A Quantitative Program Evaluation of Restorative Justice Practices at United States Medical Schools

An unquantified number of medical schools have adopted restorative justice (RJ) practices as an alternative method to build community and address mistreatment. Due to the recency of RJ’s adoption, there has not been any literature that has studied where and how RJ has been adopted and implemented across US medical schools. Given the lack of peer-reviewed literature, an ample number of potential studies need to be comprehensively investigated in undergraduate medical education (UME), including examining the impact of RJ and understanding capacity-building issues. The gap at hand is that in order to conduct those proposed studies, a comprehensive study must first be conducted that characterizes the current landscape of RJ in UME. We aimed to address that gap with a survey that would assess the current landscape of RJ practices across the entire population of US medical schools. We deployed a 33-item survey to all US allopathic and osteopathic medical schools operating in the academic year 2023-2024. The survey included multiple-choice items and one open-ended question. We utilized publicly available information to see if medical school characteristics predicted whether or not a school supported restorative justice. School characteristics included enrollment, public or private, school age, state’s political ideology, and allopathic or osteopathic. The final response rate was 65%. Twenty-eight schools indicated on the survey that they have RJ practices. An additional ten schools answered no to having RJ on the survey but indicated that they had practices for their students housed outside the medical school. Eight additional schools that answered no mentioned that they are currently building out RJ practices. Regression models found that schools in liberal states are likelier to have RJ practices than in conservative states. There were no other school characteristics that were statistically significant. With the support of the AAMC, the number of schools with RJ will continue to grow. We suggest that further qualitative studies should be undertaken to investigate outcomes from RJ practices and barriers to implementation. Also, further investigation is needed to better understand the tension over RJ practices at schools in conservative states and the affect on both employees and students.