Kira Knight

Mailman Center for Child Development

University of Miami Miller School of Medicine, FL

A recent medical graduate from St. George’s University School of Medicine, Dr. Kira Knight has a commitment and appreciation for diversity, volunteering and mentoring. She was born and raised in the small Caribbean island of Grenada and moved to the United States at the age of seventeen. In 2006, Dr. Knight graduated from the University of Miami where she earned a BS in psychology with minors in Biology and Chemistry. While an undergraduate, she served as a volunteer for the Hands on Miami organization helping plan and chaperone recreational activities for developmentally disabled adults. Eager to advance, she continued on the educational route completing a MS in Biomedical Sciences at Barry University in 2009. As a graduate student, she worked at the Center for Advanced Learning where she tutored college-age students with learning disabilities. Throughout her academic career, she continues to nurture her passion for helping others and giving back by volunteering her time and services to underserved communities not only in the US but internationally as well. She has a specific interest in aiding children and adolescents with neurodevelopmental disabilities and in pediatric clinical research. Dr. Knight returned to her home country and completed her medical degree in 2014. Whilst a medical student in Grenada, she mentored high school and college students who desired to pursue a career in medicine. She completed numerous clinical rotations internationally and throughout the states of New York, New Jersey and Florida affording her the opportunity to work with a diverse patient population. Currently, she is a student of the Emerging Transformational Leadership Program – A program designed to help selected individuals reach their potential as individual leaders who transform systems of care for people with developmental disabilities. She has also spent the last year involved in clinical research in the field of Pediatric HIV at UM’s Batchelor Children’s Research Institute. Dr. Knight plans to continue her role as a healthcare advocate and lifelong learner as she prepares for residency in the field of pediatrics.

Project Narrative

1. Please describe your activities during your fellowship experience. Describe your final capstone project(s).
The overall goal of the University of Miami’s Mailman Center’s UCEDD Diversity Training Grant Supplement was to train future healthcare professionals about health disparities at the intersection of disability and minority status. To accomplish this goal, we revamped our cultural competency curriculum, adapting it to a wide audience of healthcare professionals including – UCEDD/LEND trainees, medical students, and residents and fellows at the University of Miami and Jackson Health System. In line with the University’s Cultural Transformation initiative to uphold and improve our leadership expectations and service standards as we recognize and adapt to our nation’s growing diversity and the need for culturally competent service, we at Mailman Center for Child Development have fostered an adult learning environment following the University’s common values of DIRECCT:
Diversity • Integrity • Responsibility • Excellence • Creativity • Compassion • Teamwork

We recognized the importance of valuing diversity and creating a culturally responsive environment. We maintain respect for differences among people and a commitment to high standards of thought and cross-cultural communication. With this foundation, we embarked on the development of an innovative Cultural Competence curriculum that promotes self-awareness and guides the healthcare professional’s delivery of care to meet patients’ social, cultural and linguistic needs.

During the first semester of the Diversity Fellowship, ample time was spent researching scholarly manuscripts surround the field of cultural competence in medical education. A review of the frameworks, history and theoretical concepts of cultural competence was reviewed. Apart from this, a critical analysis of health disparities, disability culture, implicit bias, and intersectionality was also performed since a key component of our program is to broaden the scope of health disparities and address the disparities at the intersection of disability and minority status (such as LGBTQ). Following the review of the literature and under the supervision of the diversity champion and implicit bias expert, Dr. Kimberly Reynolds – we co-founded The Cultural Competence Curriculum Consortium (4C) and began the recruitment process. The group currently consists of UCEDD/LEND trainees, medical students, residents and faculty who all serve as diversity champions and disability and LGBTQ Advocates. As the Diversity Fellow, my key role in 4C was to educate the members on the background knowledge in the field of Cultural Competence (CC), review the various CC models and discuss the barriers faced when implementing a CC curriculum. This allowed us to select a model that best fits our university setting and the diverse population dynamics of Miami-Dade County. On May 25, 2016, I presented this information to our members and we initially selected the theoretical framework of Perdersen et al (1994): Utilizing knowledge, attitudes, and skills to provide high-quality, culturally competent care. Our curriculum is centered on the lifelong Learner Model where “Cultural competence in clinical practice is best defined not by a discrete end point but as a commitment and active engagement in a lifelong process that individuals enter into an ongoing basis with patients, communities, colleagues, and with themselves (Tervalon & Murray-Garcia, 2008).”
After the review of the literature and feedback from our consortium, an outline of the content for the online series was formulated. We agreed that there are crucial gaps in Cultural Competence education and we developed four principles that we believe are vital to address in any cultural competence curriculum:
Self Reflection, Intersectionality, Implicit Bias, Cross-Cultural Communication
Phase 1:
• Cultural Competence Models
• Health Disparities
• Self-Reflection in Medical Education • Disability Culture
• Implicit Bias
• Intersectionality
• Leadership Development
• Cross-Cultural Communication

Phase 2: Establish a Consortium consisting of faculty and trainees who serve as Diversity Champions, and disability and LGBTQ advocates at the University.
• The goal of our Consortium was to receive feedback and guidance as we develop the content for our Cultural Competence curriculum.

