Faculty Physician and Trainee Experiences with Micro- and Macroaggressions: a Qualitative Study

Kay, Cynthia; Bernstein, Joanne Scheff; Yass, Natalie; Woodard, Jennifer; Tesfatsion, Sara; Scholcoff, Cecilia

doi:10.1007/s11606-022-07423-6

Cited by 10 publications

(8 citation statements)

References 25 publications

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“…Alternatively, because residents and attending physicians directly contribute to clerkship grading, students may feel instances of bias more poignantly from them. Regardless, the number of reported bias events stemming from attending physicians and residents should be concerning to medical education leaders, particularly given that the reporting of events likely underestimates the total experienced 28 …”

Section: Discussionmentioning

confidence: 99%

“…Regardless, the number of reported bias events stemming from attending physicians and residents should be concerning to medical education leaders, particularly given that the reporting of events likely underestimates the total experienced. 28 Many respondents perceived that the incidence of bias reports has been increasing. There are many possible reasons for this phenomenon.…”

Section: Clerkship Director Self-reported Gender Cmentioning

confidence: 99%

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Bias Reporting in the Clinical Learning Environment: A National Survey of Internal Medicine Clerkship Directors

Henschen,

Pascoe,

Kisielewski

et al. 2023

Acad Med

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Purpose Bias exists in the internal medicine (IM) clinical learning environment; however, it is unclear how often bias is identified by clerkship directors (CDs), how bias is addressed, and whether best practices exist for identifying or mitigating bias. This study investigated how IM CDs receive and respond to bias reports in the clinical learning environment. Method In May 2021, the Clerkship Directors in Internal Medicine (CDIM) created an 18-question survey assessing the frequency of bias reports, macroaggressions and microaggressions, and report outcomes. Of the 152 U.S. medical schools that met study accreditation criteria, the final survey population included 137 CDs (90%) whose medical schools held valid CDIM membership. Results Of the 137 surveys sent, 100 were returned (survey response rate, 73%). Respondents reported a median of 3 bias events (interquartile range, 4-1; range, 0-50) on the IM clerkship in the past year. Among 76 respondents who reported 1 or more event, microaggressions represented 43 of the 75 total events (57%). No mechanism emerged as the most commonly used method for reporting bias. Race/ethnicity (48 of 75 [64%]) and gender (41 of 75 [55%]) were cited most as the basis for bias reports, whereas the most common sources of bias were student interactions with attending physicians (51 of 73 [70%]) and residents (40 of 73 [55%]). Of the 75 respondents, 53 (71%) described the frequency of bias event reports as having increased or remained unchanged during the past year. Only 48 CDs (49%) responded that they were “always” aware of the outcome of bias reports. Conclusions Bias reports remain heterogeneous, are likely underreported, and lack best practice responses. There is a need to systematically capture bias events to work toward a just culture that fosters accountability and to identify bias events through more robust reporting.

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Section: Discussionmentioning

confidence: 99%

Section: Clerkship Director Self-reported Gender Cmentioning

confidence: 99%

Bias Reporting in the Clinical Learning Environment: A National Survey of Internal Medicine Clerkship Directors

Henschen,

Pascoe,

Kisielewski

et al. 2023

Acad Med

View full text Add to dashboard Cite

show abstract

“…In deciding whether to name the microaggression, participants acknowledged not wanting to "make it a big deal" or said, "I don't feel comfortable to call him out." The challenge of calling out a vague yet inappropriate comment has been reported previously (Kay et al, 2022). Even when participants experienced overt discrimination, they often felt hesitant to report these experiences, citing fear of retaliation, job insecurity, and not wanting to "rock the boat.…”

Section: Workplace Discrimination and Microaggressions In The Child L...mentioning

confidence: 94%

Workplace Discrimination and Microaggressions in the Child Life Profession

Gourley

Ginter

Valencia

2022

The Journal of Child Life: Psychosocial Theory and Practice

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The child life profession in the United States primarily comprises White females. Little is known about the experiences of child life specialists with marginalized identities. This exploratory qualitative study examines the experiences of child life students and specialists with marginalized racial, ethnic, sexual orientation, age, and disability identities. Eighteen participants with self-identified marginalized identities took part in a study on navigating the field of child life. The authors used thematic analysis to find themes and subthemes in the data. In this manuscript, themes surrounding microaggressions, the perception of being othered, tokenism, and discrimination experienced in the workplace are described. These findings have implications for research and practice.

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“…They may include transgenders (Nadal et al, 2012), professionals from minority groups (Smith et al, 2022), HIV-positive individuals (Eaton et al, 2020), gender non-conforming and agender individuals (Pulice-Farrow et al, 2020), or adoptees (Baden, 2016). They may even experience microaggressions because their profession is regarded as inappropriate for someone of their sex (Ahmad et al, 2022;Kay et al, 2022).…”

Section: Microaggression Typologiesmentioning

confidence: 99%

Operationalizing Microaggressions: Definitions, Conceptualization and Typologies

McCallaghan,

Steyn

2024

jsss

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Microaggressions are a form of subtle everyday discrimination. Originally proposed in the 1970s, the concept of microaggressions has received increasing attention, particularly in the current cultural focus on social justice. However, recent research has presented a challenge, as several authors have redefined microaggressions and proposed various conceptual frameworks and typologies based on the context of the deed. In this study, a systematic literature review of mainstream definitions, typologies and conceptual features of microaggressions was conducted to consolidate these frameworks. In total 108 research items were found; after screening, 39 research items were included in the review. The main findings suggest that microaggressions are a real form of subtle everyday discrimination, often committed unknowingly by the aggressor. They can take the form of microinsults, microassaults and microinvalidation. While many of the typologies in the research are linked to the minority status of the victim, all microaggression conceptualizations share a distinct but linked set of actions and reactions. The study concludes that there is a need to reconsider the context-specific use of microaggression conceptualizations. In addition, future research should attempt to work within a universal conceptual framework that can be applied across target groups and environments. This will contribute to the development of a larger and more credible body of knowledge, as research findings can then be conceptually linked, opening up possibilities for meta-analyses. Overall, this research provides a summative and inclusive definition and central typology for microaggressions, which will aid in conceptualization and assessment in various contexts.

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Faculty Physician and Trainee Experiences with Micro- and Macroaggressions: a Qualitative Study

Cited by 10 publications

References 25 publications

Bias Reporting in the Clinical Learning Environment: A National Survey of Internal Medicine Clerkship Directors

Bias Reporting in the Clinical Learning Environment: A National Survey of Internal Medicine Clerkship Directors

Workplace Discrimination and Microaggressions in the Child Life Profession

Operationalizing Microaggressions: Definitions, Conceptualization and Typologies

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