicians National Conference of Students and Residents. American Academy of Family Physicians, Virtual, 2020. Oral.

Christen Johnson, MD, MPH. Treating the Whole Patient: Improving the preparation of resident physicians through Health Equity Curricula. The Ohio State University Wexner Medical Center Family Medicine Research Forum, Virtual, 2020, Oral.

Christina Kelly, MD, FAAFP, Christen Johnson, MD, MPH, Jamal Lawrence, MD, and Julia Wang. Intergenerational Differences: Learning to Move Forward Together in Academics and Practice for Our Patients, Our Specialty, and Our Wellness. American Academy of Family Physicians National Conference of Students and Residents. American Academy of Family Physicians, Kansas City, Kansas, 2019. Oral

Christen Johnson, MD, MPH. On Health Equity in Training. The Forum for Children’s Wellbeing. The National Academies of Science, Engineering, and Medicine, Washington, DC, 2019. Oral

Christen Johnson, MD, MPH. Zip Codes or Sick Codes. Conference Session. Student National Medical Association Annual Medical Education Conference, San Francisco, CA, 2018, Oral.

Christen Johnson, MD, MPH, and Elise Mike. Cultural Humility Summit 2.0. Conference Session. Student National Medical Association Annual Medical Education Conference, San Francisco, CA, 2018, Oral.

Christen Johnson, Dowin Boatright, and Elise Mike. Cultural Humility Summit. Conference Plenary Session. Student National Medical Association Annual Medical Education Conference, Atlanta, Ga, 2017, Oral.

Christen Johnson. The Medical School Training Experience. Training the Future Child Healthcare Workforce to Improve Behavioral Health Care Outcomes for Children. The National Academies of Science, Engineering, and Medicine, Washington, DC, 2016. Oral

Christen Johnson. Addiction Medicine in Medical School Curricula. Medicine Responds to Addiction II. Office of National Drug Control Policy. The White House, Washington, DC, 2016, Oral.

Christen Johnson, Dr. Krisanna Deppen. Hepatitis A and B Immunization in Hepatitis C Positive Patients. Family Medicine Clerkship, Wright State University Boonshoft School of Medicine, 2015, Oral.

Dr. Romena Holbert, Christen Johnson. Student Leadership Identity Development: Narratives from Women as Leaders. Wright State University Celebration of Research and Scholarship, 2013, Oral.

Presentations, Poster:

Christen Johnson. The Calm Before the Storm: The Diagnosis and Management of Cerebral Hyperperfusion Syndrome, A Case Report and Review of the Literature. Department of Family Medicine Research Symposium, The Ohio State University Wexner Medical Center, Columbus, Ohio, 2018, Poster.

Christen Johnson, Amaha Sellasie, and Dr. Sabrina Neeley. Opportunity and Life-Long Health Outcomes: A review of the effects and solutions of hypersegregation on health disparities. Department of Community Health Culminating Experience Poster Presentation, 2017, Poster.

Christen Johnson, Dr. Naila Khalil. The Effects of Uranium Exposure on Native American Adolescent Pregnancy Rates. Ohio Public Health Association Poster Forum, Public Health 2.0- The Next Generation: Ohio Public Health Combined Conference, Columbus, OH, 2016, Poster.

Christen Johnson, Dr. Naila Khalil. The Effects of Uranium Exposure on Native American Adolescent Pregnancy Rates. Dr. Wilbert C. Jordan Research Forum, Student National Medical Association, Austin, TX, 2016, Poster.

Christen Johnson, Dr. Naila Khalil. Uranium Exposure or Risky Business: A Descriptive Analysis of the Sexual Risk Behaviors of Native American Adolescents. Second Florida Health Disparities Summit, Moffitt Cancer Center in Tampa, Florida, 2015, Poster.

Christen Johnson, Dr. Sara Paton. The Socioeconomic Status of Adolescent Mothers and its Relationship to Prenatal Care and Fetal Health Outcomes in Franklin County, Ohio. Dr. Wilbert C. Jordan Research Forum, Student National Medical Association, Washington, D.C, 2014, Poster.

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