Presence 5 for Racial Justice

Thursday, October 30, 2025, 12:00 AM - Sunday, October 29, 2028, 11:59 PM, On Demand

Internet Enduring Material sponsored by Stanford University School of Medicine.  Presence 5 for Racial Justice (P5RJ) is a curriculum that aims to promote racial justice and health equity for Black patients. Guided by the Presence 5 framework1 (recommended practices to foster physician humanism and meaningful connection with patients, developed by Drs. Donna Zulman and Abraham Verghese), P5RJ trains clinicians in communication practices that address anti-Black racism, build trusting relationships, and empower Black individuals in their clinical care. This online course aims to enhance participant knowledge and self-efficacy in implementing P5RJ practices and communication strategies to best support their Black patients. Participants will directly apply what they learn through interactive cases that walk through the P5RJ domains: Prepare with intention, Listen intently and completely, Agree on what matters most, Connect with the patient’s story, and Explore emotional cues.

Original Release Date: October 31, 2022

Review Date: October 03, 2025

Expiration Date: October 29, 2028

Estimated Time To Complete: 31 minutes

Registration Fee: Free

Click Begin to launch the course.

AMA PRA Category 1 Credits™ (0.50 hours), Non-Physician Participation Credit (0.50 hours)

1. Describe the content, background, and communication practices comprising the Presence 5 for Racial Justice Curriculum.
2. Enhance confidence and skills in incorporating Presence 5 for Racial Justice strategies in daily clinical practice to enhance delivery of equitable care to Black patients.
3. Reflect on personal biases and privileges that may impact incorporation of Presence 5 for Racial Justice strategies in daily clinical practice.

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this Enduring Material for a maximum of 0.50 AMA PRA Category 1 Credits^TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Accessibility Statement
 Stanford University School of Medicine is committed to ensuring that its programs, services, goods and facilities are accessible to individuals with disabilities as specified under Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Amendments Act of 2008.  If you have needs that require special accommodations, please contact Stanford CME.

Cultural and Linguistic Competency
The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area for the purpose of complying with California Assembly Bill 1195. Moreover, the Stanford University School of Medicine Multicultural Health Portal contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws.  You are encouraged to visit the Multicultural Health Portal: https://laneguides.stanford.edu/multicultural-health

References/Bibliography
Zulman, D. M., Haverfield, M. C., Shaw, J. G., Brown-Johnson, C. G., Schwartz, R., Tierney, A. A., Zionts, D. L., Safaeinili, N., Fischer, M., Thadaney Israni, S., Asch, S. M., & Verghese, A. (2020). Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter. JAMA, 323(1), 70–81. https://doi.org/10.1001/jama.2019.19003 

Brown-Johnson, C., Cox, J., Shankar, M., Baratta, J., De Leon, G., Garcia, R., Hollis, T., Verano, M., Henderson, K., Upchurch, M., Safaeinili, N., Shaw, J. G., Fortuna, R. J., Beverly, C., Walsh, M., Somerville, C. S., Haverfield, M., Israni, S. T., Verghese, A., & Zulman, D. M. (2022). The Presence 5 for Racial Justice Framework for anti-racist communication with Black patients. Health services research, 10.1111/1475-6773.14015. Advance online publication. https://doi.org/10.1111/1475-6773.14015

Shankar, M., Cox, J., Baratta, J., De Leon, G., Shaw, J. G., Israni, S. T., Zulman, D. M., & Brown-Johnson, C. G. (2022). Nonmedical Transdisciplinary Perspectives of Black and Racially and Ethnically Diverse Individuals About Antiracism Practices: A Qualitative Study. JAMA network open, 5(2), e2147835. https://doi.org/10.1001/jamanetworkopen.2021.47835

Ford-Gilboe, M., Wathen, C. N., Varcoe, C., Herbert, C., Jackson, B. E., Lavoie, J. G., Pauly, B. B., Perrin, N. A., Smye, V., Wallace, B., Wong, S. T., & Browne For The Equip Research Program, A. J. (2018). How Equity-Oriented Health Care Affects Health: Key Mechanisms and Implications for Primary Health Care Practice and Policy. The Milbank quarterly, 96(4), 635–671. https://doi.org/10.1111/1468-0009.12349

Browne, A. J., Varcoe, C., Ford-Gilboe, M., Nadine Wathen, C., Smye, V., Jackson, B. E., Wallace, B., Pauly, B. B., Herbert, C. P., Lavoie, J. G., Wong, S. T., & Blanchet Garneau, A. (2018). Disruption as opportunity: Impacts of an organizational health equity intervention in primary care clinics. International journal for equity in health, 17(1), 154. https://doi.org/10.1186/s12939-018-0820-2

Purkey, E., & MacKenzie, M. (2019). Experience of healthcare among the homeless and vulnerably housed a qualitative study: opportunities for equity-oriented health care. International journal for equity in health, 18(1), 101. https://doi.org/10.1186/s12939-019-1004-4

