Caring for patients can be highly rewarding and can also at be times stressful or hurtful. Most clinical encounters go smoothly, but some may involve microaggressions, biased comments or assaults toward you, your colleagues or your educators. We feel that it is important to acknowledge that these encounters will occur and to empower you with different tools and ways to potentially respond.
The Microaggression module (please review the module) defines microaggressions, discusses their impact on you as the learner and gives several potential responses in the moment. It focuses on interactions with patients, but many of these techniques also apply to the classroom environment and addressing biased comments from your educators, co-workers or peers. We acknowledge that addressing these comments is challenging and a burden that disproportionately impacts certain students. The additional element of the patient care relationship can make this even harder. We invite you to review this module so you can continue to develop a tool box of potential approaches to addressing biased behavior. Options include:
- Excuse yourself from the encounter and find your mentor/preceptor or someone you trust to debrief the encounter.
- Redirect the comment in the moment and proceed with the clinical encounter. We would encourage you to debrief the situation with someone you trust after the encounter.
- Address the comment in the moment to correct/redirect/interrupt the biased statement. Consider using one of these options:
- Interrupt: Speak up against biased remarks
- Question: Ask questions to understand why the remark was made
- Educate: Explain why the remark was offensive
- Echo: If someone else speaks out, thank them
Early on in medical school most of your interactions with patients are focused on your education. As you progress into your clerkships and beyond, you will assume a greater level of responsibility for patient care. The option of excusing yourself from the encounter is still available but will require some additional assessment of the patient’s illness acuity and strategies to continue to provide medical care while still addressing the hurtful behavior. Reaching out to other team members for help with addressing the hurtful behavior and caring for the patient is encouraged.
Optional reading: The chapter Deconstructing Racism and Bias in Clinical Medicine introduces the following strategies for care providers to follow. Specific examples of how to accomplish these approaches are included in the section on Biased Patient Behavior. Some of the approaches address the following:
- Assess illness acuity
- Cultivate a therapeutic relationship
- Depersonalize the event
- Ensure a safe learning environment for trainees
There are two ways to access this content:
- Via Clinical Key (Links to an external site.) using your NetID. Readable but not optimally formatted
- Via the publisher’s e-book. Free and more readable, requires registration https://bit.ly/2YAzvqn
Reflecting back upon any challenging encounters consider whether any of these approaches may have been helpful? Might you be able to utilize any of these approaches in the future? As college faculty mentors, it is our responsibility to acknowledge that these situations will occur and make a commitment to you all that we will work to respond to these situations when then occur and we will support you in the choices you make on how you want to respond in the moment. We invite conversations with you and the opportunity to provide support for the times when we are not around when these microaggressions or other assaults may occur.
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