Storylines of family medicine IV: perspectives on practice-lenses of appreciation.

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'IV: perspectives on practice-lenses of appreciation', authors address the following themes: 'Relational connections in the doctor-patient partnership', 'Feminism and family medicine', 'Positive family medicine', 'Mindful practice', 'The new, old ethics of family medicine', 'Public health, prevention and populations', 'Information mastery in family medicine' and 'Clinical courage.' May readers nurture their curiosity through these essays.

Reflections in the mirror: Bias, stereotypes and professional responsibility.

In this issue, Flynn and colleagues (see record 2020-40858-002) have authored an important article on the positive role for behavioral health integration in improving health, mental health, and quality of life for Latinx primary care patients along the U.S.-Mexico border (Flynn, Gonzalez, Mata, Salinas, & Atkins, 2020). The title of the article is "Integrated Care Improves Mental Health in a Medically Underserved US-Mexico Border Population." Article titles, of course, never tell the full story contained within. The author's use of the term medically underserved as a descriptor invites reflection on other potential descriptors of this tender and vulnerable population. How about soul-battered? Isolated and invisible? Medically maltreated? Human rights denied? In this commentary, I hope to draw heightened attention to the importance of health care practitioners' turning inward, exploring our contributions to health inequities, and turning down the impacts of stereotypes and implicit bias in how we work with our patients and our teams. You will also find within these lines a call for upstream social change in how our society rectifies historical social, environmental, and health injustice and inequities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Addressing Racism in Medical Education An Interactive Training Module.

BACKGROUND AND OBJECTIVES: Education of health care clinicians on racial and ethnic disparities has primarily focused on emphasizing statistics and cultural competency, with minimal attention to racism. Learning about racism and unconscious processes provides skills that reduce bias when interacting with minority patients. This paper describes the responses to a relationship-based workshop and toolkit highlighting issues that medical educators should address when teaching about racism in the context of pernicious health disparities. METHODS: A multiracial, interdisciplinary team identified essential elements of teaching about racism. A 1.5-hour faculty development workshop consisted of a didactic presentation, a 3-minute video vignette depicting racial and gender microaggression within a hospital setting, small group discussion, large group debrief, and presentation of a toolkit. RESULTS: One hundred twenty diverse participants attended the workshop at the 2016 Society of Teachers of Family Medicine Annual Spring Conference. Qualitative information from small group facilitators and large group discussions identified some participants' emotional reactions to the video including dismay, anger, fear, and shame. A pre/postsurvey (N=72) revealed significant changes in attitude and knowledge regarding issues of racism and in participants' personal commitment to address them. DISCUSSION: Results suggest that this workshop changed knowledge and attitudes about racism and health inequities. Findings also suggest this workshop improved confidence in teaching learners to reduce racism in patient care. The authors recommend that curricula continue to be developed and disseminated nationally to equip faculty with the skills and teaching resources to effectively incorporate the discussion of racism into the education of health professionals.

Review of Clinical Uncertainty in Primary Care: The Challenge of Collaborative Engagement.

Reviews the book, Clinical Uncertainty in Primary Care: The Challenge of Collaborative Engagement edited by Lucia Siegel Sommers and John Lautner (see record 2013-30484-000). The bulk of this book comprises a wide array of different models for collaborative uncertainty work. From Balint groups that help participants to tolerate uncertainty to narrative-based supervision that poses challenging self-reflective questions, each chapter provides a description of group intervention design, theoretical context, the structure for facilitation, and outcome data on impact. The book is a powerfully thoughtful and detailed exploration of the often overlooked topic of not understanding or knowing how to act in the best interest of a patient. The beautiful and self-disclosing writing is a gift to the reader, and the testimonies of the utility of these practices are undeniably compelling. (PsycINFO Database Record

Culturally responsive integrated health care: Key issues for medical education.

Primary care providers are increasingly responsible for providing mental health care in the United States. For those patients who do receive specialty mental health services, the primary care provider functions as the main entry point into the mental health system. Given the persistent racial and ethnic health disparities in the United States, it is not surprising that mental health disparities also present a difficult challenge for both the U.S. health system and for frontline practitioners. Physicians-in-training require tools for rapid psychiatric assessment that will quickly identify pertinent symptom clusters and distinguish between major psychological disorders. It is incumbent on residency faculty to teach resident physicians how to provide culturally responsive mental health assessment and intervention/referral knowledge and skills toward the elimination of these disparities and toward patient-centered care. This article begins with an overview of health disparities and barriers to health and mental health care access, followed by a discussion of culturally responsive care including an example of a culturally responsive educational program in the United States that is directly targeting the problem of access in that geographic region. It concludes with a review of educational strategies for enhancing culturally responsive behavioral and mental health care by physicians in training.

Psychology and medical education: collaborations for culturally responsive care.

Recent years have witnessed an increasing attention to the vast and alarming health disparities in the United States. This paper explores provider factors in health disparities, considering the role of medical education in training health care providers to practice culturally responsive health care toward a diminution of health inequalities. The paper begins with a description of culturally responsive care along with an overview of the key elements of a comprehensive curriculum for health care providers in this arena. Next, the paper explores the key contributions from the field of psychology to collaborative instruction of health care providers in the areas of attitudes/awareness, knowledge and skills components of culturally responsive care. Finally, the paper concludes with a description of collaborative teaching from a family medicine residency program where a 33-h 'cultural medicine curriculum within the curriculum' is delivered over the course of 3 years.