Justice-Oriented Evaluation of Antiracist Medical Education: A Critical Scoping Review of Antiracism Educational Intervention Methodologies in Medical Education

Through a Critical Whiteness lens, we examined the extent to which the measures developed, or selected, to evaluate the effectiveness of the antiracist curricula also reflected a commitment to (or understanding of the importance of) disrupting white supremacist norms with respect to what and how measures should be used. We were curious to understand if development teams critically audited the content of their measures, scoring rubrics, and/or feedback loops for embedded norms associated with whiteness, ensuring that even the measures (beyond the interventions themselves) served justice rather than reinforcing whiteness as the invisible standard. Findings revealed that while measurement is happening, it is (a) often limited in psychometric rigor (i.e., validity and reliability evidence); (b) infrequently includes any actual behavioral changes (12% of studies); (c) rarely includes the input of patients in the development process; and (d) is absent of any critical theoretical orientation. In fact, the dominant patterns in measure development and use across the antiracist medical education interventions we identified revealed a persistent centering of whiteness-visible in the prioritization of white normative standards, the marginalization of minorized voices in design and validation, the absence of explicit justice-oriented theoretical frameworks, and outcome measurement focused on institutional and professional comfort. To ensure our measurement processes have the same justice-orientation as our interventions, we propose three principles, or guidelines, for measure design/development (critical theory integration, centering rights-holders with marginalized identities, and justice-aligned validity evidence).