From Tension to Transformation: Navigating Bias and Microaggressions in C-L Psychiatry Education -- A Fellowship Education Subcommittee-sponsored session

Abstract: Acts of bias directed towards trainees, faculty, or patients are among the most difficult situations which C-L Psychiatry teaching faculty must navigate when supervising trainees on their clinical services. In addition to responding to overtly hostile and discriminatory behaviors, supervisors often find themselves challenged to intervene when they witness subtle or covert behaviors, known as microaggressions, which demean or denigrate members of their clinical environment. Acts of bias and microaggressions against women, people of minoritized racial identity, and LGBTQ+ people are prevalent in medical training settings, and the harms that they inflict, including trainee burnout and potentially negative impacts on rotation evaluations, are well-documented. The unique positioning of C-L psychiatrists and their trainees at the intersection of numerous medical specialties, disciplines, and patients renders them particularly likely to witness microaggressions across medical settings. On the other hand, as experts in the psychosocial aspects of medical care, C-L psychiatrists bring important skills in demonstrating how to effectively intervene when acts of bias or microaggressions occur, and as such have the potential to transform challenging training experiences into opportunities for growth, wellness, transformation, and safety. This general session, sponsored by the Fellowship Education Subcommittee, will empower attendees with information, skills, and opportunities for idea development and practice so as to expand their ability to effectively intervene and supervise trainees around instances of bias and microaggressions in the C-L clinical setting.

Dr. Mark Bradley will first provide a brief overview of existing research on bias and microaggressions in the medical setting, focusing on their impact on medical education and trainee outcomes. Dr. Flannery Merideth will then review current research on microaggression interventions that have been developed and tested in clinical settings, and discuss how these may be applied in medical training environments. Next, Dr. Adrienne Taylor will discuss specific supervisory and training approaches, and explore the learning opportunities and pitfalls that may arise when acts of bias or microaggression occur in clinical and educational spaces. Attendees will then break into small groups in order to apply specific concepts acquired to specific challenging supervisory scenarios, with the goal of developing 1-2 new skills to take back to their own teaching services. Finally, Dr. Paula Zimbrean will summarize lessons learned from the breakout groups and synthesize these into best practices and future directions.