Attending Physician The Children's Hospital of Philadelphia Philadelphia, Pennsylvania, United States
Background: Trainees often report struggles with identifying/addressing microaggressions in real-time. In response, we developed an innovative simulated microaggression response training session, entitled, "Building Comfort in the Uncomfortable: Identifying and Addressing Microaggressions in the Clinical Learning Environment" to provide trainees with skills in this area. Objective: The objectives of the session are for learners to describe the subtypes of microaggressions and the subsequent negative impacts, identify microaggressions in real-time and utilize communication tools/cognitive maps to address them in a simulated environment, while recognizing the need to support colleagues who have experienced microaggressions. Design/Methods: We disseminated a needs assessment to our trainees (n = 157) to identify the frequency of pediatric residents experiencing/witnessing workplace microaggressions which revealed the presence of frequent workplace microaggressions with our URiM trainees experiencing the highest burden and a general sense from all of feeling ill-equipped to address them. Resident-led focus groups (n = 23, PGY-1 - 4s) were completed utilizing a semi-structured interview guide to gather resident perspectives on the design of the session's simulated role-plays which revealed a desire to learn new communication tools for addressing microaggressions, a variety of techniques to ensure psychological safety in the session, and the generation of case ideas for the role-plays. We used our needs assessment/focus group information and collaborated with experts in microaggressions, simulation, and the nationally validated communication methodology, VitalTalk, to develop a 4-hour session consisting of a 40-minute didactic about microaggressions and the communication tools/cognitive maps needed to address them followed by 2 hours of role-play with professionally trained improv actors, and a 30 minute debrief. Results: We conducted pre-and post-surveys. Post-surveys revealed marked improved comfort with identifying/addressing microaggressions, and reporting/escalating encounters to leadership with slight-moderate improved comfort in supporting colleagues who experienced microaggressions, improved knowledge, and confirmed the successful creation of a safe simulation learning environment.
Conclusion(s): We successfully launched a microaggression response training session utilizing simulation. Next steps include completing 6-month follow-up qualitative interviews with residents who completed the sessions to assess for sustained knowledge acquisition/behavior change.
