Gazaway Shena B, Barnett Michael D, Bowman Ella H, Ejem Deborah, Harrell Erin R, Brown Cynthia J, Bakitas Marie
School of Nursing Center for Palliative and Supportive Care, University of Alabama, 1720 2nd Avenue South, AL 35294-1210 Birmingham, USA.
Associate Professor of Medicine & Pediatrics, Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, USA.
Curr Geriatr Rep. 2021;10(4):148-156. doi: 10.1007/s13670-021-00365-7. Epub 2021 Oct 30.
Most aging Americans lack access to specialist palliative care aimed at those experiencing serious illness and/or high symptom burden at end of life. The curricula used by training programs for all healthcare professions should focus on helping learners develop the primary palliative care skills and competencies necessary to provide compassionate bias-free care for adults with serious illness. We believe there is much opportunity to improve this landscape via the incorporation of palliative care competencies throughout generalist healthcare professional programs.
Several recent publications highlight multiple issues with recruitment and retention of diverse students and faculty into healthcare professional training programs. There are also concerns that the curricula are reinforcing age, race, and gender biases. Due to these biases, healthcare professionals graduate from their training programs with socialized stereotypes unquestioned when caring for older adult minority patients and caregivers.
Important lessons must be incorporated to assure that bias against age, race, and gender are discovered and openly addressed in healthcare professional's education programs. This review highlights these three types of bias and their interrelationships with the aim of revealing hidden truths in the education of healthcare professionals. Ultimately, we offer targeted recommendations of focus for programs to address implicit bias within their curricula.
大多数美国老年人无法获得针对临终时患有严重疾病和/或症状负担较重者的专科姑息治疗。所有医疗保健专业培训项目所使用的课程应侧重于帮助学习者培养必要的初级姑息治疗技能和能力,以便为患有严重疾病的成年人提供富有同情心且无偏见的护理。我们认为,通过在全科医疗保健专业项目中纳入姑息治疗能力,有很大机会改善这一局面。
最近的几份出版物强调了在医疗保健专业培训项目中招收和留住不同学生及教师方面的多个问题。人们还担心课程正在强化年龄、种族和性别偏见。由于这些偏见,医疗保健专业人员在完成培训项目后,在照顾老年少数族裔患者和护理人员时,带着未经质疑的社会化刻板印象毕业。
必须吸取重要经验教训,以确保在医疗保健专业人员的教育项目中发现并公开解决对年龄、种族和性别的偏见。本综述强调了这三种偏见及其相互关系,目的是揭示医疗保健专业人员教育中的隐藏真相。最终,我们为各项目提供了有针对性的重点建议,以解决其课程中的隐性偏见问题。