Ufomata, E., Merriam, S., Puri, A., Lupton, K., LeFrancois, D., Jones, D., Nemeth, A., Snydman, L. K., Stark, R., & Spagnoletti, C. (2021). A Policy Statement of the Society of General Internal Medicine on Tackling Racism in Medical Education: Reflections on the Past and a Call to Action for the Future. Journal of general internal medicine, 36(4), 1077–1081. https://doi.org/10.1007/s11606-020-06445-2

Bailey, Z. D., Krieger, N., Agénor, M., Graves, J., Linos, N., & Bassett, M. T. (2017). Structural racism and health inequities in the USA: evidence and interventions. Lancet (London, England), 389(10077), 1453–1463. https://doi.org/10.1016/S0140-6736(17)30569-X

Tsai, J., Brooks, K., DeAndrade, S., Ucik, L., Bartlett, S., Osobamiro, O., Wynter, J., Krishna, G., Rougas, S., & George, P. (2018). Addressing racial bias in wards. Advances in medical education and practice, 9, 691–696. https://doi.org/10.2147/AMEP.S159076

DallaPiazza, M., Padilla-Register, M., Dwarakanath, M., Obamedo, E., Hill, J., & Soto-Greene, M. L. (2018). Exploring Racism and Health: An Intensive Interactive Session for Medical Students. MedEdPORTAL : the journal of teaching and learning resources, 14, 10783. https://doi.org/10.15766/mep_2374-8265.10783

Batista, R., Pottie, K., Bouchard, L., Ng, E., Tanuseputro, P., & Tugwell, P. (2018). Primary Health Care Models Addressing Health Equity for Immigrants: A Systematic Scoping Review. Journal of immigrant and minority health, 20(1), 214–230. https://doi.org/10.1007/s10903-016-0531-y

Nieblas-Bedolla, E., Christophers, B., Nkinsi, N. T., Schumann, P. D., & Stein, E. (2020). Changing How Race Is Portrayed in Medical Education: Recommendations From Medical Students. Academic medicine : journal of the Association of American Medical Colleges, 95(12), 1802–1806. https://doi.org/10.1097/ACM.0000000000003496

Vyas, D. A., Eisenstein, L. G., & Jones, D. S. (2020). Hidden in Plain Sight - Reconsidering the Use of Race Correction in Clinical Algorithms. The New England journal of medicine, 383(9), 874–882. https://doi.org/10.1056/NEJMms2004740

Martin, K. D., Roter, D. L., Beach, M. C., Carson, K. A., & Cooper, L. A. (2013). Physician communication behaviors and trust among black and white patients with hypertension. Medical care, 51(2), 151–157. https://doi.org/10.1097/MLR.0b013e31827632a2

Drake, C., Keeport, M., Chapman, A., & Chakraborti, C. (2017). Social Contexts in Medicine: A Patient-Centered Curriculum Empowering Medical Students to Provide Contextualized Care. MedEdPORTAL : the journal of teaching and learning resources, 13, 10541. https://doi.org/10.15766/mep_2374-8265.10541

Medlock, M., Weissman, A., Wong, S. S., Carlo, A., Zeng, M., Borba, C., Curry, M., & Shtasel, D. (2017). Racism as a Unique Social Determinant of Mental Health: Development of a Didactic Curriculum for Psychiatry Residents. MedEdPORTAL : the journal of teaching and learning resources, 13, 10618. https://doi.org/10.15766/mep_2374-8265.10618

Chen, X., Hay, J. L., Waters, E. A., Kiviniemi, M. T., Biddle, C., Schofield, E., Li, Y., Kaphingst, K., & Orom, H. (2018). Health Literacy and Use and Trust in Health Information. Journal of health communication, 23(8), 724–734. https://doi.org/10.1080/10810730.2018.1511658

Roter D. L. (2003). Observations on methodological and measurement challenges in the assessment of communication during medical exchanges. Patient education and counseling, 50(1), 17–21. https://doi.org/10.1016/s0738-3991(03)00074-0

Peek, M. E., Odoms-Young, A., Quinn, M. T., Gorawara-Bhat, R., Wilson, S. C., & Chin, M. H. (2010). Racism in healthcare: Its relationship to shared decision-making and health disparities: a response to Bradby. Social science & medicine (1982), 71(1), 13–17. https://doi.org/10.1016/j.socscimed.2010.03.018

Cuevas, A. G., O'Brien, K., & Saha, S. (2016). African American experiences in healthcare: "I always feel like I'm getting skipped over". Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 35(9), 987–995. https://doi.org/10.1037/hea0000368

Oliver, M. N., Wells, K. M., Joy-Gaba, J. A., Hawkins, C. B., & Nosek, B. A. (2014). Do physicians' implicit views of African Americans affect clinical decision making?. Journal of the American Board of Family Medicine : JABFM, 27(2), 177–188. https://doi.org/10.3122/jabfm.2014.02.120314

