Introduction

Health profession schools have acknowledged the need for a diverse workforce by increasing diversity in recruitment, but little has been done to build inclusive excellence in learning environments. Microaggressions and other forms of mistreatment can increase stress levels and depression and negatively impact academic performance. To increase student performance, retention, and wellness, mitigating microaggressions is needed to promote an inclusive culture.

Methods

We designed this workshop as a framework to think critically about microaggressions, how they impact the health professions academic environment, and how administrators, faculty, and students can promote inclusion excellence. The workshop included a presentation discussing microaggression theory, seven cases describing microaggressions in the health professions education environment, and discussion and facilitator guides. Cases were based on prior research conducted by the primary author and upon interactions authors shared from their professional experience. Participants completed pre- and postsurveys.

Results

During six workshops at three different institutions, 138 out of 190 participants (73% response rate), including nursing and medicine faculty, students, and leadership, completed the pre- and postsurveys. Pre- and posttraining measurements found statistically significant improvements in participants' knowledge of the impact of microaggressions, self-efficacy in responding to microaggressions, and commitment to being an active bystander in the face of microaggressions. Participants were highly satisfied with the training.

Discussion

This humanistic, case-based learning curriculum allows facilitators to guide faculty, student, and leadership conversations to build skills to promote inclusion excellence through preventing microaggressions, repairing and reestablishing relationships, and restoring reputations once microaggressions occur.

Purpose

To describe how racial microaggressions may affect optimal learning for under-represented health professions students.

Method

The authors conducted focus groups and individual interviews from November 2017 to June 2018 with 37 students at University of California, Davis and Yale University who self-identified as underrepresented in medicine or nursing. Questions explored incidence, response to, and effects of racial microaggressions, as well as students' suggestions for change. Data were organized and coded, then thematic analysis was used to identify themes and subthemes.

Results

The data showed consistent examples of microaggressions across both health professions and schools, with peers, faculty, preceptors, and structural elements of the curricula all contributing to microaggressive behavior. The 3 major themes were: students felt devalued by microaggressions; students identified how microaggressions affected their learning, academic performance, and personal wellness; and students had suggestions for promoting inclusion.

Conclusions

The data indicated that students perceived that their daily experiences were affected by racial microaggressions. Participants reported strong emotions while experiencing racial microaggressions including feeling stressed, frustrated, and angered by these interactions. Further, students believed microaggressions negatively affected their learning, academic performance, and overall well-being. This study shows the need for leadership and faculty of health professions schools to implement policies, practices, and instructional strategies that support and leverage diversity so that innovative problem-solving can emerge to better serve underserved communities and reduce health disparities.