Plenary Session Comments

Mitigating Microaggressions in Medical Education Through the TRAUMA Framework

“…As students are constantly navigating these interactions, microaggressions cause distress and affect the victim’s well-being, 1,5 leading to depression, performance anxiety, general anxiety, and burnout. URM students have endured lower quality of life, decreased well-being, and lack of support 4,6 compared with their White colleagues, demonstrating the detriment of these learning environments and of microaggressions in education 4–8 …”

“…A report from the Student National Medical Association (SNMA) discussed reflections from student-led discussions among over 300 URM students from 19 states held during the 2016–2017 Regional Medical Education Conferences 8 . Students noted that inappropriate jokes and statements most often came from efforts to amuse others.…”

“…Students noted that inappropriate jokes and statements most often came from efforts to amuse others. However, additional statements intended as compliments were also insulting, including commenting on names, outward appearances, and even speech (e.g., including the surprise that one “sound[s] professional”) 8 . Immigrant or first-generation American URM students noted additional comments targeting their culture, language, and names, and the challenges associated with the erasure of themselves to assimilate into the culture of medical education as offering alternate preferred names and codeswitching were used to cope 8 …”

“…Students of African, Hispanic, and/or Latinx descent, as well as those from a lower socioeconomic status, nonmale gender identity, and lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) identity face unique struggles on the path to becoming to a physician. These challenges include discriminatory practices, both institutional and otherwise, and “microaggressions,” subtle critical remarks directed toward marginalized groups 1–14 . Microaggressions also affect those impacted by stereotypes, including students of varying ability, size, and nationality.…”

“…Microaggressions are categorized as (1) microassaults, or direct offenses like racial slurs; (2) microinsults, or insinuations that people from minoritized backgrounds are worth less than others; and (3) microinvalidations, or words and actions that negate the experiences of those from minoritized backgrounds 2,11,12 . This marginalization is detrimental to the health and success of targeted students and groups 4–8,12 . Themes of microaggressions include “ascriptions of intelligence,” or assumptions about one’s abilities; “alien in one’s own land,” or assumptions about culture and dialect; “denial of racial reality,” wherein the experiences of URM students are dismissed; and “assumptions of criminality,” or assumptions that URM students are untrustworthy 3 …”