Abstract
BackgroundInterpersonal biases between clinicians and patients contribute to disparities in health care and outcomes by race, ethnicity, and socioeconomic status. We used standup comedy principles and exercises to help medical students recognize how others perceive them and how they perceive others, and engage in difficult discussions around implicit biases and interpersonal racism.Methods90 min Zoom workshop with 40 first-year medical students in urban medical school. Intervention consisted of three exercises: Naming icebreaker, Rant and Rave (communicate strong perspective clearly), and Personal Monologue about how others perceive you and how you perceive yourself. Discussion debriefed the personal monologue exercise. Likert scale questions on post-session survey evaluated workshop overall, whether workshop increased skills, and safety of learning environment. Open-ended questions included what trainees liked about the module, what could be improved, and what impact the module had on them?ResultsSeventeen (42.5%) students responded to survey. Six respondents identified as white, 4 as Asian, 1 as Black, 1 as multiracial, and 5 did not identify. Seventy-six percent rated the module as “very good” or “excellent”, and 94% would recommend the module to others. Most respondents reported the workshop helped them become better listeners (75%) and more observant (82%). Eighty-three percent reported the training could help them take better care of patients with lived experiences different than their own. All respondents believed the learning environment was safe, and 94% reported that instructors created an atmosphere in which they could take risks. Thirty-six percent felt stressed. Students reported the workshop helped them recognize their own identities, others’ perceptions, and bidirectional biases, and inspired them to strive for more accurate, authentic interactions with patients.ConclusionsStandup comedy principles show promise for engaging students in meaningful, safe discussions about perceptions and interpersonal biases rooted in their own personal experiences and those of their classmates.
Highlights
Interpersonal biases between clinicians and patients contribute to disparities in health care and outcomes by race, ethnicity, and socioeconomic status
They were told at the beginning of the workshop: “You may be wondering why you are in a standup comedy session in medical school at the University of Chicago
Questions After Personal Monologue Exercise How did you find this journaling and monologue exercise? As you think about your own story and the monologues of your classmates, what did you notice? [Eventually discussion will get to the mismatch between how others perceive you and how you perceive yourself ] Why does this disconnect matter? What does this disconnect mean for how we communicate with people? [Realization that perception of self has been shaped by American stereotypes]
Summary
Interpersonal biases between clinicians and patients contribute to disparities in health care and outcomes by race, ethnicity, and socioeconomic status. We used standup comedy principles and exercises to help medical students recognize how others perceive them and how they perceive others, and engage in difficult discussions around implicit biases and interpersonal racism. It is critical to engage in free, frank, and fearless discussions about perceptions, biases, and systemic racism [3, 4]. We believe that exercises and principles used to train modern American standup comedians could engage health professional trainees to collectively discover perceptions and belief systems, and explore the world’s truths and absurdities [8]. Standup comedy exercises around perceptions could engage trainees in difficult discussions around interpersonal biases and improve their skills communicating and developing relationships with diverse patients [9, 10]
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