Third-Year Resident, Department of Medicine, Massachusetts General Hospital.
Associate Professor of Medicine, Endocrine Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School.
MedEdPORTAL. 2024 Aug 6;20:11424. doi: 10.15766/mep_2374-8265.11424. eCollection 2024.
Resident physicians frequently experience bias at work, with patients and families often being the source. Women and other trainees underrepresented in medicine are disproportionately impacted by these negative experiences, and experiencing bias contributes to resident physician burnout. Unfortunately, many resident physicians feel inadequately prepared to respond to bias.
We developed a 45-minute, peer-led, case-based workshop that equipped trainees with tools to respond to patient-expressed bias. Our toolkit centered on resident physicians by including an assessment of the trainee's emotional well-being, a team-based response, and an embedded debrief. The toolkit provided resident physicians with possible responses to bias directed towards themselves (bias-towards-self) or bias directed towards others (bias-towards-others). Surveys were administered pre- and postworkshop to assess change in participants' comfort in responding to patient-expressed bias.
Thirty-seven residents completed both surveys. The workshop significantly increased comfort in responding to bias-towards-self ( < .001; 95% CI, 1.00-1.50) and bias-towards-others ( < .001; 95% CI, 1.00-1.50).
We improved resident physicians' comfort responding to patient bias-towards-self and bias-towards-others through a toolkit and workshop designed specifically for trainees. The toolkit centers the resident physician perspective, incorporates clinical context, and embeds a debrief. Our novel approach situates the toolkit's teaching in a highly scalable, case-based workshop.
住院医师在工作中经常会遇到偏见,而患者和家属往往是偏见的来源。女性和其他在医学领域代表性不足的受训者受到这些负面经历的影响尤为严重,而经历偏见会导致住院医师倦怠。不幸的是,许多住院医师觉得自己应对偏见的能力不足。
我们开发了一个 45 分钟的、由同行领导的、基于案例的研讨会,为受训者提供应对患者表达的偏见的工具。我们的工具包以住院医师为中心,包括对受训者情绪健康的评估、团队应对以及嵌入式讨论。该工具包为住院医师提供了可能的应对方法,针对的是针对他们自己的偏见(偏见自)或针对他人的偏见(偏见他)。在研讨会前后进行了调查,以评估参与者对患者表达的偏见的反应舒适度的变化。
37 名住院医师完成了两次调查。研讨会显著提高了对偏见自( <.001;95%置信区间,1.00-1.50)和偏见他( <.001;95%置信区间,1.00-1.50)的反应舒适度。
我们通过专门为受训者设计的工具包和研讨会,提高了住院医师对患者偏见自和偏见他的反应舒适度。该工具包以住院医师的视角为中心,纳入临床背景,并嵌入讨论。我们的新方法将工具包的教学置于高度可扩展的、基于案例的研讨会中。