Applying a Health Justice Lens to Curriculum Review in Primary Care Education: A Practice-Based Reflection
Michael COLEE
Addressing inequities in health outcomes requires that medical curricula facilitate critical evaluation of the structural determinants of health and the intersectional oppression of marginalised groups. To support Primary Care Placement Leads in enhancing their curricula, I applied a health justice lens – a structured evaluative framework designed to promote equity-focused education. This work is sustainable as it aligned with continuing initiatives, including curriculum ‘deep dive’ processes, assessment question-writing days, and faculty development activities, and informs ongoing strategy.The health justice lens assessed materials across three intersecting EDI themes: representation, humility, and advocacy. Representation analysed the diversity of people depicted in case studies and materials, assessing whether they reflect local populations, redress under-representation, and subvert stereotypes. Humility focused on person-centredness, accessibility, and decolonising within content, outcomes, and assessments. Advocacy explored how learners apply knowledge to challenge health injustices in primary care. The process followed a structured EDI mapping approach: meetings with placement leads; review of existing mapping; systematic resource review using the health justice lens; collaborative discussions; feedback to management; implementation of adjustments; and presentation of findings and future considerations. Strengths included strong engagement and reflective dialogue; limitations included time and curriculum space.This approach operationalises EDI review through a health justice framing that integrates representation, humility, and advocacy across curriculum, assessment, and faculty development. It differs from existing audits by embedding health justice and decolonising principles into curriculum design processes in a context-specific, iterative and sustainable manner.The experience highlighted the value of iterative collaboration and reflective discussion in embedding EDI principles. Findings now inform curriculum deep dives, assessment question-writing, and faculty development, supporting sustainable, health justice-oriented educational practice.Specific examples of changes included the innovative 'Stop and Think' bias resource.The mapping process was deeply interpersonal and reflective, relying on open communication to navigate faculty members’ diverse lived experiences and positionalities. Establishing trust and shared understanding was essential when introducing new health justice perspectives within an already content-dense curriculum, highlighting the need for dialogue-led, empathetic curriculum change.Using a health justice lens provides a transferable, systematic method to align primary care education with broader institutional equity goals, advancing healthcare training.
