Teaching resident physicians the power of implicit bias and how it impacts patient care utilizing patients who have experienced incarceration as a model

Abstract

Over 2 million adults in the United States are incarcerated and over 650,000 return to the community each year. This disparate population is known to have an elevated burden of chronic disease and lower socioeconomic status. Medical residency training about care of incarcerated or previously incarcerated patients is significantly lacking in the United States. Curriculum can be developed and implemented in residency programs to help physicians learn how to work with this population, be sensitive to their unique needs, and achieve positive health outcomes. This article describes a method for "educating the educators" based on a workshop presented at a peer-reviewed national conference during the fall of 2016. Attendees participated in exercises addressing assumptions, expectations, bias, and worldview and increased their ability for self-reflection when interacting with patients who are or have experienced incarceration. In this session, strategies were identified that engaged the patient with the goal to aid in patient retention and compliance. Future steps include development of a formal curriculum for training in this area, incorporation into existing community medicine rotations or electives, and establishment of structured transition clinics where residents can be exposed to this population on a more regular basis and improve their overall health outcomes.

Remediation Through Transformation: Applying Educational Theory to the Struggling Resident

“…38 There are multiple examples of transformative learning for social change through care of the medically underserved. 25,[41][42][43] While these experiences highlighted active learning, an interactive approach to TL for social change may result in a higher engagement. 44 This was demonstrated in a singlecenter study where self-regulated learning through medical student team-created videos exploring the societal role of the physician and the importance of social determinants of health were shown to be interesting, enjoyable, and preferred over all prior methods used to topics, including simple field visits.…”

Criminality labelling influences reactions to others’ pain

“…Our finding that criminality labelling did not influence pain intensity estimates implies that providing interventions that focus on decoding of pain signals may not be effective to counteract disparities in pain management. Instead, interventions that target cognitive biases ( Berry & Weiner, 2020 ; Cikara, Bureau & Saxe, 2011 ; Hofmeister and Soprych, 2017 ; Sevillano and Fiske, 2016 ), such as individuation of out-group members and imagining positive interactions with out-group members ( Miles and Crisp, 2014 ), might be more effective to reduce pain underestimations.…”

An ecological approach to understanding and addressing health inequities of systemic lupus erythematosus

“…A mutual, open dialog with students and residents about health inequities can help seasoned and incoming practitioners improve practice. 89,90 Research A first step toward addressing inequities would be to adopt a lens that focuses a researcher's eye on broader societal structures and their effects on individual-level phenomena. Intersectionality is such a lens.…”

“…A mutual, open dialog with students and residents about health inequities can help seasoned and incoming practitioners improve practice. 89,90…”