#52: Glass Half Full: Best Practices for Teaching with an Anti-Deficit Framework with Dr. Chavon M. Onumah, MD, MPH, MEd

June 4, 2025 | By Era Kryzhanovskaya

Audio

Video

In this episode, we sit down with Dr. Chavon Onumah to explore the anti-deficit approach in medical education, emphasizing the importance of recognizing strengths in our learners rather than focusing on perceived shortcomings. We discuss the importance of emotional well-being in healthcare and creating supportive and psychologically safe learning environments and how shifting to an anti-deficit framework in medical education can empower learners, promote a growth mindset, and reduce feelings of imposter syndrome. Dr. Onumah also highlights practical strategies and resources for educators to employ an anti-deficit framework when working with learners.

Claim CME for this episode at curbsiders.vcuhealth.org!

Website | Instagram | Twitter | Subscribe | Patreon | CME!| Youtube

 thecurbsidersteach@gmail.com

Meet our Guest:

Dr. Chavon Onumah, MD, MPH, MEd, FACP is a board-certified internal medicine physician, HIV specialist, and medical educator with formal training and expertise in curriculum development and innovation. Dr. Onumah is a proud HBCU alum hailing from Xavier University of Louisiana, earned a combined MD-MPH degree at Tulane University, and completed internal medicine residency training in the Global Medicine Pathway at the University of Minnesota. She completed an HIV Clinical fellowship from the HIV Medical Association and Infectious Diseases Society of America and joined the GW Faculty in 2011. Dr. Onumah later earned a Master of Education at the George Washington University School of Education and Human Development. She is passionate about advancing health equity, supporting learner growth and development, and enhancing educational quality and equity through teaching and assessment strategies that enable all learners to reach their full potential.

Show Segments

• Intro, guest bio
• Advice and emotional well-being in healthcare
• 9:04 The anti-deficit approach in medical education
• Case from Kashlack Memorial
• 14:52 Deficit vs anti-deficit perspectives
• 17:47 Role of faculty in supporting students
• 20:48 Broader implications of anti-deficit frameworks
• 36:51 Understanding imposter syndrome and stereotype threat
• 43:34 Fostering a growth mindset in education
• 44:12 Creating psychological safety for learners
• 50:29 Institutional strategies for anti-deficit approaches
• 55:09: Practical resources for educators
• 1:00:03 Takeaways
• Outros

Anti-Deficit Framework Pearls

1. The anti-deficit framework encourages recognizing and valuing learners’ strengths, especially those shaped by their unique backgrounds and experiences, rather than framing them by their perceived shortcomings.
2. Traditional metrics of success that we use in medicine (e.g. test scores, publications) do not fully capture learners’ capabilities. Success should also include competency-based assessments and skills which learners can demonstrate in a variety of ways.
3. Create an environment in which learners can show up as their authentic selves by getting to know learners personally and avoiding deficit-based labels such as “at-risk’. Encourage their growth through feedback and assessments based on direct observation.
4. Institutions can support anti-deficit practices through holistic review during the recruitment process, faculty development in bias mitigation, and shifting research to focus on studying thriving learners rather than analyzing deficits.

Anti-Deficit Framework Notes

Defining anti-deficit framework 

Anti-deficit is a framework in which we shift our focus from a learner’s shortcomings or failure to focus on the learners’ strengths shaped by their unique experiences. This is particularly important in marginalized and underrepresented learner groups who are often perceived to have shortcomings. 

In medicine, we tend to have a more traditional approach that emphasizes one formula or path to success, and Dr. Onumah challenges us to reevaluate what success looks like in medicine. For example, someone’s score on a standardized test does not directly correlate with patient care, which is one of the ACGME competencies (Saguil 2015, Miller 2019). Additionally, we should consider how learners may demonstrate the same skills that are associated with traditional assessment metrics in different ways. For example, the number of publications someone has demonstrates their ability to collaborate with others, be creative, and follow through on a long term project, but this can also be seen through other nonacademic activities such volunteer work in low income neighborhoods. By letting go of these traditional measures that are ingrained in our system, we can stop perpetuating systemic inequities and celebrate learners for their passions and contributions.

Broader Implications of Anti-Deficit Framework on Learning Environments

When we allow our learners to show up as their authentic selves and highlight the variety of assets we notice that they bring to the table, this creates psychological safety and contextual equity (acknowledging that learner’s access to opportunities are different based on their unique circumstances) (Lucey 2020). Therefore, anti-deficit framework helps to counteract stereotype threat and imposter syndrome because it empowers the learner and makes them less likely to feel that they have something to prove.

Using anti-deficit framework as individual educators  

Get to know your learners. Ensure that you know their name and how they prefer their name to be pronounced, as well as their preferred pronoun. When learners feel that you are invested in them both as a learner and as a person, they can be more comfortable to show up as their authentic selves. Observe learners directly while interacting with patients and their families, consultants, and interdisciplinary team members, in order to provide a more accurate evaluation. Avoid fixed terms or labels of learners as “at-risk” or “struggling”, as this undermines the learner’s confidence and biases educators. Instead, she encourages focusing on growth mindset and the potential of the learner, to normalize feedback as an opportunity for improvement in the learner (Onumah 2023).

Incorporating Anti-Deficit Framework at the Institutional/System-wide Level

Promoting recruitment and retention of underrepresented learners and learners from all types of diverse experiences can be assets to our programs. Additionally, faculty training on bias mitigation and narrative assessment (i.e. writing learner evaluations that are based on directly observed behaviors and grounded in the competencies and skill sets of the learners). Additionally, from a medical education culture perspective, reframing research questions to ask less about what deficits exist and why these deficits exist, and instead identify learners who are thriving and study the characteristics that enable them to do so (Salib 2023). 

Resources for Educators

1. Strategies for Advancing Equity in Frontline Clinical Assessment (Onumah 2023)
2. Equity in Assessment Checklist (Hauer 2023)
3. Twelve Tips for Teaching Implicit Bias Recognition and Management (Gonzalez 2022)

Take home points

Be mindful about the learning environment we create as educators; get to know our learners as people so that they can bring their full selves and perform at their best. Don’t be afraid to give honest feedback to learners, as they need to know where their opportunities are, just be sure to also highlight their assets so that they know that they can make strong contributions to patient care. Perform direct observations of learners’ behaviors while interacting with patients and staff and be mindful of the language we use, particularly in assessment. 

Links

1. Book: Medical Apartheid by Harriet Washington
2. Book: Coddling of the American Mind by Jonathan Haidt and Greg Lukianoff 
3. Book: Rivers in the Sky Elif Shafak
4. Podcast: Mindful Healers
5. Equity in Assessment Checklist (Hauer 2023)
6. Twelve Tips for Teaching Implicit Bias Recognition and Management (Gonzalez 2022)

Goal

Listeners will appreciate the value of an anti-deficit approach to teaching in creating a more equitable and empowering learning climate and learn strategies to incorporate an anti-deficit framework into both the broader educational infrastructure as well as daily practice as an educator. 

Learning objectives

After listening to this episode listeners will…

1. Recognize the differences between a deficit and anti-deficit approach to teaching.
2. Describe the impacts and implications of an anti-deficit approach to teaching.
3. Name strategies to incorporate an anti-deficit lens into teaching strategies, feedback, and assessment of learners for a more supportive, equitable learning environment enabling learner success

Disclosures

Dr. Onumah has no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Heublein M, Onumah CM, Patel, K, Kryzhanovskaya E. #53: Glass Half Full: Best Practices for Teaching with an Anti-Deficit Framework. The Curbsiders Teach Podcast. https://thecurbsiders.com/teach. June 4, 2025.