Microaggressions – brief and commonplace interactions that intentionally or unintentionally communicate insults and derogatory sentiments towards people of marginalized backgrounds – can happen anywhere. This is true in healthcare, where both patients and healthcare professionals can be subject to microaggressions during clinical encounters, training, and even professional interactions among colleagues.
To better understand available interventions and training programs (hereafter interventions) to help address microaggressions in healthcare, researchers from the Center for Violence Prevention (CVP) at Children’s Hospital of Philadelphia (CHOP) conducted a systematic literature search and found 44 interventions that have been developed over the past two decades. The findings were recently published in the journal Trauma, Violence, & Abuse.
Several of the interventions have shown promising potential in addressing microaggressions, with behavioral strategies targeting different roles involved in microaggression situations. Most strategies reflect a mix of “calling in and calling out.” Calling-in aims to invite the committers of microaggressions and give them time to reevaluate their actions, whereas calling-out is intended to stop the microaggressive behaviors by confronting the committer, and the behavioral manifestations of microaggressive behavior directly.
The study also identified areas for potential improvement. While many programs were reported as being effective, there was a lack of randomized controlled trials and other methods for evaluating the effectiveness of these interventions and measuring observable improvements in behavior. Interventions should also acknowledge power differentials between providers and patients, as well as preceptors and trainees, and provide strategies for committers on what to do when involved in microaggressions.
“Prejudices and discrimination may not be as overt as in the past, but over time, they have transformed into commonplace microaggressions that remain prevalent in clinical encounters, even unwittingly,” said Rui Fu, PhD, a research scientist and research scholar at CVP at CHOP and lead author of the paper. “Our review found a number of promising strategies for addressing microaggressions, but there are opportunities to improve how we develop and evaluate strategies that could inform how future interventions could be more targeted to address microaggressions in healthcare.”
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Microaggressions – brief and commonplace interactions that intentionally or unintentionally communicate insults and derogatory sentiments towards people of marginalized backgrounds – can happen anywhere. This is true in healthcare, where both patients and healthcare professionals can be subject to microaggressions during clinical encounters, training, and even professional interactions among colleagues.
To better understand available interventions and training programs (hereafter interventions) to help address microaggressions in healthcare, researchers from the Center for Violence Prevention (CVP) at Children’s Hospital of Philadelphia (CHOP) conducted a systematic literature search and found 44 interventions that have been developed over the past two decades. The findings were recently published in the journal Trauma, Violence, & Abuse.
Several of the interventions have shown promising potential in addressing microaggressions, with behavioral strategies targeting different roles involved in microaggression situations. Most strategies reflect a mix of “calling in and calling out.” Calling-in aims to invite the committers of microaggressions and give them time to reevaluate their actions, whereas calling-out is intended to stop the microaggressive behaviors by confronting the committer, and the behavioral manifestations of microaggressive behavior directly.
The study also identified areas for potential improvement. While many programs were reported as being effective, there was a lack of randomized controlled trials and other methods for evaluating the effectiveness of these interventions and measuring observable improvements in behavior. Interventions should also acknowledge power differentials between providers and patients, as well as preceptors and trainees, and provide strategies for committers on what to do when involved in microaggressions.
“Prejudices and discrimination may not be as overt as in the past, but over time, they have transformed into commonplace microaggressions that remain prevalent in clinical encounters, even unwittingly,” said Rui Fu, PhD, a research scientist and research scholar at CVP at CHOP and lead author of the paper. “Our review found a number of promising strategies for addressing microaggressions, but there are opportunities to improve how we develop and evaluate strategies that could inform how future interventions could be more targeted to address microaggressions in healthcare.”
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