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Much of clinical medical education is accomplished by utilizing patient cases to illustrate important points or teach students about clinical reasoning or medical knowledge. Over time it has become apparent that some of the cases could contain information about the patient that might be viewed as expressing the intrinsic bias of the case creator or actually serve as a microaggression toward the students utilizing the case in order to learn. Socioeconomic identities, including race, culture, ethnicity, gender and sexual orientation are recognized as important determinants of health, with significant effects on the medical care patients receive and patients’ health outcomes. Racial or cultural profiling and stereotyping of patients by providers can result in delay or missed diagnosis and contribute to poorer patient outcomes. Examples might be always having the patient be a woman when the case is dealing with hysteria or anxiety or always having the patient be a gay man when discussing HIV transmission. During this elective students will have a chance to review practice cases for intrinsic bias and microaggressions as well as to reformulate the case to mitigate the intrinsic bias and microaggressions and include evidence based information about healthcare disparities and structural and social determinants of health for each particular case scenario. 

Elective Details:

Primary Contact for Add/Drops: Dr. Tori (ajtori@iu.edu)

Director: Alvaro Tori, M.D.

Campus: Indianapolis

Location: Riley Hospital for Children at IU Health (Indianapolis)

Learning Objectives

  • By the end of this course, a student will: 
    1. Identify implicit bias and potential microaggressions in cases developed for medical student education. (PBLI1)
    2. Articulate the impact of racial, gender or cultural profiling and stereotyping of patients and how this can affect patient outcomes. (MK7)
    3. Recognize structural and social determinants of health of each particular case scenario and propose a plan for modifiable risk factors that could contribute to these issues. (SBP2)


  • Professional Development Evaluation Form; (The elective course director will give formative feedback to the student upon completion of the analysis of each case review, upon completion of the rewrite or creation of a new case to accomplish the same original objectives and upon completion of the discussion with the course director or course management team. The final assessment will be based on the Professional Development Evaluation Form.)

Enrollment Information

Prerequisites: 2nd, 3rd or 4th year status

Availability with Max Students per Month:


Duty Hours: 40

Time Distribution: 80% Library/Research; 20% Online

Elective Type Category: PD - Professional Development

Notes and Enrollment Information:

Add/Drop Contact Person: Dr. Tori (ajtori@iu.edu) The student may work with the faculty member in person or online. Most of the work for this elective will be done independently and will involve working with the MSE staff. 

Third Year Elective? Yes

Interprofessional Skills and Service Learning

Interprofessional Collaborative Skills: None

Service Learning Included: None