T.R. Wyatt is associate professor, Department of Medicine, Center for Health Professions Education, Uniformed Services University, Bethesda, Maryland; ORCID: https://orcid.org/0000-0002-0071-5298 .
T.R. Taylor is assistant professor of pediatrics and emergency medicine, Emory University School of Medicine, Atlanta, Georgia; ORCID: https://orcid.org/0000-0001-8099-900X .
Acad Med. 2021 Nov 1;96(11S):S17-S22. doi: 10.1097/ACM.0000000000004263.
The United States has an implicit agreement known as the racial contract that exists between white and non-white communities. Recently, the racial contract has produced much tension, expressed in racial violence and police brutality. This study explores how this racial violence and police brutality have affected the practice and education of Black trainees and physicians who are members of the racial community being targeted.
This qualitative cross-sectional study interviewed 7 Black trainees and 12 physicians from 2 Southern medical schools in 2020. Interview data were collected using aspects of constructivist grounded theory, and then analyzed using the concept of racial trauma; a form of race-based stress minoritized individuals experience as a result of inferior treatment in society. Data were then organized by the causes participants cited for feeling unsafe, conditions they cited as producing these feelings, and the consequences these feelings had on their education and practice.
The results show that even though participants were not direct victims of racial violence, because their social identity is linked to the Black community, they experienced these events vicariously. The increase in racial violence triggered unresolved personal and collective memories of intergenerational racial trauma, feelings of retraumatization after more than 400 years of mistreatment, and an awakening to the fact that the white community was unaware of their current and historical trauma. These events were felt in both their personal and professional lives.
As more minoritized physicians enter medicine and medical education, the profession needs a deeper understanding of their unique experiences and sociohistorical contexts, and the effect that these contexts have on their education and practice. While all community members are responsible for this, leaders play an important role in creating psychologically safe places where issues of systemic racism can be addressed.
美国存在一种隐性协议,即白人和非白人社区之间的种族契约。最近,这种种族契约产生了很大的紧张关系,表现为种族暴力和警察暴行。本研究探讨了这种种族暴力和警察暴行如何影响作为目标种族社区成员的黑人员工和医生的实践和教育。
本定性横断面研究于 2020 年在南方的两所医学院采访了 7 名黑人员工和 12 名医生。使用建构主义扎根理论的各个方面收集访谈数据,然后使用种族创伤的概念进行分析;这是少数族裔个人因在社会中受到不平等待遇而经历的一种基于种族的压力形式。然后根据参与者提出的感到不安全的原因、他们提出的产生这些感觉的条件以及这些感觉对他们的教育和实践的影响来组织数据。
研究结果表明,即使参与者不是种族暴力的直接受害者,因为他们的社会身份与黑人社区有关,他们也间接地经历了这些事件。种族暴力的增加引发了未解决的个人和集体代际种族创伤记忆,在遭受了 400 多年的虐待后再次受到创伤的感觉,以及对白人社区不知道他们当前和历史创伤的认识。这些事件在他们的个人和职业生活中都有所体现。
随着越来越多的少数族裔医生进入医学和医学教育领域,该行业需要更深入地了解他们独特的经历和社会历史背景,以及这些背景对他们的教育和实践的影响。虽然所有社区成员都对此负有责任,但领导者在创造一个可以解决系统性种族主义问题的心理安全场所方面发挥着重要作用。