When Race Matters on the Wards: Talking About Racial Health Disparities and Racism in the Clinical Setting.
When Race Matters on the Wards: Talking About Racial Health Disparities and Racism in the Clinical Setting.
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DOI：
10.15766/mep_2374-8265.10523
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发表时间：
2016-12-28
影响因子：
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通讯作者：
George, Paul
中科院分区：
文献类型：
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作者：
Brooks, Katherine C;Rougas, Steven;George, Paul
简介：越来越多的文献说明种族偏见对临床护理的负面影响。尽管有越来越多的证据，医学院在做出必要的课程改变方面进展缓慢。大多数关于种族健康差异的教育尝试都侧重于传播知识，而不是促进理解个人偏见或解决临床环境中的偏见和种族主义的技能的发展。为了解决这个问题，我们为即将入学的三年级医学生开发了基于案例的小组课程。方法：本课程设计为同时进行，时长 1 小时的小组课程，每个小组最好由不超过 10 名学生和一名辅导员组成。该课程已纳入现有的为期 3 周的见习准备课程，该课程在 2015-2016 学年为 122 名学生提供。会议材料包括主持人指南和三个供讨论的案例。 结果：会议使用 6 点李克特量表进行评估（1 = 差，6 = 特殊）。学生对本次课程的总体评分为 4.28 分（满分 6 分）（N = 79）。定性反馈各不相同，最常见的主题集中在需要更多时间来讨论该主题。讨论：虽然开始临床实习前的一次会议不足以维持对临床医学中的偏见和种族主义的持续批判性思维实践，但本次会议是课程开发人员寻求在临床护理中使用基于证据的方法来解决种族偏见的起点。
INTRODUCTION: There is a growing body of literature illustrating the negative impact of racial bias on clinical care. Despite the growing evidence, medical schools have been slow to make necessary curricular changes. Most attempts to educate on racial health disparities focus on transferring knowledge and do not foster the development of skills to understand one's own bias or address bias and racism in the clinical setting. To address this, we developed a small-group, case-based curriculum for rising third-year medical students.METHODS: This session was designed to be delivered in concurrently run, 1-hour small-group sessions, with each small group ideally comprising no more than 10 students and one facilitator. The curriculum was integrated into an existing 3-week clerkship preparation course for 122 students during the 2015-2016 academic year. The session materials include a facilitator's guide and three cases for discussion.RESULTS: The session was evaluated using a 6-point Likert scale (1 = poor, 6 = exceptional). Students rated this session overall a 4.28 out of 6 (N = 79). Qualitative feedback varied, with the most common theme focusing on the need for more time to discuss this topic.DISCUSSION: Though one session before starting clinical clerkships is not enough to maintain the practice of sustained critical thinking regarding bias and racism in clinical medicine, this session is a starting point for curriculum developers looking to use an evidence-based approach to racial bias in clinical care.