H.R.C. Mason is assistant dean of students and associate professor of public health and community medicine, Tufts University School of Medicine, Boston, Massachusetts; ORCID: https://orcid.org/0000-001-6443-4244 .
M. Pérez is clinical research specialist, Washington University School of Medicine in St. Louis, St. Louis, Missouri; ORCID: https://orcid.org/0000-0002-2809-2504 .
Acad Med. 2023 Aug 1;98(8S):S68-S74. doi: 10.1097/ACM.0000000000005248. Epub 2023 Jul 21.
The authors aimed to gain a better understanding of students' and teachers' perspectives about whether clinical clerkship feedback is provided equitably irrespective of a student's race/ethnicity.
A secondary analysis of existing interview data was conducted, focusing on racial/ethnic disparities in clinical grading. Data had been acquired from 29 students and 30 teachers at 3 U.S. medical schools. The authors performed secondary coding on all 59 transcripts, writing memos focused on statements related to aspects of feedback equity and developing a template for coding students' and teachers' observations and descriptions specific to clinical feedback. Using the template, memos were coded, and thematic categories emerged describing perspectives on clinical feedback.
Forty-eight (22 teachers and 26 students) participants' transcripts provided narratives about feedback. Both student and teacher narratives described how students who are racially/ethnically underrepresented in medicine may receive less helpful formative clinical feedback needed for professional development. Thematic analysis of narratives yielded 3 themes related to feedback inequities: 1) teachers' racial/ethnic biases influence the feedback they provide students, 2) teachers have limited skill sets to provide equitable feedback, and 3) racial/ethnic inequities in the clinical learning environment shape clinical and feedback experiences.
Narratives indicated that both students and teachers perceived racial/ethnic inequities in clinical feedback. Teacher- and learning environment-related factors influenced these racial/ethnic inequities. These results can inform medical education's efforts to mitigate biases in the learning environment and provide equitable feedback to ensure every student has what they need to develop into the competent physician they aspire to be.
作者旨在更深入地了解学生和教师对临床实习反馈是否公平的看法，无论学生的种族/民族如何。
对现有的访谈数据进行二次分析，重点关注临床评分中的种族/民族差异。数据来自美国 3 所医学院的 29 名学生和 30 名教师。作者对所有 59 份转录本进行了二次编码，重点关注与反馈公平性方面相关的陈述，并制定了一个编码学生和教师对临床反馈的观察和描述的模板。使用该模板对备忘录进行编码，出现了描述临床反馈观点的主题类别。
48 名（22 名教师和 26 名学生）参与者的转录本提供了有关反馈的叙述。学生和教师的叙述都描述了在医学领域代表性不足的少数族裔学生可能会收到较少的有助于职业发展的形成性临床反馈。对叙述的主题分析产生了 3 个与反馈不公平相关的主题：1）教师的种族/民族偏见影响他们向学生提供的反馈，2）教师提供公平反馈的技能有限，3）临床学习环境中的种族/民族不平等塑造了临床和反馈体验。
叙述表明，学生和教师都认为临床反馈存在种族/民族不公平现象。教师和学习环境相关因素影响了这些种族/民族不公平现象。这些结果可以为医学教育提供信息，以减轻学习环境中的偏见，并提供公平的反馈，以确保每个学生都能获得他们发展成为理想医生所需的一切。
