Department of General Practice and Public Health Research Institute, Amsterdam UMC location AMC, Meibergdreef 9,, Amsterdam, AZ, 1105, the Netherlands.
Department of General Practice, Radboud University Medical Center, Nijmegen, the Netherlands.
Int J Equity Health. 2024 Nov 28;23(1):253. doi: 10.1186/s12939-024-02341-x.
Previous research highlights persistent differential attainment by ethnicity in medical education, wherein the perceived inclusiveness significantly influences ethnic minority students' and trainees' outcomes. Biased organizational practices and microaggressions exacerbate the challenges faced by ethnic minorities, leading to lower academic performance and higher dropout rates. Consequently, understanding ethnic minority GP-trainees' experiences and perspectives regarding relevant educational aspects is crucial for addressing these disparities and cultivating a more inclusive environment within medical education.
We aimed to investigate the experiences of minority GP-trainees throughout their educational journey in Dutch GP-specialty training, emphasizing their challenges, sources of support, and suggestions for enhancing their learning environment.
We conducted semi-structured, in-depth interviews with minority GP trainees, employing purposive convenience sampling to ensure diversity across multiple dimensions. These included gender, age, ethnicity, social background, migration generation, educational stage, encountered challenges, sources of support, and the GP training institute attended. The analysis involved iterative, open and axial coding, followed by generating, reviewing, and defining themes. For a structured analysis of encountered microaggressions, we adopted Sue's Taxonomy of Microaggressions.
All fourteen ethnic minority interviewees had faced educational barriers stemming from misunderstandings and stereotyping in a predominantly 'white' organization. These barriers impacted various aspects of their education, including professional identity formation, application, admission, assessment procedures, social networks, course content, and expert guidance. Microaggressions permeated throughout their educational journey, hindering their full expression and potential. Their ideal GP-specialty training emphasized uniqueness of all trainees, comprehensive staff engagement in inclusivity, robust diversity, equity, and inclusion (DEI)-policies, individual mentorship, transparent standards, concise language usage in test questions, and bias elimination through mandatory DEI staff training.
Ethnic minority GP-trainees in the Netherlands face significant challenges like biased assessment and admission, stereotyped course content, inadequate support networks, and microaggressions, putting them at risk for underperformance outcomes. They emphasize the need for inclusive training with robust DEI-policies to eliminate bias.
先前的研究强调了医学教育中族裔间持续存在的差异，其中感知包容性对少数民族学生和学员的结果有重大影响。有偏见的组织实践和微侵犯加剧了少数民族所面临的挑战，导致他们的学业表现较低，辍学率较高。因此，了解少数民族全科医生培训生在相关教育方面的经历和观点对于解决这些差距和培养医学教育中的更具包容性的环境至关重要。
我们旨在调查少数民族全科医生培训生在荷兰全科医学专科培训中的教育历程中的经历，强调他们的挑战、支持来源以及增强他们学习环境的建议。
我们对少数民族全科医生培训生进行了半结构化、深入的访谈，采用目的性便利抽样，以确保在多个维度上的多样性。这些维度包括性别、年龄、族裔、社会背景、移民代际、教育阶段、遇到的挑战、支持来源以及所参加的全科医生培训学院。分析涉及迭代、开放式和轴向编码，随后生成、审查和定义主题。为了对遇到的微侵犯进行结构化分析，我们采用了 Sue 的微侵犯分类法。
所有 14 名少数民族受访者都曾面临源自于一个以“白人”为主的组织中的误解和刻板印象的教育障碍。这些障碍影响了他们教育的各个方面，包括专业身份的形成、申请、录取、评估程序、社交网络、课程内容和专家指导。微侵犯贯穿他们的整个教育历程，阻碍了他们的充分表达和潜力。他们理想的全科医学专科培训强调所有培训生的独特性、全面的员工参与包容性、强大的多样性、公平性和包容性（DEI）政策、个人指导、明确的标准、测试问题中简洁的语言使用以及通过强制性的 DEI 员工培训消除偏见。
荷兰的少数民族全科医生培训生面临着重大挑战，如评估和录取的偏见、刻板的课程内容、不足的支持网络和微侵犯，使他们面临表现不佳的风险。他们强调需要有强大的 DEI 政策的包容性培训以消除偏见。
