Addressing Racism
About this Framework
Closing the Divide: Building Trust by Addressing Bias in Medicine provides a framework for how to respond internally and externally to encounters marked by biased behaviors in the clinical and nonclinical settings. The tools provided will assist with creating a platform for honest, open discussions about the presence and impact of biased behaviors in both clinical and nonclinical settings in medicine.
About this Module
In this module, Dr. Branch experiences a patient encounter marked by biased comments and behavior related to his race or ethnicity. The comments and behaviors depicted in this module are considered forms of microaggressions related to race or ethnicity. Microaggressions are defined as snubs, slights, or insults directed toward minorities or stigmatized groups that implicitly communicate or engender hostility (Sue et al. 2007 American Psychologist). If unjust treatment occurs as the result of microaggressions or macroaggressions related to race, this is considered racial discrimination. Consider the questions below:
Discussion Questions
Have you ever experienced or witnessed microaggressions related to race or ethnicity directed towards yourself or a colleague?
What are some of the thoughts or questions that came to mind as you viewed this encounter?
In this situation, should you respond to the patient or ignore the comments and continue with the encounter?
How would you respond during an encounter like this?
How would you support a colleague if you witnessed an encounter like this?
Clear the AIRR
The Clear the AIRR provides a framework for how to respond internally and externally to encounters marked by biased behaviors in the clinical and nonclinical settings
The Clear the AIRR tool is a curriculum that supports and empowers the healthcare team to respond when experiencing or witnessing macroaggressions and microaggressions or other biased behaviors in the clinical and nonclinical settings.
ASSESS
Assess the patient and environment. Ensure the safety of both the patient and yourself. If concerned about physical harm, be mindful of the position of your body in relation to the patient and to the door. It is acceptable to leave the room and return with the appropriate personnel as needed to ensure you are safe and the patient is safe.
IDENTIFY
Seek to understand the patient’s perspective and the underlying cause of the behavior being displayed. At times it may be helpful to name the emotion or behavior that is being displayed.
RESPOND
This is your opportunity to provide your perspective and the goals of the encounter. There are times when you have to be more direct in naming the specific behavior while clearly stating the standards for continuation of the encounter. Refer to the video portion of this module for useful phrases for these encounters.
REPORT
Debriefing and reporting the encounter ensures the person subjected to the behavior has a safe space to process the experience. This can also be a way for the hospital system to track these types of behaviors which can be used to create policies to address these types of behaviors in the future. Refer to the video portion of this module for specific reporting methods.
Thank You for Participating
With this framework, we hope that you learned helpful tips and techniques on how to address encounters marked by biased behaviors. Our goal is that this serves as a platform for honest, open discussions about the presence and impact of biased behaviors in various settings. We encourage you to share this training with your trainees and colleagues
