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考虑文化和冲突:积极旁观者干预的新方法。

Considering Culture and Conflict: A Novel Approach to Active Bystander Intervention.

机构信息

Fourth-Year Resident, Department of Psychiatry and Behavioral Sciences, Stanford Hospitals and Clinics.

Professor of Medicine, Department of Medicine, NYU Grossman School of Medicine.

出版信息

MedEdPORTAL. 2023 Aug 29;19:11338. doi: 10.15766/mep_2374-8265.11338. eCollection 2023.

Abstract

INTRODUCTION

Workplace microaggressions are prevalent in clinical settings and contribute to poorer mental health outcomes, as well as to higher rates of burnout for physicians and students experiencing them. While bystander workshops customarily provide guidance on direct interventions to a general audience, the literature does not yet address workshops in an academic setting that consider the individual's motivations and behavior patterns. We implemented a psychologically informed approach to microaggression training to increase participants' understanding and willingness to undergo behavioral change.

METHODS

We created a survey that included 10 distinct scenarios of discrimination in the clinical setting. Participants' willingness to intervene was assessed on a Likert scale prior to, then following, a 1-hour active bystander intervention workshop conducted virtually. The workshop outlined the role of culture and conflict management style in willingness to intervene. Four modes of intervention were outlined, including direct and indirect methods.

RESULTS

A total of 78 medical students, graduate students, residents, and faculty members participated in the workshop. Of those, we compared 68 individuals' pre- and postworkshop responses to our questionnaire. We then focused on the 54 participants with no previous training in psychiatry or psychology. Utilizing a Wilcoxon signed rank test, we compared the average pre/post scores of willingness to intervene and found scores to have improved following workshop attendance ( = -6.339, < .001).

DISCUSSION

Our findings suggest that a psychiatrically informed and culturally sensitive approach to active bystander intervention workshops may promote upstanding more effectively in academic medicine.

摘要

简介

工作场所中的微侵犯行为在临床环境中很普遍,不仅会导致医生和学生的心理健康状况恶化,还会导致更高的倦怠率。虽然旁观者工作坊通常会为大众提供有关直接干预的指导,但文献尚未涉及学术环境中的工作坊,这些工作坊考虑到了个人的动机和行为模式。我们采用了一种受心理学启发的微侵犯培训方法,以提高参与者对行为改变的理解和意愿。

方法

我们创建了一个包含 10 种不同临床环境下歧视场景的调查。在参与者参加虚拟的 1 小时主动旁观者干预工作坊之前和之后,我们使用李克特量表评估他们进行干预的意愿。该工作坊概述了文化和冲突管理风格在干预意愿中的作用。我们概述了四种干预模式,包括直接和间接方法。

结果

共有 78 名医学生、研究生、住院医师和教师参加了工作坊。在这些参与者中,我们比较了 68 人在工作坊前后对我们问卷的回答。然后,我们专注于 54 名以前没有接受过精神病学或心理学培训的参与者。利用 Wilcoxon 符号秩检验,我们比较了干预意愿的平均前后得分,发现参加工作坊后得分有所提高( = -6.339, <.001)。

讨论

我们的发现表明,采用精神病学和文化敏感的主动旁观者干预工作坊方法可能更有效地促进学术医学中的正直行为。

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