Thread by @SarooSharda_MD

So grateful that @javeedsukhera accepted my invitation to speak on #bias #implicitbias #oppression to @MacAnesthesia

Live tweeting some pearls!

Stigma has a negative impact on clinical outcomes

Shame is not an effective pedagogic strategy in calling out stigma. Shaming and calling out may actually make problem worse

Education may be helpful but it also isn’t enough alone

We often have conversations about #equity that are blaming (“us” vs. “them”)

Blame has an inverse relationship with accountability

Intentions can be good and we can still perpetuate #inequity.

Instead of blaming and shaming can we look in the mirror as a first step?

Bias education is not simple! As clinicians we are hardwired to use bias in making clinical decisions.

Bias influences our behaviour no matter what our intention

In medicine we filter data on the beliefs and assumptions we hold. There is a cost to this

Can use implicit association test e.g. implicit.harvard.edu
@javeedsukhera research used IAT to provoke discussion on implicit bias.Found deep emotional reactions in clinicians. “Idealized self”vs. “Actual self”
As professionals,research participants felt they had 2b unbiased

Despite emotional reaction to feedback about their bias, @javeedsukhera research found that there was still motivation to act once feedback on bias was given

Rich pictures used in next study. Process of reconciling the fact we are biased needs to address the fact that we are human

Simply making people aware of their biases led to frustration. Intervention is needed.

Also found that if educating people about biases in a certain way, led to system and policy change.

“There is a human cost to inaction on issues related to inequity”

“The imperfect biased self”

If we are constantly trying to reconcile our biases in a culture that rewards toxic perfection then there may be psychological consequences. We must be cautious. People will give up

How can we do this?

Creating psychologically safe culture
Feedback should lead to reflection AND action
Setting new behavioural goals, changing our behaviour
Vulnerability in teams is key.

“It is NOT about a workshop, it is about a way of being”

We can strive to be better but also need to accept that we are human and flawed.

How can we apply courage, compassion and connection?

We can’t call everything out all the time but it requires courage to note the systemic biases around us.

Compassion is about being more mindful about our interactions with certain groups. Appreciate that compassion fatigue is really. We are flawed. We will make mistakes.

Connection. When we encounter challenges/groups we find challenging, we have to lean in to the discomfort and challenge to move towards a more just practice.

This is NOT a one and done approach.

Has to be more than an individual level solution. Bias is baked into our orgs

We need substantive change in policy and practice

Fantastic talk! Thank you @javeedsukhera

Questions from audience:
@javeedsukhera does not feel that IAT should be used as a metric of bias. Bias is not something that can be “fixed”. He prefers to use it as a tool for refection.

It isn’t until we can be vulnerable that we can be a true ally. We need to have humility to see other peoples’ experiences and then use our privilege&recognize that it is all of our collective responsibility to be part of the solution. We cannot put the burden on oppressed group

In acute health care we are trained to be “fixers”. This is problematic when it comes to complex problems. There is no “quick fix” for things like systemic racism. We often ignore /run away from the problems that don’t have a quick fix.

For students/learners who feel vulnerable speaking out @javeedsukhera recommends that they remember the types of
power they DO have. “Please help me understand why we....”

As educators we also need to recognize that we are both teachers and learners. We need to create space

“We need to create brave spaces where we lean into difficult conversations”

Love this comment by @javeedsukhera!

Reminds us to be compassionate with ourselves as we use our privilege to do this work. We often have a hard time with this as clinicians.

Fantastic talk! ThnkU

Oh and all this was delivered seamlessly even though @javeedsukhera was post call!

Hope you get some 😴

Thanks again.