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被压迫者剧场用于向医学生传授权力、生活经历和健康公平相关知识。

Theatre of the Oppressed to Teach Medical Students About Power, Lived Experience, and Health Equity.

作者信息

Chin Marshall H, Pace-Moody Angela, Vela Monica B, Peek Monica E, Zhu Mengqi, Appah-Sampong Abena, Miller Doriane C

机构信息

Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL, USA.

Bucksbaum Institute for Clinical Excellence, University of Chicago, Chicago, IL, USA.

出版信息

J Gen Intern Med. 2025 Feb;40(2):330-338. doi: 10.1007/s11606-024-09057-2. Epub 2024 Oct 15.

Abstract

BACKGROUND

A difficult challenge in health equity training is conducting honest and safe discussions about differences in lived experience based on social identity, and how racism and other systems of oppression impact health care.

OBJECTIVE

To evaluate a Theatre of the Oppressed workshop for medical students that examines systems of oppression as related to lived health care experiences.

DESIGN

Mixed-methods cross-sectional survey and interviews.

PARTICIPANTS

Forty randomly assigned early first-year medical students.

INTERVENTIONS

A 90-min virtual workshop with three clinical scenes created by students where a character is being discriminated against or oppressed. During performance, students can stop scene, replace oppressed character, and role play how they would address harm, marginalization, and power imbalance. Participants discuss what they have witnessed and experienced.

MAIN MEASURES/APPROACH: Likert-scale questions assessing workshop's impact. Open-ended survey questions and interviews about workshop.

KEY RESULTS

Thirty-one (78%) of 40 participants completed the survey. Fifty-three percent were female. Thirty-seven percent were White, 33% Asian American, 15% Black, 11% Latinx, and 4% multiracial. Ninety percent thought this training could help them take better care of patients with lived experiences different from their own. Most agreed or strongly agreed the workshop helped them develop listening (23, 77%) and observation (26, 84%) skills. Twelve (39%) students felt stressed, while 29 (94%) felt safe. Twenty-five (81%) students agreed or strongly agreed there were meaningful discussions about systemic inequities. Students reported the workshop helped them step into others' shoes, understand intersectional experiences of multiple identities, and discuss navigating and addressing bias, discrimination, social drivers of health, hierarchy, power structures, and systems of oppression. Some thought it was difficult to have open discussions because of fear of being poorly perceived by peers.

CONCLUSIONS

Theatre of the Oppressed enabled medical students to engage in meaningful discussions about racism and other systems of oppression.

摘要

背景

健康公平培训中的一项艰巨挑战是,基于社会身份,就生活经历的差异以及种族主义和其他压迫制度如何影响医疗保健展开坦诚且安全的讨论。

目的

评估为医学生举办的一场被压迫者戏剧工作坊,该工作坊审视与实际医疗保健经历相关的压迫制度。

设计

混合方法横断面调查与访谈。

参与者

40名随机分配的医学专业一年级新生。

干预措施

一场90分钟的线上工作坊,包含由学生创作的三个临床场景,其中一个角色受到歧视或压迫。在表演过程中,学生可以暂停场景、替换受压迫角色,并角色扮演他们将如何应对伤害、边缘化和权力失衡。参与者讨论他们所目睹和经历的事情。

主要测量方法/途径:用李克特量表问题评估工作坊的影响。关于工作坊的开放式调查问题和访谈。

关键结果

40名参与者中有31名(78%)完成了调查。53%为女性。37%为白人,33%为亚裔美国人,15%为黑人,11%为拉丁裔,4%为多种族。90%的人认为这种培训可以帮助他们更好地照顾生活经历与自己不同的患者。大多数人同意或强烈同意该工作坊帮助他们培养了倾听(23人,77%)和观察(26人,84%)技能。12名(39%)学生感到有压力,而29名(94%)学生感到安全。25名(81%)学生同意或强烈同意存在关于系统性不平等的有意义的讨论。学生们表示,该工作坊帮助他们设身处地为他人着想,理解多种身份的交叉经历,并讨论如何应对和解决偏见、歧视、健康的社会驱动因素、等级制度、权力结构和压迫制度。一些人认为由于担心被同龄人负面看待,很难进行公开讨论。

结论

被压迫者戏剧使医学生能够就种族主义和其他压迫制度展开有意义的讨论。

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