Kleinman, A., & Benson, P. (2006). Anthropology in the clinic: the problem of cultural competency and how to fix it. PLoS medicine, 3(10), e294. https://doi.org/10.1371/journal.pmed.0030294

Saha, S., Beach, M. C., & Cooper, L. A. (2008). Patient centeredness, cultural competence and healthcare quality. Journal of the National Medical Association, 100(11), 1275–1285. https://doi.org/10.1016/s0027-9684(15)31505-4

Brooks, K. C., Rougas, S., & George, P. (2016). When Race Matters on the Wards: Talking About Racial Health Disparities and Racism in the Clinical Setting. MedEdPORTAL : the journal of teaching and learning resources, 12, 10523. https://doi.org/10.15766/mep_2374-8265.10523

Moffett, S. E., Shahidi, H., Sule, H., & Lamba, S. (2019). Social Determinants of Health Curriculum Integrated Into a Core Emergency Medicine Clerkship. MedEdPORTAL : the journal of teaching and learning resources, 15, 10789. https://doi.org/10.15766/mep_2374-8265.10789

Chick, D., Bigelow, A., Seagull, F. J., Rye, H., Davis, P., & Williams, B. (2014). Caring With Compassion, domain 2: bio-psychosocial care of uninsured, homeless, underserved, and at-risk populations. MedEdPORTAL, 10, 9755

Hall, J. A. (2011). Clinicians’ accuracy in perceiving patients: Its relevance for clinical practice and a narrative review of methods and correlates. Patient Education and Counseling, 84(3), 319-324.

Weng, H. C., Hung, C. M., Liu, Y. T., Cheng, Y. J., Yen, C. Y., Chang, C. C., & Huang, C. K. (2011). Associations between emotional intelligence and doctor burnout, job satisfaction and patient satisfaction. Medical education, 45(8), 835–842. https://doi.org/10.1111/j.1365-2923.2011.03985.x

Park, K. Y., Chaiet, S. R., & Greenberg, C. C. (2020). Diversity and Inclusion-One Size Does Not Fit All. JAMA surgery, 155(1), 30–31. https://doi.org/10.1001/jamasurg.2019.4082

Bruce, M. M., Kassam-Adams, N., Rogers, M., Anderson, K. M., Sluys, K. P., & Richmond, T. S. (2018). Trauma Providers' Knowledge, Views, and Practice of Trauma-Informed Care. Journal of trauma nursing : the official journal of the Society of Trauma Nurses, 25(2), 131–138. https://doi.org/10.1097/JTN.0000000000000356

Liu, S. R., & Modir, S. (2020). The outbreak that was always here: Racial trauma in the context of COVID-19 and implications for mental health providers. Psychological trauma : theory, research, practice and policy, 12(5), 439–442. https://doi.org/10.1037/tra0000784

Reeves E. (2015). A synthesis of the literature on trauma-informed care. Issues in mental health nursing, 36(9), 698–709. https://doi.org/10.3109/01612840.2015.1025319

Sacks, T. K., Savin, K., & Walton, Q. L. (2021). How Ancestral Trauma Informs Patients' Health Decision Making. AMA journal of ethics, 23(2), E183–E188. https://doi.org/10.1001/amajethics.2021.183

Schwartz, GL, Chu, L (n.d.). Do laws protecting tenants' health work?: Implied warranties of habitability and respiratory health.. American journal of epidemiology. https://pubmed.ncbi.nlm.nih.gov/40407235

Travis, A, Fitzpatrick, JJ (n.d.). Examining the Relationship Between Hospital Nurses' Structural Empowerment, Missed Nursing Care and Quality of Care: A Cross-Sectional Study.. Journal of clinical nursing. https://pubmed.ncbi.nlm.nih.gov/40407198

Shankar, M., Henderson, K., Garcia, R., Li, G., Titer, K. A., Acholonu, R. G., Essien, U. R., Brown-Johnson, C., Cox, J., Shaw, J. G., Haverfield, M. C., Taylor, K., Israni, S. T., & Zulman, D. (2022). Presence 5 for racial justice workshop: Fostering dialogue across medical education to disrupt anti-Black racism in clinical encounters [version 1]. MedEdPORTAL, 18, 11227. https://doi.org/10.15766/mep_2374-8265.11227

Black, C., Shamaskin-Garroway, A., Arquilla, E. M., Roessler, E., & Wilkins, K. M. (2023). Undoing institutional and racial trauma through interprofessional, trauma-informed education. AMA Journal of Ethics, 25(5), E324–E331. https://doi.org/10.1001/amajethics.2023.324
For CME general questions, please contact 
     Email: [email protected]

Mitigation of Relevant Financial Relationships

Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education. The content of this activity is not related to products or the business lines of an ACCME-defined ineligible company. Hence, there are no relevant financial relationships with an ACCME-defined ineligible company for anyone who was in control of the content of this activity. 

Special acknowledgment to the P5RJ National Community Advisory Board for the development of this CME activity.