Background: Effective strategies that integrate anti-racism education into clinical practice are needed to address persistent racial disparities. Existing curricula are often limited by time and inconsistent exposure, reducing their ability to support sustained behavior change. The 5-Minute Moment for Racial Justice (5MMRJ) curriculum addresses this gap through brief, structured 10-minute case-based sessions illustrating how bias and racism influence clinical decisions. This study evaluated the curriculum’s longitudinal impact on hospitalists’ knowledge, attitudes, and behaviors.
Methods: This multi-site longitudinal survey study included hospitalist educators from six academic sites. All sites implemented the 5MMRJ curriculum at monthly division meetings over 10 consecutive months between February 2024 to March 2025. Participants completed four surveys: baseline and quarterly follow-ups (Time 1–3). Outcomes included self-rated knowledge, attitudes (comfort speaking with patients, colleagues, learners; skill navigating anti-racism discussions), and behaviors (discussion frequency; changes in clinical or teaching practice). Descriptive statistics summarized participant characteristics. Generalized mixed-effects models estimated longitudinal changes using adjusted odds ratios (aORs).
Results: Sixty-three participants were enrolled; 59 completed at least one post-intervention survey. Two sites disenrolled mid-study due to institutional constraints. Survey completion rates: Time 1, 88.1%; Time 2, 71.2%; Time 3, 72.9%. Participants demonstrated improvement across knowledge, attitudes, and behaviors. Self-rated confidence in the ten anti-racism topics increased over time (Figure 1). Participants increased comfort discussing anti-racism topics with patients (Figure 2, aOR, Time 1: 9.6, p=0.011; Time 2: 15.9, p< 0.001; Time 3: 25.0, p< 0.001), colleagues (aOR, Time 1: 6.4, p< 0.001; Time 2: 6.4, p< 0.001; Time 3: 13.6, p< 0.001), and learners (aOR, Time 3: 6.0, p=0.038). Skill navigating discussions with learners improved at Time 2 (aOR 16.0, p< 0.001) and Time 3 (aOR 19.8, p< 0.001). Behavioral impact was substantial: odds of reporting a change in clinical or teaching practice were higher at Time 2 (aOR 65.6, p=0.015) and Time 3 (aOR 43.1, p=0.03). Likelihood of discussions increased with patients at Time 2 (aOR 7.0, p=0.02) and Time 3 (aOR 6.2, p=0.038), and with colleagues at Time 2 (aOR 8.0, p=0.012) and Time 3 (aOR 6.40, p=0.03). Likelihood of discussion with learners did not significantly change.
Conclusions: A brief and consistent longitudinal curriculum can meaningfully shift hospitalists’ anti-racism knowledge, attitudes, and behaviors. Substantial gains in comfort, skill, and practice change – an up to 66-fold increase in the odds of modifying clinical decisions – were achieved through monthly ten-minute sessions. These findings support the integration of consistent, small dose case-based teaching into anti-racism education and clinical work flows to strengthen equity-focused clinical decision making.
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