Speak Up! Simulation Workshop: Teaching Graduate Medical Trainees to Recognize and Respond to Microaggressions in the...

The negative effects of microaggressions on patient care, provider well-being, and medical education are well-documented. Critically evaluated programs addressing microaggressions remain largely absent in the literature.

We developed the 90-minute Speak Up! Simulation Workshop for GME trainees (residents, fellows), physician attendings, other health care professionals (e.g., nurses, nurse practitioners, child life specialists) based on Kolb's Experiential Learning Cycle. We utilized deidentified cases reported at our institution, emphasizing psychological safety and upstanding. Based on Kirkpatrick's Evaluation Model, we distributed pre- and postworkshop surveys to assess perceptions of psychological safety, confidence in recognizing microaggressions, comfort in upstanding, and likelihood of addressing future discrimination incidents. Five-point Likert scales and Bowker's symmetry tests were used.

Eighty anonymous postworkshop surveys were collected from GME trainees (N = 151) at 14 sessions. Of the respondents, 63 (79% [95% CI 70% to 88%]) reported feeling psychologically safe. When the 80 respondents compared their comfort in addressing microaggressions before and after the workshop, a significant shift was seen in the likelihood of speaking up when witnessing a microaggression (χ²[df5] = 42, p < .01), with scores from 42 respondents (52%) increasing by at least 1 point. Significant shifts in confidence in identifying microaggressions also occurred (χ²[df5] = 43, p < .01), with 43 respondents (54%) showing increased confidence.

Evaluation of our curriculum demonstrated improved understanding of microaggressions and enhanced self-efficacy in upstanding. This simulation workshop provides psychologically safe opportunities to explore the impact of microaggressions and empowers participants to respond effectively in professional settings.