JSNMA SUMMER 2019 Sneak Preview

32 Scientific Focus
DEAR MAN: A TRAUMA-INFORMED
APPROACH TO ADDRESSING
RACISM IN THE CLINICAL SETTING
Roy Collins, MPH 1 ; Nia
Johnson 1 ; Felisha Perry-
Smith 1 ; Albert Kombe 1 ;
Alauna Curry, MD 2
Abstract
Background Many healthcare providers express
discomfort with exploring the topic of racism within
the patient care setting. Even in environments where
cultural competence training is present, providers
are often ignorant to institutional oppression at
large. They are often inadequately trained to make
significant improvements to an otherwise oppressive
system for diverse patients. As a result, empathy—a
means for providers to gain the perspectives of
their patients—is lost. The desired outcome of our
workshop was utilization of empathy, applied such
that participants can effectively address racial
trauma and communicate using evidenced-based
techniques: Describe, Express, Assert, Reinforce,
be Mindful, Appear confident, and Negotiate (DEAR
MAN). The research question is centered around
the efficacy of the workshop in improving empathetic
skills.
Methods The researchers adapted a presentation
originally provided to mental health providers into
a student-led workshop during a Health and Social
Justice Conference held at Saint Louis University.
It included a slideshow presentation and smallgroup
discussions where presenters and attendees
explored the complexities of racism in healthcare,
gave anecdotal experiences relevant to racism and
discrimination, and developed practical strategies
for improving communication. Attendees included:
medical students, physicians, nurses, and social
workers affiliated with the university. Surveys
consisted of pre- and post-workshop questionnaires.
Each survey recorded the participants’ demographic
information and self-assessments in utilizing empathy
1
Saint Louis University School of Medicine,
MD Candidate
2
Baylor College of Medicine
by assessing their comfort level in identifying and
addressing racism in the clinical setting. Data was
analyzed using SPSS.
Results The surveys showed demographics that
suggest moderate diversity among the participants.
The pre-test survey showed that the reported comfort
level for addressing racism with a patient of a different
race varied significantly by the participants’ race and
generation, and also showed that the reported level of
the importance of addressing racial trauma in clinical
practice differed by the participants’ generation and
religion. Post-test data showed that the participants’
comfort with the concept of empathy varied by
income, gender, race, and religion. Comfort using
DEAR MAN skills differed by the participants’ income,
race, and profession; while their likelihood for future
incorporation of these techniques varied by gender
and religion. In comparing the two questionnaires,
participants showed modest improvement in their
comfort level for addressing racism with patients
independent of their race, and also in their comfort
with responding to the psychologically traumatizing,
racial interactions their patients report in the clinical
setting.
Conclusions The results suggest improved utilization
of empathy in addressing racism and responding to
its psychological trauma. Limitations include selection
bias and sample size. Overall, this workshop shows
promise as a tool for empathy-based training
designed to positively impact physician behaviors.
J o u r n a l o f t h e S t u d e n t N a t i o n a l M e d i c a l A s s o c i a t i o n