Sherman Michelle D, Ricco Jason, Nelson Stephen C, Nezhad Sheila J, Prasad Shailendra
University of Minnesota, Department of Family Medicine and Community Health.
University of Minnesota Medical School, Department of Family Medicine and Community Health.
Fam Med. 2019 Sep;51(8):677-681. doi: 10.22454/FamMed.2019.947255.
Implicit bias often affects patient care in insidious ways, and has the potential for significant damage. Several educational interventions regarding implicit bias have been developed for health care professionals, many of which foster reflection on individual biases and encourage personal awareness. In an attempt to address racism and other implicit biases at a more systemic level in our family medicine residency training program, our objectives were to offer and evaluate parallel trainings for residents and faculty by a national expert.
The trainings addressed how both personal biases and institutional inequities contribute to structural racism, and taught skills for managing instances of implicit biases in one's professional interactions. The training was deliberately designed to increase institutional capacity to engage in crucial conversations regarding implicit bias. Six months after the trainings, an external evaluator conducted two separate 1-hour focus groups, one with residents (n=18) and one with program faculty and leadership (n=13).
Four themes emerged in the focus groups: increased awareness of and commitment to addressing racial bias; appreciation of a safe forum for sharing concerns; new ways of addressing and managing bias; and institutional capacity building for continued vigilance and training regarding implicit bias.
Both residents and faculty found this training to be important and empowering. All participants desired an ongoing programmatic commitment to the topic.
隐性偏见常常以潜移默化的方式影响患者护理,且有可能造成重大损害。针对医疗保健专业人员已开展了多项关于隐性偏见的教育干预措施,其中许多措施促进了对个人偏见的反思并提高了个人意识。为了在我们的家庭医学住院医师培训项目中更系统地解决种族主义和其他隐性偏见问题,我们的目标是由一位全国专家为住院医师和教员提供并评估并行培训。
培训内容涉及个人偏见和机构不公平现象如何导致结构性种族主义,并教授了在专业互动中处理隐性偏见情况的技巧。该培训特意设计用于提高机构开展有关隐性偏见关键对话的能力。培训结束六个月后,一名外部评估人员分别组织了两个1小时的焦点小组,一个由住院医师组成(n = 18),另一个由项目教员和领导层组成(n = 13)。
焦点小组中出现了四个主题:提高了对解决种族偏见的认识和承诺;对分享担忧的安全论坛表示赞赏;处理和管理偏见的新方法;以及关于隐性偏见持续保持警惕和培训的机构能力建设。
住院医师和教员都认为此次培训很重要且能赋予人力量。所有参与者都希望该项目持续关注这一主题。