Loomis Heidi, Hackley Barbara, Alexander-Delpech Paula, McGahey Emily, Perlman Dana
Midwifery and Women's Health, Frontier Nursing University, Versailles, Kentucky.
Montefiore Bronx Health Collective, Center for Research, Evaluation, and Preventive Health, Bronx, New York.
J Midwifery Womens Health. 2025 Jan-Feb;70(1):50-60. doi: 10.1111/jmwh.13680. Epub 2024 Aug 7.
Exposure to bias in clinical learning environments may undermine students' confidence, cause emotional harm, impede learning, and potentially delay graduation. However, little is known about the prevalence of bias experienced by midwifery students in the United States. This cross-sectional, descriptive study aimed to quantify clinical midwifery students' experiences of bias based on 7 self-identified characteristics (gender identity, race or ethnicity, body size, age, sexual orientation, religion, and occupational background). Additionally, this research explored the impact of bias on student well-being, learning, and professional commitment.
The survey consisted of 39 items addressing (1) prevalence and types of bias, (2) emotional impact and influence on clinical learning, (3) ways students coped, (4) whether anyone spoke up at the time bias occurred, (5) whether students reported bias to faculty, and (6) impact of bias on commitment to midwifery. The survey was distributed to midwifery students and recent graduates in 2022 via American College of Nurse-Midwives email discussion lists and social media. Participants were eligible if they were in a clinical rotation in an Accreditation Commission for Midwifery Education-accredited midwifery program between 2019 and 2022.
Surveys were returned by 383 participants, with 301 meeting inclusion criteria. Most participants (66.5%) reported personally experiencing or witnessing bias against at least 1 of 7 personal characteristics. The most commonly reported biases were related to gender, occupational background, age, and race or ethnicity. Only half of the participants reported these occurrences to someone with academic authority, and nearly a third considered withdrawing from their educational programs.
In this study bias was common and significantly impacted students. These results underscore the need for creative and bold interventions at personal, educational, and institutional levels to prevent and mitigate bias. Safeguarding clinical learning environments will enable students to thrive, graduate with confidence and competence, and thereby contribute to the diversification and strengthening of the midwifery profession.
在临床学习环境中遭遇偏见可能会削弱学生的信心，造成情感伤害，阻碍学习，并有可能延迟毕业。然而，对于美国助产专业学生所经历的偏见的普遍程度，人们知之甚少。这项横断面描述性研究旨在根据7种自我认定的特征（性别认同、种族或民族、体型、年龄、性取向、宗教和职业背景），对临床助产专业学生的偏见经历进行量化。此外，本研究还探讨了偏见对学生幸福感、学习和职业承诺的影响。
该调查包括39个项目，涉及（1）偏见的普遍程度和类型，（2）情感影响以及对临床学习的影响，（3）学生的应对方式，（4）偏见发生时是否有人站出来说话，（5）学生是否向教师报告过偏见，以及（6）偏见对助产专业承诺的影响。该调查于2022年通过美国助产士学院的电子邮件讨论列表和社交媒体分发给助产专业学生和应届毕业生。如果参与者在2019年至2022年期间参加了助产教育认证委员会认证的助产专业临床实习，则符合参与条件。
383名参与者返回了调查问卷，其中301人符合纳入标准。大多数参与者（66.5%）报告称自己亲身经历或目睹过针对7种个人特征中至少1种的偏见。最常报告的偏见与性别、职业背景、年龄以及种族或民族有关。只有一半的参与者向有学术权威的人报告了这些事件，近三分之一的人考虑退出他们的教育项目。
在本研究中，偏见很常见且对学生有显著影响。这些结果强调了在个人、教育和机构层面采取创新大胆的干预措施以预防和减轻偏见的必要性。保障临床学习环境将使学生能够茁壮成长，自信且有能力地毕业，从而有助于助产专业的多元化和壮大。
