Theatre of the Oppressed to Teach Medical Students About Power, Lived Experience, and Health Equity.

Abstract

A difficult challenge in health equity training is conducting honest and safe discussions about differences in lived experience based on social identity, and how racism and other systems of oppression impact health care. To evaluate a Theatre of the Oppressed workshop for medical students that examines systems of oppression as related to lived health care experiences. Mixed-methods cross-sectional survey and interviews. Forty randomly assigned early first-year medical students. A 90-min virtual workshop with three clinical scenes created by students where a character is being discriminated against or oppressed. During performance, students can stop scene, replace oppressed character, and role play how they would address harm, marginalization, and power imbalance. Participants discuss what they have witnessed and experienced. Likert-scale questions assessing workshop's impact. Open-ended survey questions and interviews about workshop. Thirty-one (78%) of 40 participants completed the survey. Fifty-three percent were female. Thirty-seven percent were White, 33% Asian American, 15% Black, 11% Latinx, and 4% multiracial. Ninety percent thought this training could help them take better care of patients with lived experiences different from their own. Most agreed or strongly agreed the workshop helped them develop listening (23, 77%) and observation (26, 84%) skills. Twelve (39%) students felt stressed, while 29 (94%) felt safe. Twenty-five (81%) students agreed or strongly agreed there were meaningful discussions about systemic inequities. Students reported the workshop helped them step into others' shoes, understand intersectional experiences of multiple identities, and discuss navigating and addressing bias, discrimination, social drivers of health, hierarchy, power structures, and systems of oppression. Some thought it was difficult to have open discussions because of fear of being poorly perceived by peers. Theatre of the Oppressed enabled medical students to engage in meaningful discussions about racism and other systems of oppression.