Sree Natesan, MD (she/her) Profile picture
May 26, 2022 21 tweets 28 min read Read on X
.@MacEmerg Virtual Regional Rounds: Thankful for the opportunity to share about #DEI in #MedEd and practice #upstander skills to address #microaggressions within the #ER.

🗣️#MedTwitter: Here's a #Tweetorial of how you can be an #upstander! Image
.@MacEmerg Virtual Regional Rounds: #DEI in #MedEd: Being an #upstander!

💭Why does #DEI matter? Many benefits, here are just a few:
🗺️Improved cultural competence
🏥Expanded delivery of health care to low resource settings
🗨️Improved intellectual discussion in MedEd Image
.@MacEmerg Virtual Regional Rounds: #DEI in #MedEd: Being an #upstander!

💭The issue is that Racism exists on all levels. And because its so embedded in our societies, it's hard to recognize and even harder to change. Image
.@MacEmerg Virtual Regional Rounds: #DEI in #MedEd: Being an #upstander!

👀We need to be on a lookout for #bias, #microaggression, #racism in #MedEd.

💭Examples where it exists:
💯Grades
📰LOR/MSPE
🎖️Awards/Accolades
📈Promotion/Leadership opportunities Image
.@MacEmerg Regional Rounds: #DEI in #MedEd.

📰Bias in LOR:
🤝Reflective of students’ network & support system (difficult #women & #URM to develop)
📝 Data shows = similar clerkship grades: URM more - comments & fewer + comments when compared to White counterparts Image
.@MacEmerg Regional Rounds: #DEI in #MedEd

💭Bias in MSPE:
♂️ Men described with words that are:
-“Considered standout”
-“Related to ability”
-“Emphasis on Research”

♀️Women described with words that are:
-“Considered grindstone”
-“Emphasis on teaching”
-“More communal words” ImageImage
.@MacEmerg Virtual Regional Rounds: #DEI in #MedEd: Being an #upstander!

💭Bias in MSPE: Crosses over into race.
🔉URM students described with comments on Personal Attributes
🔊Non- URIM students described with Competency-based Attributes Image
.@MacEmerg Virtual Regional Rounds: #DEI in #MedEd: Being an #upstander!

🎖️Bias in awards & accolades:
⤵️Shown to be given less to UIM students
📝In a study of nearly 5⃣K students, #AOA membership was six times more likely for White students than for Black students. Image
.@MacEmerg: #DEI in #MedEd!

📝Standardized tests: does NOT predict success in residency overall or an ability to provide safe & quality clinical care.

📖USMLE = common screening tool; subject to systemic biases of accessibility and affordability of test prep Image
.@MacEmerg Rounds: #DEI in #MedEd

🤝URM experience differential trx due to race/ethnicity
🧠Impacts wellness, mental health, academic productivity
🔍Creates feelings of ⬆️scrutiny, need to represent entirety of their race/culture
🗜️Pressure to be near-perfect within/outside #ER Image
.@MacEmerg Rounds: #DEI in #MedEd

💭Leadership: Disparity in opportunities offered and accepted for URM and WiM
🔍Within the US: Minorities = 40% of the US population but URM physicians = 9% of Med school faculty; 18% of medical students.
📈URMs/#WIM less likely to be promoted Image
.@MacEmerg Virtual Regional Rounds: #DEI in #MedEd: Being an #upstander!

🔍Need to recognize #intent vs #impact. ImageImage
.@MacEmerg Virtual Regional Rounds: #DEI in #MedEd: Being an #upstander!

💡There is #hope. We can be the #change.

💭Step 1⃣: Recognition. #MedTwitter: 💭Where do you fall on this diagram on becoming #antiracist? Image
.@MacEmerg Virtual Regional Rounds: #DEI in #MedEd: Being an #upstander!

💡There is #hope. #Bias exists around & within ourselves!

💭Step 2⃣: Learn about yourself. #implicitbias ImageImage
.@MacEmerg Virtual Regional Rounds: #DEI in #MedEd: Being an #upstander!

