Building a Tool Kit for Medical and Dental Students: Addressing Microaggressions and Discrimination on the Wards

Sandoval, Raquel Sofia; Afolabi, Titilayo; Said, Jordan T.; Dunleavy, Spencer; Chatterjee, Avik; Ölveczky, Daniele

doi:10.15766/mep_2374-8265.10893

Cited by 64 publications

(65 citation statements)

References 49 publications

(58 reference statements)

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“…4 Institutional training often omits guidance on dealing with sexual harassment from patients, 4 and formal reporting procedures do not account for more common forms of discrimination, such as inappropriate sexual remarks and gender-based microaggressions. 5 To our knowledge, there is no published resource for resident physicians on how to address patient-initiated sexual harassment themselves.…”

Section: Introductionmentioning

confidence: 99%

“…Previous authors in MedEdPORTAL have described curricula for faculty on responding to patient mistreatment of medical trainees; however, their work has focused on directly observed mistreatment. To our knowledge, there are only two modules 5 , 10 in MedEdPORTAL on addressing patient mistreatment of medical trainees. Like the ERASE curriculum of Wilkins and colleagues, 10 , 11 our module uses an interactive workshop to teach communication tools for responding to discriminatory comments made by patients.…”

Section: Introductionmentioning

confidence: 99%

“…Like the ERASE curriculum of Wilkins and colleagues, 10 , 11 our module uses an interactive workshop to teach communication tools for responding to discriminatory comments made by patients. However, where the ERASE model trains faculty and senior residents to address directly observed patient mistreatment toward junior medical trainees and the model by Sandoval and colleagues 5 encourages junior medical students to enlist supervising faculty in responding to microaggressions, our workshop empowers residents and faculty to respond to inappropriate patient comments themselves. Our module recognizes that many instances of inappropriate patient behavior occur in one-on-one situations, such as during after-hours clinical care, and are unlikely to be witnessed by supervisors.…”

Section: Introductionmentioning

confidence: 99%

“…Our module recognizes that many instances of inappropriate patient behavior occur in one-on-one situations, such as during after-hours clinical care, and are unlikely to be witnessed by supervisors. Unlike the ERASE model 10 and the module on microaggressions by Sandoval and colleagues, 5 this workshop limits its focus to gender-based harassment, though its communication tools are applicable to other forms of identity-based discrimination. We emphasize gender-based discrimination and harassment because they are the most common type experienced by resident physicians 8 and the workshop was developed to address resident needs at our institution.…”

Section: Introductionmentioning

confidence: 99%

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Tools for Responding to Patient-Initiated Verbal Sexual Harassment: A Workshop for Trainees and Faculty

Hock

Barlow

Scruggs³

et al. 2021

MedEdPORTAL

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Introduction: Patients are the most common source of gender-based harassment of resident physicians, yet residents receive little training on how to handle it. Few resources exist for residents wishing to address patient-initiated verbal sexual harassment themselves. Methods: We developed, taught, and evaluated a 50-minute workshop to prepare residents and faculty to respond to patient-initiated verbal sexual harassment toward themselves and others. The workshop used an interactive lecture and role-play scenarios to teach a tool kit of communication strategies for responding to harassment. Participants completed retrospective pre-post surveys on their ability to meet the learning objectives and their preparedness to respond. Results: Ninety-one participants (57 trainees, 34 faculty) completed surveys at one of five workshop sessions across multiple departments. Before the workshop, two-thirds (67%) had experienced patient-initiated sexual harassment, and only 28 out of 59 (48%) had ever addressed it. Seventy-five percent of participants had never received training on responding to patient-initiated sexual harassment. After the workshop, participants reported significant improvement in their preparedness to recognize and respond to all forms of patient-initiated verbal sexual harassment (p < .01), with the greatest improvements noted in responding to mild forms of verbal sexual harassment, such as comments on appearance or attractiveness or inappropriate jokes (p < .01). Discussion: This workshop fills a void by preparing residents and faculty to respond to verbal sexual harassment from patients that is not directly observed. Role-play and rehearsal of an individualized response script significantly improved participants' preparedness to respond to harassment toward themselves and others.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Tools for Responding to Patient-Initiated Verbal Sexual Harassment: A Workshop for Trainees and Faculty

