Virtual Communication Across Differences: Development of a Workshop on Managing Patient Bias

Authors

Monica Zewdie, M. Zewdie is medical student, University of Virginia School of Medicine, Charlottesville, Virginia.
Margaret Duval, M. Duval is medical student, George Washington University School of Medicine and Health Sciences, Washington, DC.
Chang Liu, C. Liu is biostatistician and epidemiologist, Department of Surgery, Inova Fairfax Medical Campus, Fairfax, Virginia.
Sharon L. Bachman, S.L. Bachman is surgical clerkship director, Department of Surgery, Inova Fairfax Medical Campus, Fairfax, Virginia.
L Gordon Moore, L.G. Moore is family medicine physician, medical director, 3M Health Information Systems, Inc., Wallingford, Connecticut.
Denise Mohess, D. Mohess is geriatrician, Department of Medicine, Inova Fairfax Medical Campus, Fairfax, Virginia.
Muneera R. Kapadia, M.R. Kapadia is associate professor, Department of Gastrointestinal Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Jonathan Dort, J. Dort is surgical residency program director, Department of Surgery, Inova Fairfax Medical Campus, Fairfax, Virginia.
Anna B. Newcomb, A.B. Newcomb is research manager and surgical residency communication curriculum director, Division of Trauma Acute Care Surgery, Inova Fairfax Medical Campus, Fairfax, Virginia.

Document Type

Journal Article

Publication Date

10-11-2022

Journal

Academic medicine : journal of the Association of American Medical Colleges

DOI

10.1097/ACM.0000000000005030

Abstract

PROBLEM: Despite the prevalence and detrimental effects of racial discrimination in American society and its health care systems, few medical schools have designed and implemented curricula to prepare medical students to respond to patient bias and racism. APPROACH: During the summer of 2020, a virtual communication class was designed that focused on training medical students in how to respond to patient bias and racism. Following brief didactics at the start of the session, students practiced scenarios with actors in small groups and received direct feedback from faculty. For each scenario, students were instructed to briefly gather a patient's history and schedule an appointment with the attending whose name triggered the patient to request an "American" provider. In one scenario, the patient's request was motivated by untreated hearing loss and difficulty understanding accents. In another, it was motivated by racist views toward foreign physicians. Students were to use motivational interviewing (MI) to uncover the reasoning behind the request and respond appropriately. Students assessed their presession and postsession confidence on 5 learning objectives that reflect successful communication modeled after MI techniques. OUTCOMES: Following the session, student skills confidence increased in exploring intentions and beliefs (P = .026), navigating a conversation with a patient exhibiting bias (P = .019) and using nonverbal skills to demonstrate empathy (P = .031). Several students noted that this was their first exposure to the topic in a medical school course and first opportunity to practice these skills under supervision. NEXT STEPS: The experience designing and implementing this module preparing students in responding to patient bias and racism suggests that such an effort is feasible, affordable, and effective. With the clear need for such a program and positive impact on student confidence navigating these discussions, including such training in medical school programs appears feasible and is strongly encouraged.

APA Citation

Zewdie, Monica; Duval, Margaret; Liu, Chang; Bachman, Sharon L.; Moore, L Gordon; Mohess, Denise; Kapadia, Muneera R.; Dort, Jonathan; and Newcomb, Anna B., "Virtual Communication Across Differences: Development of a Workshop on Managing Patient Bias" (2022). GW Authored Works. Paper 1784.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1784

Department

School of Medicine and Health Sciences Student Works