💭Step 3⃣: Build your #Upstander Language Toolbox. 🧰Here are a few to build your armamentarium:
✏️ERASE Framework
📼VCR Method
🏋️‍♂️LIFT Method
👁‍🗨Bystander 4D's
🗣️CURT Technique ImageImage
.@MacEmerg Virtual Regional Rounds: #DEI in #MedEd: Being an #upstander!

🛠️For your Upstander Language Toolbox🧰: The ERASE Framework✏️ Image
.@MacEmerg Virtual Regional Rounds: #DEI in #MedEd: Being an #upstander!

🛠️For your Upstander Language Toolbox🧰: The VCR method 📼 Image
.@MacEmerg Virtual Regional Rounds: #DEI in #MedEd: Being an #upstander!

🛠️For your Upstander Language Toolbox🧰: The LIFT Method 🏋️‍♂️ Image
.@MacEmerg Virtual Regional Rounds: #DEI in #MedEd: Being an #upstander!
🛠️For your Upstander Language Toolbox🧰: The 4Ds of Bystander Intervention 👁‍🗨 ImageImageImageImage
.@MacEmerg Virtual Regional Rounds: #DEI in #MedEd: Being an #upstander!

🛠️For your Upstander Language Toolbox🧰: The CURT Technique 🗣️ Image
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More from @sreeja_natesan

Oct 26, 2020
#ACEP20: Dr Fauci amazing pearls shared with us today! Stay tuned!
2/ #ACEP20: the coronavirus has been part of our past as it is now part of our present (& foreseeable future).

We've beat it before: we can beat it again!
3/ #ACEP20 Dr Fauci pearl: the #UnitedStates has been the leaders in cases...

I'm hopeful we can be the leaders of the best recovery story of all time.. 🤞#WearAMask #FlattenTheCurve
Read 12 tweets
Sep 12, 2020
Yikes: lots of #MedEd teaching but no time to tweet to #MedTwitter! Here's a thread of #postitpearls with @dukeemergency !
Read 23 tweets
Jul 30, 2020
Excited to Dr. @AnjniJoiner sharing with @dukeemergency on #seizure and management.

First step is knowing the classifications!
2/ Seizure Mimics are key! Its important to keep a broad differential diagnosis as you approach a seizing patient!
3/ Management of seizure:

1⃣ The first step in management is ABCs!
2⃣ ✅ a blood glucose!!
3⃣Determine if Sz vs mimic: (mimics can look like true seizures. Get a good Hx/PE. (Thanks @GeraldMDMD for this great DDx chart!)
Read 10 tweets
Jul 16, 2020
Excited for Dr. @JohnPurakal sharing his passion for #SocialEM with @dukeemergency !
2/ Thanks for sharing how impt this is @JohnPurakal.

We need to be seeing past the disease and treat our patients. We must walk in their shoes to understand the steps that have led them down the path to the doors of the ED. Only then can we truly serve our patients.
3/ We might be the only provider that the patient sees all year! We need to address the social aspects that may be hindering their access to care!

Taking that moment to reach out and understand the barriers to care can make a lasting impact!
Read 5 tweets
Jun 23, 2020
#MedTwitter: SO Excited to talk with @MacPFD
and #MedEd champions @TChanMD @MGottliebMD
and @sherbino!

Register for our talk that is TONIGHT starting at 8pm! Come join us! bit.ly/FacDevReg
.@MacPFD with @TChanMD @MGottliebMD @sherbino . Excite to talk tonight. Stay tuned for pearls on Multiple Wins!
Read 18 tweets
Jun 20, 2020
Here are some highlights from our 🎓.@dukeemergency #Classof2020 graduation!

Here's a highlight from our Resident Roast. Shout out to @adam_breslin - your photoshop skills are like none other!

Theme: What faculty are doing during quarantine #Covid19
Here are some highlights from our 🎓.@dukeemergency #Classof2020 graduation!

Here's a highlight from our Resident Roast. Shout out to @adam_breslin - your photoshop skills are like none other!

Dr. @EmergencyImages Roast:
Here are some highlights from our 🎓.@dukeemergency #Classof2020 graduation!

Here's a highlight from our Resident Roast. Shout out to @adam_breslin - your photoshop skills are like none other!

Dr. @DMBuckland Roast:
Read 11 tweets

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