Anti-Black racism in clinical supervision: asynchronous simulated encounters facilitate reflective practice.

Background Racist interactions in clinical practice remain a pervasive reality for Black healthcare providers. We sought to develop a framework to inform supervisors' actions when confronting racism in clinical practice and protecting trainees under their oversight. Methods We conducted a qualitative study in which experienced supervisors responded to seven short, videotaped interactions between: 1) Black trainees and a simulated patient (SP) in a racist role; 2) the trainees and their respective supervisors; and 3) the trainees and their supervisors together with the SP. The clinical exchanges exemplified different types of racist (entrenching) or antiracist (uprooting) behaviors by the supervisors. After viewing each clip, participants wrote their reflections confidentially; they later joined a structured debriefing together. We used thematic analysis to identify supervisors' behavioral patterns when confronting racist interactions. Results Based on the input of 52 participants recruited into five two-hour-long sessions, we categorized the behaviors of supervisors facing anti-Black racial injuries involving learners under their oversight. We organized supervisor behaviors into five interlocking domains, each with a range of possible themes: 1) Joining: from conciliatory to confrontational in communicating with the aggressor; 2) Explicitness: from avoiding to naming racism; 3) Ownership: from individual to shared responsibility of the event and the response to it; 4) Involving: from excusing to including the aggrieved party when confronting the aggressor; and 5) Stance: from protective to paternalistic in supporting the learner's autonomy. Conclusions Our qualitative findings can provide a framework for facilitated discussion toward reflective practice among healthcare providers who may have experienced, witnessed, or intervened in anti-Black racist interactions. They can also help medical educators to inform faculty development to fight anti-Black racism in clinical practice. The video materials we developed are available for viewing and download and can be used or adapted as springboards for reflective discussion or faculty development activities.

Females who maltreat animals.

Studies of animal maltreatment and of untoward or abnormal aggression predominantly involve male subjects, raising the question as to whether females who engage in such behaviors are like, or fundamentally different than, their male counterparts. Inquiry to address this issue could pertain to gender similarities and differences; moreover, it could provide greater understanding of the behavior itself, in this case, animal maltreatment. Of the various patterns of animal maltreatment in the literature, there are enough studies with gender addressed to allow some observations on two patterns: animal cruelty in childhood and animal hoarding. Animal cruelty among girls may be more common than is widely assumed, but substantial recurrent cruelty appears, as expected, to be more common among males and is consistent with conduct disorder occurring more frequently among boys. Females, especially older females who live alone, predominate among animal hoarders, whose psychology is altogether different from those who engage in antisocial cruelty. The potential significance of these observations is discussed within the contexts of developmental and gender psychology.