一种应对医学教育环境中微侵犯行为的创新方法。

An Innovative Approach to Navigating Microaggressions in Medical Education Settings.

作者信息

Morrison Nariell, Ashaye Olutunmise, Onanuga Simisola, Okechukwu Hannah, Wihba Kinan, Izzi-Engbeaya Chioma, Sam Amir H

机构信息

N. Morrison is a physician and clinical education fellow (equality, diversity, and inclusivity), Imperial College School of Medicine, Imperial College London, London, United Kingdom, and honorary clinical research fellow, Warwick Medical School, University of Warwick, Coventry, United Kingdom; ORCID: https://orcid.org/0000-0001-6961-0032.

O. Ashaye is a physician and former clinical education fellow (equality, diversity, and inclusivity), Imperial College School of Medicine, Imperial College London, London, United Kingdom.

出版信息

Acad Med. 2024 Dec 18;100(5):567-71. doi: 10.1097/ACM.0000000000005946.

DOI:10.1097/ACM.0000000000005946

PMID:39692475

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12036769/

Abstract

PROBLEM

Microaggressions negatively affect the experiences of medical students, especially those from minoritized groups, indicating the need for heightened awareness and open dialogue. The increasing recognition of the potential harm caused by such behaviors has led to a call for educational strategies that enable medical students to identify and address microaggressions effectively. This report details an innovative approach designed to navigate the complexities of microaggressions within medical education settings.

APPROACH

In December 2023, 2 senior medical educators facilitated an in-person lecture, which consisted of short videos cocreated with students, interactive online surveys, and a presentation. The lecture aimed to enable third-year medical students at Imperial College School of Medicine to describe and recognize microaggressions and other forms of inappropriate behavior, understand the impact of microaggressions in medical education settings, develop problem-solving skills to challenge inappropriate behavior, and differentiate the informal and formal mechanisms to raise concerns.

OUTCOMES

The final data set consisted of 183 participants. Participants reported increases in confidence in identifying microaggressions (median [IQR], 4.00 [3.00-4.00] before vs 4.00 [4.00-5.00] after intervention; P < .001), understanding their potential effect on affected individuals (median [IQR], 4.00 [3.00-5.00] before vs 5.00 [4.00-5.00] after intervention; P < .001), and feeling better equipped to challenge inappropriate experienced (median [IQR], 2.00 [2.00-3.00] before vs 3.00 [2.00-4.00] after intervention; P < .001) or witnessed (median [IQR], 3.00 [2.00-3.00] before vs 4.00 [3.00-4.00] after intervention; P < .001) behaviors. They also reported increases in confidence in seeking support from their peers if they experienced (median [IQR], 4.00 [3.00-5.00] before vs 4.00 [4.00-5.00] after intervention; P < .001) or witnessed (median [IQR], 4.00 [3.00-4.00] before vs 4.00 [3.00-5.00] after intervention; P < .001) microaggressions.

NEXT STEPS

Next steps include integrating small group workshops on microaggressions into curricula and adapting these interventions for other health care professionals.

摘要

问题

微侵犯行为对医学生的经历产生负面影响，尤其是对来自少数群体的医学生，这表明需要提高认识并开展开放对话。人们越来越认识到此类行为可能造成的危害，因此呼吁制定教育策略，使医学生能够有效识别和应对微侵犯行为。本报告详细介绍了一种创新方法，旨在应对医学教育环境中微侵犯行为的复杂性。

方法

2023年12月，两名资深医学教育工作者组织了一场面对面讲座，内容包括与学生共同创作的短视频、交互式在线调查和一次演示。该讲座旨在使帝国理工学院医学院的三年级医学生能够描述和识别微侵犯行为及其他形式的不当行为，理解微侵犯行为在医学教育环境中的影响，培养解决问题的技能以应对不当行为，并区分提出关切的非正式和正式机制。

结果

最终数据集包括183名参与者。参与者报告称，在识别微侵犯行为方面的信心有所增强（干预前中位数[四分位间距]为4.00[3.00 - 4.00]，干预后为4.00[4.00 - 5.00]；P <.001），对微侵犯行为对受影响个体的潜在影响的理解有所增强（干预前中位数[四分位间距]为4.00[3.00 - 5.00]，干预后为5.00[4.00 - 5.00]；P <.001），并且感觉更有能力应对自己经历（干预前中位数[四分位间距]为2.00[2.00 - 3.00]）或目睹（干预前中位数[四分位间距]为3.00[2.00 - 3.00]）的不当行为（干预后自己经历的中位数[四分位间距]为3.00[2.00 - 4.00]；目睹的为4.00[3.00 - 4.00]；P <.001）。他们还报告称，如果自己经历（干预前中位数[四分位间距]为4.00[3.00 - 5.00]，干预后为4.00[4.00 - 5.00]；P <.001）或目睹（干预前中位数[四分位间距]为4.00[3.00 - 4.00]，干预后为4.00[3.00 - 5.??0]；P <.001）微侵犯行为，向同伴寻求支持的信心有所增强。