Assistant Professor, Division of Palliative Medicine, Department of Internal Medicine, University of Kansas School of Medicine.
Assistant Professor, Department of Obstetrics and Gynecology, University of Kansas School of Medicine.
MedEdPORTAL. 2024 Oct 24;20:11453. doi: 10.15766/mep_2374-8265.11453. eCollection 2024.
Medical educators feel ill equipped to respond to racism directed towards trainees. Available tools for responding to microaggressions rely on clarifying questions or aligning with the aggressor, which may add to the harm experienced by the target. We aimed to provide methods for faculty to recognize and respond to overt racism so that trainees feel supported in the clinical learning environment.
We created a faculty development workshop with didactic and experiential learning components based on Kolb's theory for program leadership to teach how to respond when racism was directed towards trainees. In the didactic session, we shared the IRES (identify, respond, end, support) tool we created to respond to overt racism. Participants took part in two small-group case-based practice sessions with group debriefing, followed by a postsession survey.
Over 2 years, we held two sessions with a total of 43 faculty participants. Postsession survey response rate was 74% and showed a 1-point Likert-scale median increase ( < .001) in ability to distinguish the strategies for addressing overt racism versus microaggressions, confidence in responding to microaggressions versus overt racism, and ability to debrief learners. The majority of participants noted that scripted language was a valuable tool to promote upstander behavior.
Participants appreciated this novel framework for responding to racism directed at trainees in the learning environment. Providing scripted language and being able to practice in a safe environment were particularly important. This training can be adapted to include residents, fellows, and other disciplines.
医学教育工作者觉得自己无法应对针对受训者的种族主义。现有的回应微侵犯的工具依赖于澄清问题或与攻击者保持一致，这可能会增加目标所经历的伤害。我们旨在为教师提供识别和应对公然种族主义的方法，以使受训者在临床学习环境中感到得到支持。
我们根据科尔布的方案领导力理论创建了一个包含理论和实践学习的教师发展工作坊，以教授如何在针对受训者的种族主义发生时做出回应。在理论部分，我们分享了我们创建的 IRES（识别、回应、结束、支持）工具，以回应公然种族主义。参与者参加了两个以小组为基础的案例实践会议，并进行小组讨论，然后在课后进行调查。
在两年内，我们举行了两次会议，共有 43 名教师参加。课后调查的回复率为 74%，显示出在区分解决公然种族主义和微侵犯的策略、在回应微侵犯和公然种族主义方面的信心、以及在指导学习者方面的能力方面的能力的中位数增加了 1 分（<.001）。大多数参与者指出，脚本语言是促进积极行为的有价值的工具。
参与者赞赏这种在学习环境中针对受训者的种族主义的新颖回应框架。提供脚本语言和能够在安全的环境中进行实践特别重要。这种培训可以适应包括住院医师、研究员和其他学科的人员。
