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International Journal of Healthcare Simulation
The Power of We: Confronting Bias in Medical Education

Article Type: Perspective, Article History

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    Dotson: The Power of We: Confronting Bias in Medical Education

    ‘The Power of We: Confronting Bias in Medical Education’ was written to bring awareness to a global community of the inequities and financial burden of healthcare in the United States.

    As a poet/playwright, my wife and I founded Inner City South (2008), a production company that uses educational programming and performing arts as a platform to raise the profile and support for creative solutions towards youth education, community pride and job creation. Using poetry and plays we explore ways to break down barriers that render our community members invisible, powerless and disposable.

    In 2014, I was first exposed to simulation-based training. I became a simulated patient, and later in 2019 became an Simulated/Standardized Patient (SP) Educator. As I began to learn more about the power of simulation, I saw natural connections to my theatre experience. As a playwright, I was using the art of storytelling to entertain my audience, but as an SP Educator in simulation, I am using the art of storytelling to educate our learners. I found that simulation can help learners see their blind spots and have a safe environment to practice effective communication skills.

    In 2020, I became very interested in being a part of the case development team. As a playwright, my experience gave me a unique opportunity to promote an open-minded learning environment and create a culture of normalizing the visibility of marginalized populations.

    In 2022, colleagues and I at the Center for Healthcare Improvement and Patient Simulation (CHIPS) created the ‘Power of We Townhall’. The Townhall was designed to bring staff, students and faculty together to discuss how simulated-based training can challenge our learners’ critical thinking skills about specific cultural characteristics or pre-conceived notions about specific groups of people.

    The poem, ‘The Power of We: Confronting Bias in Medical Education’, originally named ‘Sometimes it’s not Political’, was a poem I wrote years ago that seems to have such relevance to the simulation work I do today. There seems to be a natural connection between the community focus of my theatre work, to training learners to communicate with their patients more effectively.

    To give some context to the poem from my perspective as an SP Educator I will dissect some of the lines for readers to gain more insight into their meaning.

    I begin the poem, “Sometimes it’s not political, It’s not a black or a white thing.” I associate this to the national conversation in the United States about healthcare; how race and socioeconomic status dictate who has access to care in our society. We must remember, healthcare is about taking care of another human being in need and not politics.

    The poem continues “We can’t be selective with our perspective, because the answers are frightening.” This line denotes that “the facts” should not be skewed to avoid responsibility. There must be an urgency to find solutions to providing more equitable care and not turn a blind eye to how racism and bias effect outcomes with the US healthcare system. The statistics do not lie; we have a systematic problem with disparity in healthcare (race, gender, ethnicity, age, etc.). I think simulation gives us a space to start dismantling some of these inequities.

    Around line 10, “Instead of acting out of anger, fear and insecurity,” I implore the reader to avoid emotional reactions to things they may not be informed about. Transitioning to how bridges are constructed through diverse thought, the feelings of inclusion, and each unique individual having the ability to bring their strengths to the table.” We must create, innovate and expand; In ways that most don’t understand, Thinking outside the box only scares those with a limited view. So don’t be a hater, be a decision maker. The culture of the country is dictated by you.” Healthcare professionals have a responsibility to identify and mitigate the effects of their own personal bias on the patients they serve. It is a call to action to move past emotional reactions to more strategic responses to promote safer, more equitable care.

    As a person of colour, lines 20-34 was a direct message to other persons of colour in the healthcare community whose culture and uniqueness are often discounted. Once we realize we can capitalize off our own originality, It’s essential we use our potential to do more than collect a salary. The natural passion to be a caregiver should not be reduced to a paycheck. Creating a culturally diverse learning environment starts with diverse leadership.

    In closing the poem I give my motivations to share my message and the final message of unity. “God gave these words to me, So I share hoping a seed would be planted. We can be effective collectively. If we use our knowledge and skill to our advantage. I believe simulation can be a helpful tool that gives future providers the skills needed to care for patients from various backgrounds. I used the pronoun ‘we’ throughout the poem (11) to illustrate how it is all our responsibility to confront how racism and bias effect our patients.

    Sometimes it’s not political

    It’s not a Black or a White thing

    We can’t be selective

    With our perspective

    Because the answers are frightening

    Hate can consume the soul

    So, beware of its consequence.

    Sometimes we must use common sense

    Before prejudice takes control

    Instead of acting out of anger

    Fear and Insecurity

    We must

    Create, Innovate and Expand

    In ways that most don’t understand.

    Thinking outside the box

    Only scares those with a limited view.

    So don’t be a hater

    Be a decision maker

    The culture of the country is dictated by you

    Once we realize we can capitalize

    Off our own originality

    It’s essential we use our potential

    To do more than collect a salary

    Creating revenue for those like you

    Builds a cultural foundation

    We won’t have time to complain

    If we get our heads in the game

    And financially influence the nation

    Issues like healthcare,

    Education and welfare

    Become the community’s responsibility

    The visibility of the poor

    Is a problem we can no longer ignore

    Because it doesn’t affect us individually

    God gave these words to me

    So, I share hoping a seed would be planted

    We can be effective collectively

    If we use our knowledge and skill

    To our advantage