Hock

Barlow

Scruggs³

et al. 2021

MedEdPORTAL

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“…Implicit bias contributes to health disparities through clinical decision‐making and communication by health professionals 1,3 . Therefore, implicit bias continues to be a focus of health professions education 4‐17 . One of the most widely used tools in implicit bias research and education is the Implicit Association Test (IAT) 1,18 ; the IAT is an online latency response test measuring reaction times to matching images and value‐laden words 19,20 .…”

Section: Introductionmentioning

confidence: 99%

Qualitative analysis of medical student reflections on the implicit association test

et al. 2021

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Introduction Health professions educators use the Implicit Association Test (IAT) to raise awareness of implicit bias in learners, often engendering strong emotional reactions. Once an emotional reaction ensues, the gap between learner reaction and strategy identification remains relatively underexplored. To better understand how learners may identify bias mitigation strategies, the authors explored perspectives of medical students during the clinical portion of their training to the experience of taking the IAT, and the resulting feedback. Methods Medical students in Bronx, NY, USA, participated in one 90‐minute session on implicit bias. The focus of analysis for this study is the post‐session narrative assignment inviting them to take the race‐based IAT and describe both their reaction to and the implications of their IAT results on their future work as physicians. The authors analysed 180 randomly selected de‐identified essays completed from 2013 to 2019 using an approach informed by constructivist grounded theory methodology. Results Medical students with clinical experience respond to the IAT through a continuum that includes their reactions to the IAT, acceptance of bias along with a struggle for strategy identification, and identification of a range of strategies to mitigate the impact of bias on clinical care. Results from the IAT invoked deep emotional reactions in students, and facilitated a questioning of previous assumptions, leading to paradigm shifts. An unexpected contrast to these deep and meaningful reflections was that students rarely chose to identify a strategy, and those that did provided strategies that were less nuanced. Conclusion Despite accepting implicit bias in themselves and desiring to provide unbiased care, students struggled to identify bias mitigation strategies, a crucial prerequisite to skill development. Educators should endeavour to expand instruction to bridge the chasm between students’ acceptance of bias and skill development in management of bias to improve the outcomes of their clinical encounters.

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Assessing the experience of dental students with an asynchronous online course about racism, cultural competence

Crawford

Hillier

2022

Journal of Dental Education

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SP2) designed an asynchronous online course about racism and cultural competence to address student concerns about harmful interactions with peers across race/ethnicity. The Penn Experience Course establishes common language and concepts to facilitate difficult conversations about racism in the classroom and clinical spaces. Methods: The course included six modules addressing the history of racism in the Philadelphia area and at the University of Pennsylvania: implicit bias and microaggressions; racism and other forms of oppression; gender identity and sexuality; construction of whiteness and white supremacy ideology; cultural humility, disparities, and equity; and access in healthcare. Students completed pre-and post-course surveys about their likelihood of engaging with the neighborhood surrounding Penn, confidence discussing the topics covered, and general experience with the course.Results: Four hundred forty-nine students completed post-course surveys, 220 of which could be linked to precourse survey responses. Overwhelmingly, students reported a positive experience with the course, an increase in their likelihood to engage with the Penn neighborhood, and increased confidence in discussing course topics with peers. Many students suggested incorporating synchronous discussion, while a smaller group expressed resentment about the focus on whiteness, white fragility, and anti-Black racism. Several students of color expressed concern that the course centered the learning needs of white students. Conclusion:Asynchronous online content offers an effective and efficient way of teaching dental students about the basics of cultural competence. Educators should anticipate resistance from some white students and the distinct learning needs of students of color.

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Building a Tool Kit for Medical and Dental Students: Addressing Microaggressions and Discrimination on the Wards

Cited by 64 publications

References 49 publications

Tools for Responding to Patient-Initiated Verbal Sexual Harassment: A Workshop for Trainees and Faculty

Tools for Responding to Patient-Initiated Verbal Sexual Harassment: A Workshop for Trainees and Faculty

Qualitative analysis of medical student reflections on the implicit association test

Assessing the experience of dental students with an asynchronous online course about racism, cultural competence

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