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当种族问题在病房凸显:探讨临床环境中的种族健康差异与种族主义

When Race Matters on the Wards: Talking About Racial Health Disparities and Racism in the Clinical Setting.

作者信息

Brooks Katherine C, Rougas Steven, George Paul

机构信息

Recent Graduate, Warren Alpert Medical School of Brown University; Resident Physician in Internal Medicine, Brigham and Women's Hospital.

Assistant Professor of Emergency Medicine and Medical Science, Warren Alpert Medical School of Brown University.

出版信息

MedEdPORTAL. 2016 Dec 28;12:10523. doi: 10.15766/mep_2374-8265.10523.

Abstract

INTRODUCTION

There is a growing body of literature illustrating the negative impact of racial bias on clinical care. Despite the growing evidence, medical schools have been slow to make necessary curricular changes. Most attempts to educate on racial health disparities focus on transferring knowledge and do not foster the development of skills to understand one's own bias or address bias and racism in the clinical setting. To address this, we developed a small-group, case-based curriculum for rising third-year medical students.

METHODS

This session was designed to be delivered in concurrently run, 1-hour small-group sessions, with each small group ideally comprising no more than 10 students and one facilitator. The curriculum was integrated into an existing 3-week clerkship preparation course for 122 students during the 2015-2016 academic year. The session materials include a facilitator's guide and three cases for discussion.

RESULTS

The session was evaluated using a 6-point Likert scale (1 = , 6 = ). Students rated this session overall a 4.28 out of 6 ( = 79). Qualitative feedback varied, with the most common theme focusing on the need for more time to discuss this topic.

DISCUSSION

Though one session before starting clinical clerkships is not enough to maintain the practice of sustained critical thinking regarding bias and racism in clinical medicine, this session is a starting point for curriculum developers looking to use an evidence-based approach to racial bias in clinical care.

摘要

引言

越来越多的文献表明种族偏见对临床护理有负面影响。尽管证据越来越多,但医学院在进行必要的课程改革方面一直行动迟缓。大多数关于种族健康差异的教育尝试都侧重于传授知识,而没有培养理解自身偏见或在临床环境中应对偏见和种族主义的技能。为了解决这个问题,我们为即将升入三年级的医学生开发了一个小组案例式课程。

方法

本次课程设计为同时进行的1小时小组课程,每个小组理想情况下不超过10名学生和一名主持人。该课程在2015 - 2016学年被纳入为122名学生开设的为期3周的临床实习准备课程中。课程材料包括主持人指南和三个讨论案例。

结果

使用6点李克特量表(1 = ,6 = )对课程进行评估。学生对本次课程的总体评分为6分中的4.28分( = 79)。定性反馈各不相同,最常见的主题是需要更多时间来讨论这个话题。

讨论

虽然在开始临床实习前的一次课程不足以维持对临床医学中偏见和种族主义进行持续批判性思考的实践,但本次课程是课程开发者寻求在临床护理中采用基于证据的方法处理种族偏见的一个起点。

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