"I Didn't Know What to Say": Responding to Racism, Discrimination, and Microaggressions With the OWTFD Approach

Sylk Sotto-Santiago; Jacqueline Mac; Francesca Duncan; Joseph Smith

doi:10.15766/mep_2374-8265.10971

"I Didn't Know What to Say": Responding to Racism, Discrimination, and Microaggressions With the OWTFD Approach

MedEdPORTAL. 2020 Jul 31:16:10971. doi: 10.15766/mep_2374-8265.10971.

Authors

Sylk Sotto-Santiago¹, Jacqueline Mac², Francesca Duncan³, Joseph Smith⁴

Affiliations

¹ Assistant Professor of Medicine, Department of Medicine, Indiana University School of Medicine; Vice Chair for Faculty Affairs, Development, and Diversity, Department of Medicine, Indiana University School of Medicine.
² Graduate Director of Faculty Affairs, Development, and Diversity, Department of Medicine, Indiana University School of Medicine.
³ Fellow, Division of Pulmonary, Critical Care, Sleep, and Occupational Health, Department of Medicine, Indiana University School of Medicine.
⁴ Assistant Professor of Clinical Medicine, Division of Pulmonary, Critical Care, Sleep, and Occupational Health, Department of Medicine, Indiana University School of Medicine; Statewide Internal Medicine Sub-Internship Director, Division of Pulmonary, Critical Care, Sleep, and Occupational Health, Department of Medicine, Indiana University School of Medicine.

Abstract

Introduction: Academic medicine has long faced the challenge of addressing health inequities, reflecting on how these contribute to structural racism, and perpetuating negative social determinants of health. Most recently, we have constructed opportunities for dialogues about racism, discrimination, and microaggressions (RDM). As such, we created a professional development program that encouraged participants to (1) openly discuss RDM and the impact they have in academia, (2) learn about tools to address and respond to RDM, and (3) move towards the creation of inclusive environments. The target audience included institutional leaders, faculty, trainees, professional staff, and health care teams.

Methods: We sought to meet workshop goals by integrating anti-racist dramaturgical teaching, introducing concepts knowledge, and practicing communication tools. To assess learning and evaluate our workshops, participants completed a pre- and postsurvey.

Results: Results showed that 30 participants were more comfortable with discussing issues related to race/ethnicity, gender identity/expression, sexual orientation, and spirituality after participating in the workshops. Prior to the two workshops, the percentage of learners who felt confident initiating conversations ranged from 29% to 54%. After the workshops, the percentage of learners who felt confident ranged from 58% to 92%. The greatest increase, 100%, was observed in the levels of confidence in initiating conversations related to race/ethnicity.

Discussion: Despite medical education's commitment to cultural competence and institutional mission statements that value diversity, equity, inclusion, and justice, professional development opportunities are limited. Participants strongly agreed their participation in such a workshop was relevant and important to their professional work.

Keywords: Anti-racism; Case-Based Learning; Clinical Learning Environment; Cultural Competence; Discrimination; Diversity; Faculty Development; Health Equity; Inclusion; Microaggressions; Professional Development; Racism.

MeSH terms

Cultural Competency
Faculty
Female
Gender Identity
Humans
Learning
Male
Racism*