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明智行事:消除医学教育中的负面偏见-第 2 部分:我们如何做得更好?

Acting Wisely: Eliminating Negative Bias in Medical Education-Part 2: How Can We Do Better?

机构信息

M.L. Plews-Ogan is Brodie Professor of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia.

T.D. Bell is assistant professor of medicine, University of Virginia School of Medicine, Charlottesville, Virginia.

出版信息

Acad Med. 2020 Dec;95(12S Addressing Harmful Bias and Eliminating Discrimination in Health Professions Learning Environments):S16-S22. doi: 10.1097/ACM.0000000000003700.

Abstract

In Part 1 of this 2-article series, the authors reviewed the problem of unmitigated bias in medical education and proposed a wisdom-based framework for a different way of educating medical students. In this article, Part 2, the authors answer a key question: How can medical educators do better? Is a bias-free environment possible? The answer to the latter question likely is "no." In fact, having a zero-bias goal in mind may blind educators and students to the implicit biases that affect physicians' decisions and actions. Biases appear to be a part of how the human brain works. This article explores ways to neutralize their destructive effects by: (1) increasing awareness of personal biases; (2) using mitigation strategies to protect against the undesirable effects of those biases; (3) working to change some negative biases, particularly learned biases; and (4) fostering positive biases toward others. The authors describe the concrete actions-interpersonal, structural, and cultural actions-that can be taken to reduce negative bias and its destructive effects.

摘要

在这篇由两部分组成的系列文章的第 1 部分中,作者回顾了医学教育中未减轻的偏见问题,并提出了一个基于智慧的框架,用于以不同的方式教育医学生。在本文的第 2 部分中,作者回答了一个关键问题:医学教育者如何才能做得更好?是否有可能创造一个没有偏见的环境?对于后一个问题的答案可能是否定的。事实上,关注零偏见目标可能会使教育者和学生忽视影响医生决策和行动的隐含偏见。偏见似乎是人类大脑运作方式的一部分。本文探讨了通过以下几种方式来中和其破坏性影响的方法:(1)提高对个人偏见的认识;(2)使用缓解策略来防止这些偏见产生不良影响;(3)努力改变一些负面偏见,特别是习得性偏见;以及(4)培养对他人的积极偏见。作者描述了可以采取的具体行动——人际、结构和文化行动——以减少负面偏见及其破坏性影响。

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