临床实践和医学教育中的种族偏见:一个范围审查
Adil Mouhab1, Rahmeth Radjack2,3,4, Marie Rose Moro2,3,4
1Université des Antilles, Pointe-à-Pitre, Guadeloupe, France. adil.mouhab@gmail.com.
BMC medical education
|October 24, 2024
概括
这次审查强调,缺乏关于种族偏见的医学教育. 干预措施存在,但缺乏临床影响评估,强调医疗教学中需要谦卑和系统方法.
科学领域:
- 医学教育 医学教育
- 健康 公平 卫生 公平
- 医学社会学 医学社会学
背景情况:
- 健康不平等仍然存在,种族偏见对医疗保健获取和结果的差异作出了重大贡献.
- 最近关于解决健康歧视的呼吁,由COVID-19危机放大,回应了长期以来对公平护理的建议.
- 法国的医学教育在很大程度上忽视了因原产地而受到的歧视问题.
研究的目的:
- 对医学中的种族偏见现有文献进行范围审查.
- 探索概念框架和教育干预措施,解决医学培训中的种族偏见.
- 确定研究中的差距,特别是关于此类干预措施的临床影响.
主要方法:
- 根据JBI和PRISMA-ScR的指导方针进行了范围文献审查.
- 在2003年至2023年期间以法语或英语出版的研究被纳入,如果它们专注于干预或教育计划的评估.
- 系统地搜索了六个数据库,以确定相关的研究.
主要成果:
- 在748项初步研究中,包括28项,涉及各种干预措施,参与者接待普遍积极,但参与者数量较少.
- 没有研究评估了教育干预措施的临床影响.
- 确定的关键概念包括种族主义水平,文化能力,文化谦卑和批判性种族理论.
结论:
- 经常引用制度化的种族主义,强调其系统性质,同时在个人层面强调隐含和无意识的偏见.
- 种族结构缺乏生物决定因素,而文化谦卑对于批判性地检查医疗实践至关重要.
- 评估临床影响需要像沉浸和虚拟患者这样的创新方法,这些方法得到了更横向的医学教学的支持.
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