Enhancing Self-Efficacy Navigating Microaggressions in Clinical Education
Background:
Clinical education (CE) is essential in health professions education, with Clinical Instructors (CIs) playing a pivotal role in assessing patients and learners within complex healthcare environments. Microaggressions in this setting can degrade the belongingness of those from historically marginalized and minoritized backgrounds. Several in-the-moment microaggression response frameworks exist. Continued development of support mechanisms for debriefing between students and CIs is needed to foster growth. This project aims to create continuous dialogue and 'brave spaces' for addressing these bias incidents in clinical settings.
Methodology:
This mixed-methods study involved distributing surveys to those engaged in CE from June 2021 to October 2023. The responses informed the creation of a qualitative interview guide. Interviews were conducted and data analysis is currently underway using Dedoose software.
Results:
The survey had a 25% response rate (99/391). Results indicated that nearly half had directly experienced microaggressions, while 70% witnessed them. Notably, 75% identified patients as the primary perpetrators, with students frequently on the receiving end (79%). Self-efficacy in debriefing after incidents was varied, with only 28% feeling highly capable, whereas 15% felt notably inadequate. Students felt more confident than other groups, with 45% expressing high self-efficacy.
Conclusions:
Findings suggest that microaggressions disproportionately impact students and involve multiple parties, including patients, CIs, and other healthcare professionals. The lack of microaggression-specific debriefing tools and training highlights a critical gap in the current educational framework. Addressing this gap is crucial for enhancing the learning environment and the overall well-being of the healthcare team.
Reflections/Lessons Learned/Implications:
The disproportionate impact of microaggressions on future clinicians raises serious concerns about the inclusivity and supportiveness of the clinical learning environment. It suggests that while diversity among students has increased, the educational settings may not adequately nurture all students’ growth. This underscores the need for better support systems and relationship building to foster a positive learning experience and ensure the wellness of the entire healthcare team.
Description of how the poster fulfills the priority criteria:
This poster aligns with the 2nd conference theme by focusing on interprofessional collaboration and advocacy to address bias in practice by focusing on crucial gaps in self-efficacy for debriefing microaggressions, a form of bias, within clinical education settings. Our project team and participants are interprofessional and include a student as a core team member. This project fosters a commitment to improving healthcare education and aligns with the quadruple aim, specifically, enhancing the well-being of the healthcare team.