Table 1C.

Leaders in Health Equity (LHE) delivery principles and detailed approaches.

Delivery principle	Approach
Diverse modalities	LHE included traditional didactic presentations, peer discussions (large and small group), interactive exercises, introspective discussions (e.g., clinical challenges related to culture, case-based discussions, and role play. Hospital interpreters took part in language-related role play). Scenarios to promote resident engagement and self-efficacy, as well as fidelity in role play experiences.
Time for introspection	Opportunities for introspection and debriefing were nested within sessions throughout the retreat (Table 1). This created space for faculty and residents to talk about their biases, habits, and personal and professional challenges related to a variety of topics. The goal was to promote un-pressured and meaningful engagement in identifying and addressing vulnerabilities and perspectives related to diversity, health equity, and inclusion where success was measured in resident engagement level. When LHE was delivered virtually in 2020, we observed a drop-off in the degree of meaningful interaction among all participants, highlighting the potential importance of in-person delivery to previous years’ successes.
Immersive design	The immersive service-free design allowed for individual introspection (e.g., What can I learn about myself and my biases?) and group-level reflection (e.g., What have we learned about our collective group's biases, diversity, and identity as a class within the institution?). Sessions were held offsite or in non-clinical buildings, where residents and faculty could commit their full attention to LHE activities.
Cohorting and group size	Sessions were primarily structured around each class of residents (n = 12) or a resident group small enough to participate and receive individual attention from facilitating faculty. Smaller groupings (2–4 residents) were used at times to facilitate trust-building and perspective-sharing. On day 2, case-based discussions including two classes of residents (n = 24) encouraged interplay based on shared clinical experiences and resident team interactions.
Multi-level session assessments	Residents completed knowledge and skill assessments 1-week pre and 1-week post LHE. Residents additionally completed formative session evaluations at the close of each day including open-ended qualitative comments. LHE faculty-facilitators rotated responsibility of taking notes on session timing, interactivity, and resident comments/questions, which were used annually to assess topic relevance and effectiveness of content delivery. LHE content was regularly modified and evaluated based on these multi-level assessments.