White-Davis Tanya, Edgoose Jennifer, Brown Speights Joedrecka S, Fraser Kathryn, Ring Jeffrey M, Guh Jessica, Saba George W
Department of Family and Social Medicine, Montefiore Medical Center-Albert Einstein College of Medicine, Bronx, NY.
Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Fam Med. 2018 May;50(5):364-368. doi: 10.22454/FamMed.2018.875510.
Education of health care clinicians on racial and ethnic disparities has primarily focused on emphasizing statistics and cultural competency, with minimal attention to racism. Learning about racism and unconscious processes provides skills that reduce bias when interacting with minority patients. This paper describes the responses to a relationship-based workshop and toolkit highlighting issues that medical educators should address when teaching about racism in the context of pernicious health disparities.
A multiracial, interdisciplinary team identified essential elements of teaching about racism. A 1.5-hour faculty development workshop consisted of a didactic presentation, a 3-minute video vignette depicting racial and gender microaggression within a hospital setting, small group discussion, large group debrief, and presentation of a toolkit.
One hundred twenty diverse participants attended the workshop at the 2016 Society of Teachers of Family Medicine Annual Spring Conference. Qualitative information from small group facilitators and large group discussions identified some participants' emotional reactions to the video including dismay, anger, fear, and shame. A pre/postsurvey (N=72) revealed significant changes in attitude and knowledge regarding issues of racism and in participants' personal commitment to address them.
Results suggest that this workshop changed knowledge and attitudes about racism and health inequities. Findings also suggest this workshop improved confidence in teaching learners to reduce racism in patient care. The authors recommend that curricula continue to be developed and disseminated nationally to equip faculty with the skills and teaching resources to effectively incorporate the discussion of racism into the education of health professionals.
针对医疗保健临床医生开展的关于种族和民族差异的教育主要侧重于强调统计数据和文化能力，而对种族主义关注甚少。了解种族主义和无意识过程能提供在与少数族裔患者互动时减少偏见的技能。本文描述了对一个基于关系的工作坊和工具包的反馈，该工作坊和工具包突出了医学教育工作者在有害健康差异背景下教授种族主义时应解决的问题。
一个多种族、跨学科的团队确定了教授种族主义的基本要素。一个1.5小时的教师发展工作坊包括一次教学讲座、一段时长3分钟的视频短片，描绘医院环境中的种族和性别微侵犯行为、小组讨论、大组汇报以及一个工具包的展示。
120名来自不同背景的参与者参加了2016年家庭医学教师协会年度春季会议的工作坊。来自小组主持人和大组讨论的定性信息确定了一些参与者对视频的情绪反应，包括沮丧、愤怒、恐惧和羞愧。一项前后调查（N = 72）显示，在关于种族主义问题的态度和知识方面以及参与者解决这些问题的个人承诺方面都有显著变化。
结果表明，这个工作坊改变了对种族主义和健康不平等的认识和态度。研究结果还表明，这个工作坊提高了在教导学习者减少患者护理中种族主义方面的信心。作者建议继续在全国范围内开发和传播课程，以使教师具备有效将种族主义讨论纳入健康专业人员教育的技能和教学资源。
