打破内科教员偏见习惯的研讨会效果：一项多站点集群随机对照研究。
Effect of a Workshop to Break the Bias Habit for Internal Medicine Faculty: A Multisite Cluster Randomized Controlled Study.
机构信息
M. Carnes is professor emeritus, Departments of Medicine, Psychiatry, and Industrial Engineering, University of Wisconsin-Madison, Madison, Wisconsin; ORCID: https://orcid.org/0000-0002-4208-0091 .
J. Sheridan is executive and research director and distinguished scientist, University of Wisconsin-Madison Inclusion in Science and Engineering Leadership Institute (WISELI), University of Wisconsin-Madison, Madison, Wisconsin.
出版信息
Acad Med. 2023 Oct 1;98(10):1211-1219. doi: 10.1097/ACM.0000000000005271. Epub 2023 May 23.
PURPOSE
Recognition that cultural stereotypes can unintentionally perpetuate inequities throughout academic medicine has led to calls for "implicit bias training" without strong evidence to support these recommendations and some evidence of potential harm. The authors sought to determine the effectiveness of a single 3-hour workshop in helping department of medicine faculty overcome implicit stereotype-based bias and in improving the climate in the working environment.
METHOD
A multisite cluster randomized controlled study (October 2017 to April 2021) with clustering at the level of divisions within departments and participant-level analysis of survey responses involved 8,657 faculty in 204 divisions in 19 departments of medicine: 4,424 in the intervention group (1,526 attended a workshop) and 4,233 in the control group. Online surveys at baseline (3,764/8,657 = 43.48% response rate) and 3 months after the workshop (2,962/7,715 = 38.39% response rate) assessed bias awareness, bias-reducing intentional behavioral change, and perceptions of division climate.
RESULTS
At 3 months, faculty in the intervention vs control divisions showed greater increases in awareness of personal bias vulnerability ( b = 0.190 [95% CI, 0.031 to 0.349], P = .02), bias reduction self-efficacy ( b = 0.097 [95% CI, 0.010 to 0.184], P = .03), and taking action to reduce bias ( b = 0.113 [95% CI, 0.007 to 0.219], P = .04). The workshop had no effect on climate or burnout, but slightly increased perceptions of respectful division meetings ( b = 0.072 [95% CI, 0.0003 to 0.143], P = .049).
CONCLUSIONS
Results of this study should give confidence to those designing prodiversity interventions for faculty in academic medical centers that a single workshop which promotes awareness of stereotype-based implicit bias, explains and labels common bias concepts, and provides evidence-based strategies for participants to practice appears to have no harms and may have significant benefits in empowering faculty to break the bias habit.
目的
认识到文化刻板印象可能会在不经意间使整个学术医学领域的不平等现象持续存在，这促使人们呼吁进行“隐性偏见培训”，但目前还没有强有力的证据支持这些建议，而且有一些潜在危害的证据。作者旨在确定单次 3 小时的研讨会在帮助医学系教职员工克服基于隐性刻板印象的偏见以及改善工作环境氛围方面的有效性。
方法
这是一项多地点群组随机对照研究（2017 年 10 月至 2021 年 4 月），在部门内部的科室水平进行聚类，参与者水平分析调查反应，涉及 19 个医学部门的 204 个科室的 8657 名教职员工：干预组 4424 名（1526 名参加了研讨会）和对照组 4233 名。基线时的在线调查（3764/8657=43.48%的回应率）和研讨会 3 个月后（2962/7715=38.39%的回应率）评估了偏见意识、减少偏见的有意行为改变以及对科室氛围的看法。
结果
在 3 个月时，干预组科室的教职员工在个人偏见易感性意识方面的增加幅度大于对照组（b=0.190[95%CI，0.031 至 0.349]，P=0.02）、减少偏见的自我效能感（b=0.097[95%CI，0.010 至 0.184]，P=0.03）和采取行动减少偏见（b=0.113[95%CI，0.007 至 0.219]，P=0.04）。研讨会对气候或倦怠没有影响，但略微增加了对尊重科室会议的看法（b=0.072[95%CI，0.0003 至 0.143]，P=0.049）。
结论
这项研究的结果应该让那些为学术医疗中心的教职员工设计多元化干预措施的人充满信心，即单次研讨会可以提高对基于刻板印象的隐性偏见的认识，解释和标记常见的偏见概念，并为参与者提供实践的循证策略，似乎没有任何危害，而且可能在赋予教职员工打破偏见习惯方面带来显著益处。
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