Theater for Healthcare Equity; A Model for Inclusion and Anti-Bias Training in Academic Medicine.

There are no standardized methods for training medical personnel in antiracist action, such as how to be an upstander or how to use micro-resistance. Roleplay and drama-based pedagogy can empower and educate healthcare professionals by providing experiential training and a safe space for antiracist practice and discussion. The Theater for Healthcare Equity (THE) is an innovative methodology that explores upstander techniques in real time with facilitated instruction. We implemented eight THE sessions at our institution and assessed participant responses via a voluntary survey. Forty-one participants completed a REDCap survey, and 32 participants completed the Continuing Medical Education survey. Participants appreciated the creation of safe spaces, the practice format, and the learning experience, which provided an honest and open environment for the sharing of experiences, addressing race-based bias, and practicing responses to real-life scenarios. Constructive feedback included changes to session duration, participant discomfort with improvisation, and lack of printed tools.

Forum theatre for training residents to be allies.

BACKGROUND: Residents are commonly targets and bystanders of workplace discrimination, yet little is known about how best to train residents to manage these incidents. We sought to train residents to respond effectively to being a target or bystander of discrimination. APPROACH: We used a novel, 75-min theatrical role-playing intervention called Theatre for Healthcare Equity (T.H.E.) to teach 71 internal medicine residents between December 2017 and February 2018. In T.H.E. residents took turns acting as either a 'resident' target or a 'student' bystander in a simulated scenario of discrimination. A facilitator led follow-up discussions including group reflection and development of learning scripts to help with difficult situations. A post-graduation survey was sent in November 2021 to assess residents' retention of knowledge, attitudes and potential application in practice. EVALUATION: T.H.E. was well received by residents, though survey response rates were low. All respondents to a post-session survey reported having acquired knowledge and skills to help them respond to incidents of bias and discrimination. Most respondents to the post-graduation survey nearly 4 years later remembered T.H.E.; seven wrote reflective narrative responses indicating that T.H.E. had raised awareness of these issues, empowered them to speak up on behalf of colleagues and validated their emotional reactions to hurtful speech from patients. We describe an incident in which a former resident attributed his ability to serve as an effective bystander ally to participating in T.H.E. years earlier. IMPLICATIONS: T.H.E. was an efficient, well-received intervention that some of our residents found to have been helpful years later. We continue to use T.H.E. as the basis for periodic ongoing allyship training for residents and teaching faculty to improve the inclusiveness of our clinical learning environment.