Chambers Tiffany, O'Brien Bridget
Department of Laboratory Medicine, University of California, San Francisco and San Francisco VA Health System, San Francisco, CA, USA.
Department of Medicine, University of California, San Francisco and San Francisco VA Health System, San Francisco, CA, USA.
Teach Learn Med. 2025 Aug-Sep;37(4):468-479. doi: 10.1080/10401334.2025.2471393. Epub 2025 Aug 5.
The health professions education literature often assumes that diversity, equity, and inclusion (DEI) efforts naturally uplift Black, Indigenous, and People of Color (BIPOC). However, when the most common manifestation of DEI efforts, DEI trainings, are examined, there is little evidence to support this assumption. Metanalyses show evaluation and research studies on DEI trainings seldom ask about the experiences of BIPOC participants, and the few that do complicate this happy narrative. To do DEI work that is transformative, we need to center the perspectives and experiences of individuals who share a history of oppression. This study began in 2022 as an evaluation of a DEI training program. It evolved into a case study after the discovery of identity-based harm in a subset of participant surveys. Using a critical lens, this research centers the experiences of those who identified as BIPOC. A semi-structured interview guide based on the evaluation findings was used to interview eight BIPOC individuals, five faculty and three staff members. Two researchers analyzed the interviews using reflexive thematic analysis to generate themes. Then, the primary author used Critical Race Theory's counterstorytelling methodology to synthesize the interview themes, evaluation findings, fieldnotes and research artifacts into a counterstory on DEI trainings. The counterstory confronts the dominant narratives about DEI training. Such training is not always a transformative education process that uplifts everyone. The counterstory problematizes pedagogies that instrumentalize racial trauma for the benefit of white learners, instructional content that activates racial trauma without the means to process it, and DEI efforts that are performative rather than transformative. This counterstory identifies the ways in which oppressive and racist structures are felt and reproduced in settings meant to uproot it. Although there are no neat answers as to how we might interrupt these systems, critical questions can help to interrogate our assumptions about DEI trainings and (re)-center those pushed to the margins so that we may find our way forward.
健康职业教育文献常常认为，多元化、公平和包容（DEI）工作自然会提升黑人、原住民和有色人种（BIPOC）的地位。然而，当审视DEI工作最常见的表现形式——DEI培训时，几乎没有证据支持这一假设。元分析表明，关于DEI培训的评估和研究很少询问BIPOC参与者的经历，而少数这样做的研究也使这种乐观的说法变得复杂。要开展具有变革性的DEI工作，我们需要以有受压迫历史的个人的观点和经历为中心。这项研究始于2022年，是对一个DEI培训项目的评估。在参与者调查的一个子集中发现基于身份的伤害后，它演变成了一个案例研究。本研究以批判性视角为基础，以那些认定自己为BIPOC的人的经历为中心。基于评估结果制定了一份半结构化访谈指南，用于采访八名BIPOC个人，其中五名教员和三名工作人员。两名研究人员采用反思性主题分析法对访谈进行分析以生成主题。然后，第一作者运用批判种族理论的反叙事方法，将访谈主题、评估结果、实地记录和研究资料综合成一个关于DEI培训的反叙事。该反叙事挑战了关于DEI培训的主流叙事。这种培训并不总是一个能提升所有人的变革性教育过程。该反叙事对将种族创伤工具化以造福白人学习者的教学法、激活种族创伤却没有处理手段的教学内容以及流于形式而非具有变革性的DEI工作提出了质疑。这个反叙事指出了压迫性和种族主义结构在旨在根除它的环境中被感知和重现的方式。虽然对于如何打破这些系统没有简单的答案，但批判性问题有助于审视我们对DEI培训的假设，并（重新）关注那些被边缘化的人，以便我们找到前进的方向。
