Numerous studies show that racism and discrimination from patients have a negative effect on resident and fellow well-being. Medical educators are in a strong position to intervene on behalf of residents and fellows, but not all feel they have the skills to do so.
In the poster, “Responding to Racism in the Learning Environment,” Shauna Gibbons, MD, explores how providing tools to educators can affect how racism is addressed in the learning environment. Dr. Gibbons presented the team’s work in the Poster Hall at the 2023 ACGME Annual Educational Conference, held February 23-25, 2023, in Nashville, Tennessee.
Poster Title: Responding to Racism in the Learning Environment
Primary Author: Shauna Gibbons, MD
Co-Authors: Lindy Landzaat, DO; Kellie Krase, MD; Lori Spoozak, MD, MHS
ACGME: Tell us about your academic and professional role.
Dr. Gibbons: I am an assistant professor of palliative medicine and a core faculty member in the internal medicine residency program at the University of Kansas Medical Center in Kansas City, Kansas.
ACGME: Can you briefly describe your research project for us?
Dr. Gibbons: We created a faculty development workshop with the aim of giving medical educators tools to help them better respond in the moment to incidents in which learners—including medical students, residents, and fellows—faced discrimination and racism directed toward them by patients or patients’ family members during rounds. The workshop included a didactic section, provision of scripted language, and the opportunity to practice this language in breakout groups, followed by large group debriefing. The aim was to increase confidence in faculty members’ ability to identify and respond to incidents of racism in a timely and appropriate manner.
ACGME: What inspired you to do this project?
Dr. Gibbons: Creating a safe and inclusive learning environment for all medical learners was our motivation for this project. We believe that it is a critical component of the work to recruit residents and fellows from diverse backgrounds.
ACGME: What did you discover?
Dr. Gibbons: Academic faculty members did not feel well equipped to deal with incidents of racism and had not had prior training on how to respond, or even an opportunity to discuss how distressing these incidents have been. Faculty members’ confidence in their ability to respond increased after going through the workshop, particularly because of the scripted language provided, coupled with the opportunity to practice and debrief. This workshop was specifically focused on faculty member upstander behavior when a learner is on the receiving end of inappropriate language or behavior. There is still a need for guidance in how to respond when the attending is the target of inappropriate language or behavior.
ACGME: What was the main takeaway?
Dr. Gibbons: Providing scripted language and the ability to practice the language in small groups helped increase faculty member confidence in responding to discrimination and racism directed at learners. This language is both scripted and direct; it does not follow traditional interpersonal communication skills taught to medical professionals that often rely on aligning and finding mutual understanding.
ACGME: Who could benefit from this?
Dr. Gibbons: We initially enrolled faculty members in leadership roles within their programs, including program directors, associate program directors, and core faculty members. I think all faculty members supervising medical students, residents, and fellows could also benefit from this.
ACGME: Any additional follow-up plans?
Dr. Gibbons: We plan to have two additional sessions this year for graduate medical education program leadership. There has also been interest in expanding this to all academic faculty members.