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Developing Awareness and Allies: Simulating Difficult Conversations about Microaggressions for Faculty and Students

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Discrimination is a common experience among medical students in clinical settings, especially those who belong to ethnic or gender minority groups in medicine. This article describes a novel, simulation-based approach… Click to show full abstract

Discrimination is a common experience among medical students in clinical settings, especially those who belong to ethnic or gender minority groups in medicine. This article describes a novel, simulation-based approach to improve medical students’ resilience and communication, as well as educates faculty members on unintentional discriminatory practices. Abstract Objectives Discrimination and bias in clinical training often take the form of microaggressions, which, albeit unintentional, are detrimental to the learning environment and well-being of students. Although there are a few reports of medical schools training students to respond to microaggressions, none have included a complementery student-led faculty training module. The aim of this study was to develop and evaluate a case-based approach to improving student resilience and increasing faculty awareness of microaggressions in the clinical setting. Methods We created four realistic cases of microaggressions and uncomfortable conversations, based on students’ experiences on the wards, to implement training for incoming third-year students and their core faculty. Standardized patients were trained to effectively portray discriminatory faculty, residents, and patients. Institutional review board–approved surveys were administered and statistically analyzed to evaluate for efficacy. Results Students had greater mean confidence scores for responding to microaggressions immediately and at 6 months after the sessions (P < 0.05). Faculty showed improved mean confidence and understanding of the definition of a microaggression (P < 0.05). Conclusions This approach had results similar to other studies, with the additional benefit of training faculty with the same scenarios. We believe that this method helped bridge the gap between students’ notions of discrimination and faculty understanding of microaggressions.

Keywords: developing awareness; awareness allies; faculty; difficult conversations; simulating difficult; allies simulating

Journal Title: Southern Medical Journal
Year Published: 2022

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