Journal of Medical Education and Curricular Development (06/05/23) Tjia, Jennifer; Pugnaire, Michele; Calista, Joanne; et al.
A simulation-based learning intervention sought to mitigate the negative impact of implicit bias in clinician-patient encounters. The multiyear intervention targeted interprofessional hypertension management trainees, including family medicine residents, internal medicine residents and Doctor of Nursing Practice students. The researchers based the intervention's design and deployment on participatory-action research, forging alliances with community, academic and educational stakeholders to fine-tune the training. The authors structured the intervention as a two-session sequence incorporating personalized and group-level learning elements. The content consisted of instruction on healthcare disparities, racismnand implicit bias; implicit association tests (IATs) to expose personal implicit bias; building bias-mitigating communication skills; and case scenarios for simulated interactions with local-community standardized patients (SPs). Sixty-five participants enrolled in the initial trial year. Although interventional experiences were generally positive for community partners and SPs, the latter group wanted more faculty support during in-person debriefings following simulation encounters. First-year trainees also said they felt uncomfortable with intensive sequencing of in-person didactics, IATs and SP simulations in both sessions. In response, the researchers separated didactic sessions from IAT administration and SP simulations. The modified intervention featured more interactive discussions on identity, race, ethnicity and resolutions to address local health system challenges concerning structural racism.
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