Taking the VITALS to Interrupt Microaggressions

Abstract

Introduction: Microaggressions are subtle statements or actions that reinforce stereotypes. Medical students, residents, and faculty report experiences of microaggressions, with higher incidences among women and marginalized groups. An educational tool utilizing the acronym VITALS (validate, inquire, take time, assume, leave opportunities, speak up) provided a framework for processing and addressing microaggressions encountered in the academic health center environment. Methods: We developed a 60-minute workshop designed to raise awareness of microaggressions encountered by medical students and trainees. The workshop consisted of a didactic presentation and multiple interactive exercises shared in small-and large-group formats. Participants also completed pre-and postsurvey instruments to assess changes in their knowledge and attitudes about promoting an environment that prevents microaggressions from occurring. Results: There were 176 participants who completed our workshop. In comparing anonymized pre-and postworkshop responses submitted by attendees, an increase in recognition of one's own potential stereotypical beliefs about social identity groups was observed. Participants also expressed a greater sense of empowerment to foster mutual respect in health care settings. After completing the workshop, attendees indicated a greater likelihood to engage in difficult conversations, including responding to microaggressions, which both peers and superiors encountered in both academic and clinical environments. Discussion: The workshop provided an interactive format for medical students and trainees to gain awareness, knowledge, and tools for addressing microaggressions encountered in health care settings.

Active Bystander Training: Using Standardized Patient Methodology to Teach Residents to Navigate Microaggressions in Patient Encounters

“…For educators interested in replicating this activity at their institution, the WAKE active bystander strategies can be utilized; however, the SP cases provided could also be used with other effective behavioral response frameworks in the medical education literature, such as the 5 D's (direct, distract, delegate, delay, and display discomfort) 24 and VITALS (validate, inquire, take time, assume, leave opportunities, speak up). 25 The SP cases and WAKE active bystander strategies could also be applied to other health care professional trainees.…”

“… 22 , 23 Due to its success on college campuses, active bystander intervention is also being modified to address other forms of oppression, including microaggressions related to racism, sexism, and other forms of prejudice in the clinical learning environment. 20 , 24 , 25 …”

Primum Non Discernere: Glass Ceilings and Female Representation at the European Association of Urology and European Society for Paediatric Urology Annual Meetings, 2012–2022

“…Exposure to an environment of subtle acts of exclusion means that the imposter syndrome becomes normalised and difficult to avoid. This leads to anxiety and fear of exposure, so the individual tries to avoid any situation and thus falls behind their colleagues [35] . It is striking that the female participation in 2021—in both societies and at congresses—was considerably lower than in the previous years and in 2022.…”

Using Simulated Encounters with Standardized Patients to Teach Medical Students to Address Implicit Biases and Microaggressions in the Clinical Setting

“…Surveys were adapted from the UCLA VITALS study to better capture demographic information and qualitative data on the interventions deployed. 8 Survey responses were collected on a 5-point Likert scale and administered using Qualtrics, a third party web-based survey tool for secure data collection. Each survey underwent pre-testing by ten different individuals of similar age range and educational level as our medical students.…”