93. TEACHING RESIDENTS TO MITIGATE PREJUDICE

Abstract

Discrimination in the workplace is prevalent and while more residency programs are teaching residents to mitigate their own biases, research remains scant on how physicians can respond to discriminatory comments. Evidence supports that discrimination contributes to physician burnout. One institution developed a longitudinal curriculum to help residents respond to discriminatory comments using the NURSE mnemonic (Name-Understand-Respect-Support-Explore). We adapted this curriculum and created a 2-hour workshop for trainees at our pediatric residency program. Workshop objectives were: 1. Recognize when discrimination occurs and how this affects patient care; 2. Utilize the NURSE mnemonic and hospital code of conduct; and 3. Apply these tools in simulations to enhance pediatric residents’ ability to effectively respond to discriminatory comments. Our workshop included videos from popular media, an overview of current literature, and our institution's code of conduct. A gold standard skit demonstrated the NURSE mnemonic, and was followed by small group activity with role playing and debriefing. Pre- and post-surveys were administered to participants. All respondents reported facing discrimination at least once with 13% reporting greater than 5 encounters. Discrimination against gender, race, and age were the most commonly faced. Prior to the workshop, 41% of respondents felt fairly well prepared to respond to discriminatory comments directed towards themselves, and 32% felt fairly well prepared when comments were directed towards a team member. After the workshop, 77% of residents felt very well prepared or fairly well prepared to respond to these comments, and no residents reported feeling very unprepared. There was also a marked difference in perceived faculty support following the workshop with 83.4% of residents reporting either fairly well or very well supported versus 55.9% pre-workshop. We found that an interactive workshop can facilitate discussion and improve residents’ self-reported preparedness to respond to discriminatory comments. Our data also demonstrate that residents in our program feel more supported following this workshop.