Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
J Natl Med Assoc. 2021 Jun;113(3):310-314. doi: 10.1016/j.jnma.2020.11.009. Epub 2020 Dec 25.
Microaggressions in the learning environment have been documented at various levels of medical training. However, there is lack of data detailing the prevalence and effects of racial microaggressions in medical school. This limits interventions that might improve the learning environment for underrepresented minority medical students (URMMS). This study describes the creation and validation of a survey instrument characterizing the experience of microaggressions in medical school and their impact on medical student education and burnout.
An anonymous survey instrument was adapted for medical students from the validated Racial and Ethnic Microaggressions Scale (REMS) and distributed to the national listservs of the Student National Medical Association (SNMA), Latino Medical Student Association (LMSA), and the Asian Pacific American Medical Student Association. Responses were categorized into two cohorts: under-represented minority (URM) and non-URM based on self-reported race or ethnicity.
A total of 217 responses were collected from medical students across the United States, with 148 (68.2%) students identifying as URM. URM respondents were significantly (p < 0.05) more likely to report experiencing race-related microaggressions during medical school (55% vs 31%), and to report that these microaggressions contributed to feelings of burnout (62% vs 29%) and compromised learning (64% vs 49%). URM students were significantly less likely to feel that adequate resources were available to address microaggressions (26% vs 39%, p < 0.05).
Our results suggest that microaggressions experienced by URMMS can be evaluated using an adapted REMS. Additionally, the experience of microaggressions negatively impact the learning environment, and students feel the availability of sufficient resources to address microaggressions and their effects are lacking. Further research is needed to evaluate microaggressions and their impact on a larger scale. This should be followed by interventions to minimize the frequency and impact of these microaggressions.
在医学培训的各个层次都记录了学习环境中的微侵犯行为。然而，缺乏详细描述医学院种族微侵犯行为的普遍性和影响的数据。这限制了可能改善代表性不足的少数族裔医学生（URMMS）学习环境的干预措施。本研究描述了一种调查工具的创建和验证，该工具用于描述医学院中微侵犯行为的经历及其对医学生教育和倦怠的影响。
从经过验证的种族和族裔微侵犯量表（REMS）中为医学生改编了一份匿名调查工具，并分发给全国学生国家医学协会（SNMA）、拉丁裔医学生协会（LMSA）和亚太裔医学生协会的全国名单服务。根据自我报告的种族或族裔，将反应分为两个队列：代表性不足的少数族裔（URM）和非 URM。
从美国各地的医学生中收集了 217 份回复，其中 148 名（68.2%）学生自我认定为 URM。URM 受访者更有可能（p<0.05）报告在医学院期间经历与种族相关的微侵犯行为（55%对 31%），并报告这些微侵犯行为导致倦怠感（62%对 29%）和学习受损（64%对 49%）。URM 学生认为可获得足够资源来解决微侵犯问题的可能性明显较低（26%对 39%，p<0.05）。
我们的结果表明，使用改编的 REMS 可以评估 URMMS 经历的微侵犯行为。此外，微侵犯行为的经历对学习环境产生负面影响，学生感到缺乏足够的资源来解决微侵犯行为及其影响。需要进一步研究来评估更大规模的微侵犯行为及其影响。随后应采取干预措施，尽量减少这些微侵犯行为的频率和影响。