Phase 3: Curriculum Development – Two Part Cultural Competence Module: • Online Cultural Competence Course • In-person Workshops

In the summer of 2016, we began collecting content for our curriculum. Our Cultural Competence course is divided into two sections: 
 1. Online Cultural Competence Series 
•  Universal Online component 
• Pre-requisite to the In person Workshops
2. In-Person Workshops 
• Tailored to different healthcare professionals 
• Small-group discussions 
• Interactive Activities

As my Diversity Fellowship comes to an end, I have successfully finalized the content material for our Cultural Competency Module. For the last 4 months, I have been testing and revising the content material by providing the UCEDD/LEND trainees with a one-hour presentation on Cultural Competence during their Understanding the Family Perspective (UFP) rotation at the Mailman Center for Child Development. This rotation included UCEDD/LEND trainees, medical students and residents and has allowed me to test online-specific content and experiential interactive learning activities. The Pilot lecture provides continuous feedback and affords me the opportunity to develop important leadership and teaching skills in an adult learning environment.

Currently, I am fortunate to work with the Senior Instructional Designer for the University of Miami – Miller School of medicine as we build the online cultural competence course on the University’s Learning Management System, BlackBoard.

2. Who did your project inform, help, influence or impact? (UCEDD, individual, community, state) How?
With the United States becoming increasingly diverse, healthcare professionals are being challenged to provide cross-cultural care that is sensitive, effective, and meets the culturally diverse needs of the patient and their family. Understanding the central role of the healthcare professional as the patient advocate, we focused our training initiatives on the individual healthcare professional. Our goal was to build an innovative cultural competence curriculum that provides the knowledge, builds skills and create diversity-valuing attitudes that transform our trainees to diversity champions who seek to understand the various cultural dynamics that play into the Healthcare Professional – Patient encounter.

We believe that by targeting this specific population (the entry-level healthcare professional) we can ingrain invaluable competencies early in their professional development. Thus, as they progress along their career paths, they impact the community both on an individual level and system level that is critical to reducing health disparities and improving overall access to care.

3. Why did you choose to work on that project(s)?
As an international student who migrated to the United States to pursue a higher education, I always recognized cultural differences between people and appreciating these differences as a valued asset. In fact, my international student status had set the stage for a lifetime of service. There are ingrained challenges that come along with being “international” that taught me to appreciate the individuality of success. I was soon able to tie this concept to healthcare – understanding the effects that cultural, social and historical factors have on access and quality of care. The lens of my past experiences gave me the perspective necessary to understand the vicious cycle of indigence and social injustice. I developed a passion to serve the underserved and underrepresented, and was inspired and empowered to become a health leader, a disability and human rights advocate, and a diversity champion.

4. What did you gain from being a Diversity Fellow?
Being a Diversity Fellow has broadened my scope of medicine. It has allowed me to look beyond the walls of the examination room and understand the critical role that research, education, and policy-making play in the dynamics of health and well-being. I have learned that through these systems-level processes massive impact can be made, thus positively shaping our healthcare system. I understand that it truly does “take a village.” I learned the art of motivating others and enhancing positive one-on-one relationships and teambuilding. Through teaching cultural competence, I have become a great listener and fostered an environment that allows healthcare professionals to tell their stories, through the cultural lens and connect emotionally with others.

5. How will this experience impact your education or career decisions?
My Diversity Fellowship has taught me that confidence is a state of mind. My leadership training and practice has boosted my self-esteem and belief in my professional abilities. I have learned that I can have a positive impact on others and drive change. This fellowship has taught me to conquer my fears of public speaking and developed a passion for teaching. It has been a pivoting point in my education and career path – shifting my mindset from a “student” to an “educator.” This has had a significant impact on my decision-making and leadership capacity. I am truly humbled and grateful for this experience.

6. What are your future goals? Where do you see yourself 5 years from now?
This fellowship allowed me to look beyond the now and take the long view of my career. I have always wanted to be a board-certified pediatrician. However, my experience as a Diversity Fellow taught me to look beyond the medical perspective and gave me a more holistic view of the role of a pediatrician. It has opened my eyes to the naturally occurring injustice of one child’s life over another. This has infused an abiding, irrepressible desire to advocate for every child. This has become my life’s purpose. Therefore, five years from now, I still see myself as a board-certified pediatrician but now I will be the pediatrician who promotes diversity and inclusion for every child; working to improve their overall health and well-being.

7. What recommendations do you have for other fellows?
“Ultimately, leadership is not about glorious crowning acts. It's about keeping your team focused on a goal and motivated to do their best to achieve it, especially when the stakes are high and the consequences really matter. It is about laying the groundwork for others' success, and then standing back and letting them shine (Chris Hadfield).” The AUCD Diversity Fellowship has enabled me to be a force for change. I have and continue to go through a process of growth, self-awareness, and change. To the future Diversity Fellows, embrace this unique opportunity of growth and development. You will come across some of the most amazing people through this journey, learn from them. Stay humble and grateful every day. Embed the ideology of diversity in your day-to-day activities – create a vision of the reality you want and seek to change the structure of society and the character of yourself and others that drives inclusion for everyone.