DEIB Principles in Development and Design of Educational Content

When developing and designing educational content, our Education team strives to acknowledge and highlight the fundamental need for diversity, equity, inclusion, and belonging (DEIB) across all aspects of clinical and translational science (CTS) work. From designing trials to engaging in team science, the principles of DEIB are critical and foundational.

MRCT logo.The curriculum development goals listed below are inspired by and adapted from the Basic Principles for the Consideration of Diverse Representation in Clinical Research, developed and disseminated by the Multi-Regional Clinical Trials Center (MRCT) of Brigham and Women’s Hospital. These principles offer a lens through which the Education course designers/developers and content experts infuse diversity, equity, inclusion, and belonging considerations when developing and presenting educational content, regardless of topic area. This webpage provides contextualized examples of the MRCT principles in pedagogical practice, illuminating the question:

What does it mean to reflect DEIB principles in the content and design of instruction?

In addition to the curricular examples provided below, our team makes use of operational standards across the curriculum development process to ensure that all content is designed to be accessible and high-quality. Our staff is continually refining operational processes, striving to ensure that all aspects of our work reflect and uphold DEIB principles—from hiring new staff, to recruiting content experts, to reviewing applications, and debriefing courses and events.

Education program Curriculum Development Goals and MRCT Basic Principles for the Consideration of Diverse Representation in Clinical Research

Visit the MRCT Center Diversity Workgroup website for additional explanations of each of the principles cited below.

1. In our design of educational resources for the clinical and translational science workforce, the Education program aims for all content to reflect and highlight the critical need to promote greater fairness in the distribution of the benefits and risks of research.

Adapted from MRCT Principle 1: Efforts to ensure diversity and inclusion in clinical research endeavor to be responsive to the ethical principle of justice by promoting greater fairness in the distribution of the benefits and risks of the research. *

For example:

  • In a course that introduces ethical considerations for conducting clinical and translational (c/t) research, content experts highlight and emphasize the importance of efforts to ensure diversity and inclusion in clinical research, aligned with other key ethical principles.
  • In a session about informed consent, the content expert facilitates discussion of vignettes that demonstrate issues of equity in the consenting process.
2. In the Education program content that describes clinical research activities, we understand that various factors can contribute to differences in disease susceptibility and manifestation. Our content must acknowledge the historical impact and ongoing challenges related to the exclusion of populations which are based on these factors, as well as provide learners with strategies for improving inclusion.

Adapted from MRCT Principle 2: Race, ethnicity, sex, gender, age, and geographic ancestry do not define distinct genetic or biological groups; yet along with social, cultural, and economic factors can be associated with important differences in disease susceptibility and manifestation, treatment response, and rates of inclusion in clinical research. *

For example:

  • In a podcast episode, researchers share their work using datasets to identify suicide outcomes in a transgender population, emphasizing the importance of partnering with community organizations when working with marginalized groups.
  • In a facilitated workshop, learners explore the impacts of historically low rates of inclusion of different populations on datasets. Learners work together to outline new protocols that address these gaps, drawing on strategies to engage populations who are not yet represented in the data.
3. The Education program develops content collaboratively with professional staff and content experts who represent a diversity of backgrounds and expertise, and our program content is designed to be inclusive of a diverse audience of learners.

Adapted from MRCT Principle 3: Enhancing diversity and inclusion in the clinical research enterprise serves to advance biomedical science and healthcare, and may help reduce health disparities. *

For example:

  • In a lecture on how to communicate with research participants, the content expert and course designer ensure that the learning outcomes address principles of equity and inclusion. The content expert supplements their lecture with additional materials, including annotated examples of participant-facing materials designed to be readable across the participant population.
  • In a course about community engagement in research, content experts review specific aims pages submitted by learners, providing targeted feedback on how community engagement efforts are reflected in the aims of the proposal.
  • All educational content, regardless of format, is designed to meet (or exceed) standards consistent with inclusive, accessible learning environments. Our online courses, webinars, and digital content are compliant with Harvard University’s Digital Accessibility Policy.
  • In an ongoing effort, the Education program is committed to expanding the demographics of our participants, shifting from a curriculum focused primarily on supporting lead investigators to one that is more inclusive of additional study team roles. We have also expanded educational content, which was previously only available within courses, via our podcastWriting and Communication Center, and our Instagram campaign called #microEd.
  • In a course for new team leaders, content experts highlight the critical importance of hiring a diverse team, providing learners with strategies and tools to support effective communication and management across a diversity of backgrounds and styles.
  • In an in-person course on successful mentoring relationships, learners role play scenarios in which they navigate common differences in mentee/mentor dynamics, including differences in gender, race, background, and rank/hierarchy.
  • In a collaboration with staff from Harvard Medical School’s Office for Diversity Inclusion and Community Partnership and the Harvard Graduate School of Education, the Education program helped develop a five-part series to provide postdoctoral fellows with guidance on having practical conversations about navigating racism, both personally and professionally, in the sciences. The synchronous online training series includes case studies, breakout rooms, live group discussions, and multimedia resources.
  • Designers and content experts work together to identify areas where existing course content requires updates, including when descriptions of race, sex, and gender may be outdated. In such cases, content is updated and replaced or it is annotated/supplemented with resources that highlight discrepancies.
4. All the Education program content should highlight the ways in which stakeholders across the research pathway (including training and funding organizations) can act in the interest of promoting appropriate inclusion of diverse populations in clinical research.

