“I Didn't Know What to Say”: Responding to Racism, Discrimination, and Microaggressions With the OWTFD Approach

Sotto-Santiago, Sylk; Mac, Jacqueline; Duncan, Francesca; Smith, Joseph G.

doi:10.15766/mep_2374-8265.10971

Cited by 61 publications

(58 citation statements)

References 13 publications

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“…A review of the literature within MedEdPORTAL using the search terms microaggressions, racism, inclusion, discrimination, and LGBT revealed three other publications about microaggressions published up to October 2020. [13][14][15] These included two resources on interrupting or addressing microaggressions in the clinical setting and one providing communication tools to assist active bystanders in responding to microaggressions. The current workshop adds to that body of work by offering the Microaggressions Triangle Model, 4 which is based on helping learners to understand microaggressions from the perspectives of all parties involved, including the recipient and the bystander as well as the source of the microaggression.…”

Section: Introductionmentioning

confidence: 99%

Addressing Microaggressions in Academic Health: A Workshop for Inclusive Excellence

et al. 2021

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Introduction Health profession schools have acknowledged the need for a diverse workforce by increasing diversity in recruitment, but little has been done to build inclusive excellence in learning environments. Microaggressions and other forms of mistreatment can increase stress levels and depression and negatively impact academic performance. To increase student performance, retention, and wellness, mitigating microaggressions is needed to promote an inclusive culture. Methods We designed this workshop as a framework to think critically about microaggressions, how they impact the health professions academic environment, and how administrators, faculty, and students can promote inclusion excellence. The workshop included a presentation discussing microaggression theory, seven cases describing microaggressions in the health professions education environment, and discussion and facilitator guides. Cases were based on prior research conducted by the primary author and upon interactions authors shared from their professional experience. Participants completed pre- and postsurveys. Results During six workshops at three different institutions, 138 out of 190 participants (73% response rate), including nursing and medicine faculty, students, and leadership, completed the pre- and postsurveys. Pre- and posttraining measurements found statistically significant improvements in participants' knowledge of the impact of microaggressions, self-efficacy in responding to microaggressions, and commitment to being an active bystander in the face of microaggressions. Participants were highly satisfied with the training. Discussion This humanistic, case-based learning curriculum allows facilitators to guide faculty, student, and leadership conversations to build skills to promote inclusion excellence through preventing microaggressions, repairing and reestablishing relationships, and restoring reputations once microaggressions occur.

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Section: Introductionmentioning

confidence: 99%

Addressing Microaggressions in Academic Health: A Workshop for Inclusive Excellence

et al. 2021

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“…For example, learning and practicing how to respond to instances of racism, sexism, discrimination, and microaggressions should be incorporated into residency education and faculty development. 30 Third, as institutional policies are developed, they should track, report, and respond to incidents in a transparent manner.…”

Section: Discussionmentioning

confidence: 99%

A Survey of Internal Medicine Residents: Their Learning Environments, Bias and Discrimination Experiences, and Their Support Structures

Sotto-Santiago¹,

Mac²,

Slaven³

et al. 2021

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Purpose While there is an emerging body of literature that demonstrates how racism and bias negatively impact the experiences of physicians and trainees from underrepresented groups in medicine in the US, little is known about the experiences of internal medicine trainees and their learning environments. The purpose of this study was to examine these learning environments and explore trainees’ perceptions of race/ethnicity-related topics. Methods A 35-item confidential electronic survey was disseminated to trainees from 11 internal medicine training programs in the US. A total of 142 trainees participated. Purposive sampling ensured alignment with 2018 IM trainee demographics by sex, race and ethnicity. Analyses were performed including chi-square, Fisher’s exact tests, and logistic regression. Results Key findings reveal 63% of respondents perceived disparities in the care provided to diverse patients. Two in three respondents were confident that their institution would respond to discrimination, but only 1/3 of respondents perceived appropriate reporting mechanisms. Black/African American trainees reported needing to minimize aspects of their race and were less likely to perceive their institutions as being supportive to people of color. Conclusion Access to timely information about trainees’ experiences with discrimination and bias in graduate medical education is imperative to disrupt systemic racism and health inequities. Findings suggest a perceived difference in health care provided to minoritized groups, a gap in formal mechanisms for reporting racism and discrimination experienced by trainees, and environments that challenge a sense of belonging. Findings add to current literature exposing the experience of underrepresented trainees in the US.

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“…Critical consciousness is a topic with limited discussion to date in MedEdPORTAL, with existing publications focusing on the application of critical consciousness to onetime educational activities related to faculty development on multicultural education, 5 community empowerment, 6 and responding to racism, discrimination, and microaggressions. 7 The educational content described here overlaps with that of other publications in MedEdPORTAL, including discussions of identity, 8-10 privilege, 8 microaggressions, 7,11,12 racism, 13,14 health disparities, 15,16 the social determinants of health, 15,17,18 and implicit bias. 19,20 However, CCM is unique in that it adopts critical consciousness as the unifying concept and approach for a series of studentled workshops spanning these topics for all first-year medical students at our institution.…”

Section: Introductionmentioning

confidence: 91%

Critical Consciousness as a Framework for Health Equity–Focused Peer Learning

et al. 2021

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Introduction Recognizing the need to teach concepts of health equity, diversity, and inclusion as a part of medical students' preclinical training, we developed a series of workshops in the first year of medical school that introduced students to issues of discrimination and inequity and their effects on health outcomes. This student-led, faculty-supported project, known as Critical Consciousness in Medicine (CCM), adopted critical consciousness as a guiding principle for student learning. Methods Over the course of the 2018–2019 academic year, student leaders developed and delivered five 2-hour workshops to 197 first-year students, with the assistance of student facilitators and input and guidance from faculty advisors. Workshops involved a mix of whole-class presentations and small-group discussions. Session topics included identity and interpersonal relationships, privilege, health disparities, and implicit bias. Results Paired t -test analysis showed statistically significant growth in student self-ratings related to CCM learning objectives as measured in the end-of-year pre-/postsurvey. Student comments in year-end reflections further suggested learning, self-assessment, growth, and appreciation for the workshops' place in the preclinical curriculum. Discussion This project modeled a student-faculty partnership for approaching diversity, inclusion, and health equity in medical education and highlighted the role of students as leaders in educating their peers. The CCM workshop series demonstrated high acceptability as a component of preclinical medical education and may increase student engagement around social issues in health care. CCM also illustrated the promise of using critical consciousness as an approach to educating medical students about equity, diversity, and inclusion.

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“I Didn't Know What to Say”: Responding to Racism, Discrimination, and Microaggressions With the OWTFD Approach

Cited by 61 publications

References 13 publications

Addressing Microaggressions in Academic Health: A Workshop for Inclusive Excellence

Addressing Microaggressions in Academic Health: A Workshop for Inclusive Excellence

A Survey of Internal Medicine Residents: Their Learning Environments, Bias and Discrimination Experiences, and Their Support Structures

Critical Consciousness as a Framework for Health Equity–Focused Peer Learning

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