UNASSIGNED: In the context of an NIH-funded clinical trial to address healthcare disparities in hypertension management, research and education faculty at an academic medical center used a participatory action research approach to engage local community members to develop and refine a \"knowledge, awareness, and skill-building\" bias recognition and mitigation program. The program targeted medical residents and Doctor of Nursing Practice students. The content of the two-session training included: didactics about healthcare disparities, racism and implicit bias; implicit association test (IAT) administration to raise awareness of personal implicit bias; skill building for bias-mitigating communication; and case scenarios for skill practice in simulation-based encounters with standardized patients (SPs) from the local community.
UNASSIGNED: The initial trial year enrolled n = 65 interprofessional participants. Community partners and SPs who engaged throughout the design and implementation process reported overall positive experiences, but SPs expressed need for greater faculty support during in-person debriefings following simulation encounters to balance power dynamics. Initial year trainee participants reported discomfort with intensive sequencing of in-person didactics, IATs, and SP simulations in each of the two training sessions. In response, authors refined the training program to separate didactic sessions from IAT administration and SP simulations, and to increase safe space, and trainee and SP empowerment. The final program includes more interactive discussions focused on identity, race and ethnicity, and strategies to address local health system challenges related to structural racism.
UNASSIGNED: It is possible to develop and implement a bias awareness and mitigation skills training program that uses simulation-based learning with SPs, and to engage with local community members to tailor the content to address the experience of local patient populations. Further research is needed to measure the success and impact of replicating this approach elsewhere.
■在NIH资助的一项旨在解决高血压管理中医疗保健差异的临床试验中,学术医学中心的研究和教育教师使用参与式行动研究方法吸引当地社区成员发展和完善“知识,意识,和技能建设“偏见识别和缓解计划”。该计划针对医疗居民和护理实践学生的医生。两节培训的内容包括:关于医疗保健差距的说教,种族主义和内隐偏见;内隐联想测验(IAT)管理,以提高对个人内隐偏见的认识;用于缓解偏见的沟通的技能建设;以及与当地社区标准化患者(SP)进行基于模拟的相遇中的技能实践的案例场景。
■初始试验年登记了n=65名跨专业参与者。参与整个设计和实施过程的社区合作伙伴和SP报告了总体积极的经验,但是SP表示,在模拟遇到以平衡动力动力的情况下,在亲自汇报期间需要更多的教职员工支持。最初一年的受训学员报告说,他们对面对面教学法的密集排序感到不适,IAT,和SP模拟在两个培训课程中的每一个。作为回应,作者改进了培训计划,将教学课程与IAT管理和SP模拟分开,为了增加安全空间,以及受训者和SP授权。最终的节目包括更多的互动讨论,重点是身份,种族和民族,以及应对与结构性种族主义有关的地方卫生系统挑战的战略。
■可以开发和实施偏见意识和缓解技能培训计划,该计划使用基于模拟的学习与SP,并与当地社区成员接触,以定制内容,以解决当地患者人群的体验。需要进一步的研究来衡量在其他地方复制这种方法的成功和影响。