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当最好的意图还不够时:帮助医学生制定管理患者偏见的策略。

When best intentions aren't enough: helping medical students develop strategies for managing bias about patients.

机构信息

Houston VA HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA.

出版信息

J Gen Intern Med. 2010 May;25 Suppl 2(Suppl 2):S115-8. doi: 10.1007/s11606-009-1243-y.

Abstract

INTRODUCTION/AIMS: Implicit bias can impact physician-patient interactions, alter treatment recommendations, and perpetuate health disparities. Medical educators need methods for raising student awareness about the impact of bias on medical care.

SETTING

Seventy-two third-year medical student volunteers participated in facilitated small group discussions about bias.

PROGRAM DESCRIPTION

We tested an educational intervention to promote group-based reflection among medical students about implicit bias.

PROGRAM EVALUATION

We assessed how the reflective discussion influenced students' identification of strategies for identifying and managing their potential biases regarding patients. 67% of the students (n = 48) identified alternate strategies at post-session. A chi-square analysis demonstrated that the distribution of these strategies changed significantly from pre-session to post-session (chi(2)(11) = 27.93, p < 0.01), including reductions in the use of internal feedback and humanism and corresponding increases in the use of reflection, debriefing and other strategies.

DISCUSSION

Group-based reflection sessions, with a provocative trigger to foster engagement, may be effective educational tools for fostering shifts in student reflection about bias in encounters and willingness to discuss potential biases with colleagues, with implications for reducing health disparities.

摘要

简介/目的:偏见会影响医患互动,改变治疗建议,并使健康差距长期存在。医学教育工作者需要提高学生对偏见对医疗影响的认识的方法。

背景

72 名三年级医学生志愿者参加了有关偏见的小组讨论。

课程描述

我们测试了一种教育干预措施,以促进医学生之间基于小组的对隐性偏见的反思。

课程评估

我们评估了反思性讨论如何影响学生识别识别和管理其对患者潜在偏见的策略。在课后,有 67%的学生(n=48)确定了其他策略。卡方分析表明,这些策略的分布从课前到课后发生了显著变化(chi(2)(11) = 27.93,p < 0.01),包括减少内部反馈和人本主义的使用,以及相应地增加反思、讨论和其他策略的使用。

讨论

基于小组的反思会议,加上一个有启发性的触发因素来促进参与,可能是促进学生对接触中的偏见进行反思并愿意与同事讨论潜在偏见的有效教育工具,这对减少健康差距有影响。

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