A national pilot study on simulation‐based upstander training for emergency medicine clinicians

• Published in: AEM education and training Vol. 8; no. 3; pp. e10990 - n/a
• Main Authors: Mundo, William, Vaughn, Jordan, Odetunde, Adetoriola, Donovan, Tai, Alvarez, Al'ai, Smith, Kristyn, Brown, Cortlyn, Brown, Italo, Datta, Suchismita, Vora, Samreen, Ward‐Gaines, Jacqueline
• Format: Journal Article
• Language: English
• Published: United States 01-06-2024
• Subjects: diversity; health equity; microaggressions; racism; simulation; upstanding; microaggressions; health equity; upstanding; diversity; racism; simulation
• ISSN: 2472-5390; 2472-5390
• DOI: 10.1002/aet2.10990

Objective
This study assesses the effectiveness of clinical simulation‐based training in boosting self‐perceived confidence for using upstander communication skills to confront racism, discrimination, and microaggressions (RDM).
Methods
We conducted an observational cohort study with emergency medicine professionals at the 2023 Scientific Assembly of the American Academy of Emergency Medicine in New Orleans, Louisiana. The study featured a clinical simulation‐based training on upstander communications skills session followed by small‐ and large‐group debriefs. Participants completed pre‐ and post‐training questionnaires assessing demographics and confidence in health equity competencies. This survey was used in a previous study with emergency medicine residents. Data were analyzed using an independent Student's t‐test, with a significance threshold of 0.05.
Results
Thirty‐two individuals participated in the simulation‐based training, and 24 completed surveys, with a 75% response rate. Most participants were non‐Hispanic (24, 85.7%) and women (18, 64%), with racial demographics mostly White (8, 28.6%), Black or African American (8, 28.6%), and Asian (6, 21.4%). After the workshop, there was a notable increase in self‐perceived ability and confidence in identifying RDM (from 7 ± 3.2 to 8.6 ± 1.6, p < 0.003), using upstander communication tools (from 6.1 ± 3.5 to 8.5 ± 1, p < 0.0001), and the likelihood of intervening in RDM situations (from 7.1 ± 3.3 to 8.8 ± 1.1, p < 0.0002).
Conclusions
The clinical simulation‐based training significantly improved participants' confidence and self‐perceived ability to address RDM in simulated clinical environments. This training method is a promising tool for teaching health equity topics in clinical medicine.