Thread by @YihanYangMD

1/ Today's #MedEdMethodsMonday reviews strategies for responding as a bystander to #microagressions and #bias from patients.

Have you seen a patient make a #sexist, #racist, ***ist comment towards a learner or peer?

2/ Why speak up as a bystander?

It lets the targetted individuals know that they are not alone, and that biased or abusive comments are not tolerated in your learning environment.

#MedThread #Medtweetorial #MedEdPearl #Medtwitter #medstudenttwitter #MedEd #MedEdMethodsMonday

3/ Speaking up or correcting a pt CAN feel uncomfortable though.

What happens to the doctor-patient relationship if I call the patient out?

There are several resources out there to build skills in responding as a bystander to microaggressions or bias in pts...

4/ “OUCH! That Stereotype Hurts" is a program used across multiple industries & highlights 6 strategies:

1. Assume good intent & explain impact
2. Ask a question
3. Interrupt & redirect
4. Broaden to universal behavior
5. Make it individual
6. Say "OUCH!"

5/ Assume Good Intent & Explain Impact

Assume pts say things with good intentions, then educate them on the actual impact.

“I think you meant that as a compliment to Dr. R’s appearance, but that takes away from all the other traits that makes Dr. R an excellent physician.”

6/ Ask a question

Create a moment for the patient to reflect on their comment.

"What do you mean by that?"
"What makes you say that?"

7/ Interrupt & redirect

Nip it in the bud.

"Okay, let's not even go there. We were talking about your breathing...”

8/ Broaden to universal behavior

Allow the patient to rethink if their voiced stereotype pertains only to a particular group of people.

"I don't think cellphone overuse is JUST a female thing. I'm sure you can think of men who are always stuck on their cell phones."

9/ Make it individual

Allow the patient to rethink if their voiced stereotype pertains to an entire group of people, or just an individual.

"Do you mean ALL Chinese people, or is there someone in particular you are thinking about?"

10/ Say "OUCH!"

A universally (English) way to tell someone you've been hurt, either intentionally or unintentionally.

11/ I went through OUCH! Training as a @YaleIMed chief resident and it helped equip me with tools to respond to patients, peers, and sometimes even senior physicians.

The OUCH training video can be found here: vimeo.com/36422104

Recommend start @ ~16:30

12/ See also 12 Tips for Responding to Microaggressions in @MedTeachJournal by Daniel Wheeler, @josuezapata, Denise Davis & @DrCalvinChou
doi.org/10.1080/014215…

End/ #Medtwitter, what stategies do you use / have seen others use effectively to respond to microaggressions or bias? Comment ⬇️!

Did you learn anything about bystander response to microaggressions?

For those attending @AAIMOnline #AIMW20 in Tampa, check out this seminar 4/21 11:45AM on responding to #ImplicitBias bias and disruptive patient behavior by Drs. Aba Black & Inginea Genao from @YaleMedicine & Drs. KeAndrea Titer & Karla Williams from @uabmedicine

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