What Happened and Why: Responding to Racism, Discrimination, and Microaggressions in the Clinical Learning Environment

Silva, Helio V Neves da; Heery, Lauren M.; Cohen, William R.; Mahalingam, Vikasini S.; Adebiyi, Oluwatosin A.; Lee, Rita S.; Netsanet, Adom; Ogundipe, Eniola; Dakhama, Yasmine; Wang, Mary L.; Vrolijk, Michael Aaron; Garcia, Mackenzie W.; Ward‐Gaines, Jacqueline; Neumeier, A.

doi:10.15766/mep_2374-8265.11280

Cited by 7 publications

(8 citation statements)

References 25 publications

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“…The present findings support previous studies that have shown that engaging in simulated scenarios can create a heightened sensitivity toward and awareness of discriminatory behaviors in the short term. 9,13,14,19 Our study indicates that a clinical simulation-based training can be an innovative and effective educational method for teaching professionals upstander communication skills.…”

Section: Reflec Tive Discussionmentioning

confidence: 71%

“…Outcome was measured on a Likert-type scale (1-10), and the data were gathered using a survey previously used in similar health equity training. 13 We also collected information on prior JEDI-related training, satisfaction with the simulation, and suggestions for future improvements. Primary outcome and demographic data were obtained and managed using REDCap tools.…”

Section: Outcome Smentioning

confidence: 99%

“…Earlier simulations for resident physicians have demonstrated enhanced confidence and comprehension of essential concepts in health care disparities. [11][12][13][14] Many clinicians encounter RDM in clinical settings, 15 but less than half report knowing how to intervene when witnessing RDM. 16 Health equity-focused simulation training is primarily based on internal medicine literature.…”

Section: Introductionmentioning

confidence: 99%

“…17 Previous simulation-based training has been employed to educate healthcare professionals about the impact of bias in patient care. 11,13,18 However, there is scarce data on its effectiveness in managing patients displaying racist behaviors. Current data on reducing racial health disparities by addressing RDM do not adequately cover the necessary training for practical implementation.…”

Section: Introductionmentioning

confidence: 99%

“…Simulation‐based training could effectively explore JEDI topics like racism, discrimination, and microaggressions (RDM). Earlier simulations for resident physicians have demonstrated enhanced confidence and comprehension of essential concepts in health care disparities 11–14 …”

Section: Introductionmentioning

confidence: 99%

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A national pilot study on simulation‐based upstander training for emergency medicine clinicians

Mundo,

Vaughn,

Odetunde

et al. 2024

AEM Education and Training

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ObjectiveThis study assesses the effectiveness of clinical simulation‐based training in boosting self‐perceived confidence for using upstander communication skills to confront racism, discrimination, and microaggressions (RDM).MethodsWe conducted an observational cohort study with emergency medicine professionals at the 2023 Scientific Assembly of the American Academy of Emergency Medicine in New Orleans, Louisiana. The study featured a clinical simulation‐based training on upstander communications skills session followed by small‐ and large‐group debriefs. Participants completed pre‐ and post‐training questionnaires assessing demographics and confidence in health equity competencies. This survey was used in a previous study with emergency medicine residents. Data were analyzed using an independent Student's t‐test, with a significance threshold of 0.05.ResultsThirty‐two individuals participated in the simulation‐based training, and 24 completed surveys, with a 75% response rate. Most participants were non‐Hispanic (24, 85.7%) and women (18, 64%), with racial demographics mostly White (8, 28.6%), Black or African American (8, 28.6%), and Asian (6, 21.4%). After the workshop, there was a notable increase in self‐perceived ability and confidence in identifying RDM (from 7 ± 3.2 to 8.6 ± 1.6, p < 0.003), using upstander communication tools (from 6.1 ± 3.5 to 8.5 ± 1, p < 0.0001), and the likelihood of intervening in RDM situations (from 7.1 ± 3.3 to 8.8 ± 1.1, p < 0.0002).ConclusionsThe clinical simulation‐based training significantly improved participants' confidence and self‐perceived ability to address RDM in simulated clinical environments. This training method is a promising tool for teaching health equity topics in clinical medicine.

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Section: Reflec Tive Discussionmentioning

confidence: 71%

Section: Outcome Smentioning

confidence: 99%