From the Gordon Center for Simulation and Innovation, the Departments of Medicine, Medical Education, and Pediatrics, and the Communications Skills Program, University of Miami Miller School of Medicine, Miami, Florida.
South Med J. 2022 May;115(5):283-289. doi: 10.14423/SMJ.0000000000001396.
Discrimination and bias in clinical training often take the form of microaggressions, which, albeit unintentional, are detrimental to the learning environment and well-being of students. Although there are a few reports of medical schools training students to respond to microaggressions, none have included a complementery student-led faculty training module. The aim of this study was to develop and evaluate a case-based approach to improving student resilience and increasing faculty awareness of microaggressions in the clinical setting.
We created four realistic cases of microaggressions and uncomfortable conversations, based on students' experiences on the wards, to implement training for incoming third-year students and their core faculty. Standardized patients were trained to effectively portray discriminatory faculty, residents, and patients. Institutional review board-approved surveys were administered and statistically analyzed to evaluate for efficacy.
Students had greater mean confidence scores for responding to microaggressions immediately and at 6 months after the sessions ( 0.05). Faculty showed improved mean confidence and understanding of the definition of a microaggression ( 0.05).
This approach had results similar to other studies, with the additional benefit of training faculty with the same scenarios. We believe that this method helped bridge the gap between students' notions of discrimination and faculty understanding of microaggressions.
临床培训中的歧视和偏见往往以微侵犯的形式出现，尽管这些行为并非有意为之，但它们不利于学生的学习环境和福祉。尽管有一些医学院校培训学生如何应对微侵犯的报道，但没有一个报道包括一个由学生主导的教师培训模块。本研究旨在开发和评估一种基于案例的方法，以提高学生的适应力，并提高临床环境中教师对微侵犯的认识。
我们根据学生在病房的经历，创建了四个现实生活中的微侵犯和不愉快对话的案例，以对即将进入三年级的学生及其核心教师进行培训。经过培训的标准化患者将有效地扮演歧视性的教师、住院医师和患者。我们进行了机构审查委员会批准的调查，并进行了统计分析，以评估其效果。
学生在课程结束后立即和 6 个月后的微侵犯应对能力的平均信心得分更高（0.05）。教师的平均信心和对微侵犯定义的理解也有所提高（0.05）。
这种方法与其他研究的结果相似，其额外的好处是培训了同样场景下的教师。我们相信，这种方法有助于弥合学生对歧视的看法和教师对微侵犯的理解之间的差距。