Adapted from MRCT Principle 4: Appropriate inclusion of diverse populations requires action by, and should become the expectation of, all relevant stakeholders across the continuum of drug development and clinical research involving human participants. *

For example:

  • As an important stakeholder committed to DEIB in clinical research, we aim to address and highlight the principles listed here within our educational content and training programs. Further, we aim to make our operational approach to accomplishing this work accessible through conference presentations and other forms of dissemination.
  • In an online course in which learners are encouraged to network and collaborate on discussion boards, the course designer crafts evaluation questions to assess whether these goals were met and to identify opportunities for supporting an inclusive course culture for future iterations.
  • In an online course about NIH grant funding, a course designer, with the aid of content experts, routinely updates grant writing guidance to reflect evolving NIH standards and expectations. Recent updates include distilling and providing learners with strategies for addressing NIH Diversity Supplements.
  • During a live pitch competition, content experts serve as judges to evaluate and provide feedback on how well the pitch successfully addresses existing disparities in the proposed treatment population, encouraging learners to consider how their innovations will overcome existing barriers to access.
  • In an online course about essential skills for research staff, the topic of recruitment and retention is introduced through the lens of community engagement. A content expert provides practical strategies for engaging the community during (instead of after) the research design process, and additional resources, such as the MRCT recruitment and retention logic model [PDF], are provided.
  • Across our resources for effective scientific communication, content experts highlight strategies for addressing broad, diverse audiences, emphasizing the critical importance of inclusivity and accessibility across all modalities, including grant applications, manuscripts, oral presentations, data visualizations, posters, and professional development documents.
5. All the Education program content focused on research methodologies and data analysis should illustrate areas in need of refinement that will lead to increased diversity and inclusion.

Adapted from MRCT Principle 5: Refinement in methodology and data analytic tools is necessary to achieve the aims of increased diversity and inclusion. *

For example:

  • In a series of brief vignettes on using imaging techniques for research, learners respond to scenarios in which researchers fail to provide an inclusive environment for participants. With the aid of additional resources, the learners propose strategies for an inclusive protocol design.
  • In a lecture about calculating risk scores, a content expert uses examples to highlight how removing race as a factor from risk scores significantly changes results.
  • In an online course lecture introducing learners to disparities in genomic medicine, a content expert unpacks research around the ways in which genomics data collection (and as a result, clinical practice) has historically been limited to those of European ancestry. The didactic lecture is paired with a series of calls to action—practical strategies for those in genomic medicine to better serve diverse and underrepresented populations.
6. All the Education program content should speak to the many and varied strategies clinical and translational researchers use to more readily detect differences across groups, highlighting new and emerging methods.

Adapted from MRCT Principle 6: Advanced and innovative approaches, including use of real-world data, may more readily detect differences across groups. *

For example:

  • In a panel discussion about their research efforts during the COVID-19 pandemic, content experts describe how real-world data was used to detect and address disparities across populations.
  • In a podcast episode about machine learning and health equity, researchers describe the evolution of electronic health record (EHR) data collection, including the significance of including structured fields for sexual orientation, gender identity, and sex assigned at birth to investigate disparities impacting LGBTQ+ populations.
  • In a webinar about data visualization, learners are encouraged to consider their dual roles and responsibilities as creators and consumers of data. They review examples of data visualizations that lead to misinterpretation, highlighting key principles in practice.
  • In a course about network medicine, a researcher shares their experience using mobile phone tracking data, rather than in-person visits, as a tool to make participation in a study more comprehensive and accessible.

Recommended Additional Resources

In addition to the principles listed above, the Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard (MRCT Center) has also developed Equity by Design in Clinical Research: The EbD Metrics Framework, a framework for evaluating DEI efforts in clinical research.

“What Makes Clinical Research Ethical?” provides a comprehensive framework of requirements for ensuring clinical research is ethical.