Houshel, L. Microaggressions in the Medical Student Experience at the University of Cincinnati College of Medicine.
From Lauren Houshel
Introduction: Microaggressions are everyday verbal, nonverbal, slights, or insults, intentional or unintentional, that can communicate hostile messages, directed at individuals or groups based on their social characteristics. Our goal is to explore the frequency in which medical students experience microaggressions before and after having education on microaggressions and evaluate the impact on students in their recognition of microaggressions, selection of specialty and residency and medical school experience.
Methods: In Fall of 2019, UCCOM incorporated a 1-hour, mandatory lecture on microaggressions given by Dr. Anisa Shomo into the 3rd year curriculum. Class of 2020 did not receive this lecture, acting as a control group, while the Class of 2021 did receive this lecture, acting as an experimental group. In the Spring of 2020 and 2021, surveys were administered to 4th-year year medical students of the Class of 2020 and 2021 after they matched into their respective residencies. The survey defined microaggressions and provided common examples reported by medical students to ensure understanding of the survey. The survey included questions about students' experiences with microaggressions including the timing, setting, and comfortability with confronting microaggressions. The control group and experimental group were then analyzed for differences in the frequency, recognition, reporting, or response to microaggressions.
Results: The study sample included 59 participants (31 male, 28 female) from Class of 2020 and 57 participants (24 male, 33 female) from Class of 2021 of UCCOM. Class of 2021 served as the control group. The percentage of participants experienced and recognized microaggressions did not differ between classes X 2 (1, N= 116)= 0 , p=0.258. A chi-square test was performed to examine the relation between gender and the experience of microaggressions. The relation between these variables was significant for the Class of 2020 X 2 (1, N= 59 )= 0 , p=0.00) as well as the class of 2021 X 2 (1, N= 57)= 0 , p=0.024). Women were more likely to experience microaggressions than men. A thematic analysis revealed themes of microaggressions on marginalized identities and lack of reporting microaggressions in both groups.
Conclusion: Women are experiencing medical school differently than men even though women make up roughly 50% of UCCOM students. Internal medicine, surgery, and obstetrics-gynecology were the most specifically named reported rotations where students experienced microaggressions. Despite this, participants were not more likely to address or report microaggressions, most students ignored them in both groups. It was found that experience of microaggressions impacted some individuals’ decision to stay in Cincinnati for residency and/or practice. Lastly, after learning about microaggressions, a higher percentage of students reported experiencing microaggression, but the difference was not significant.
Contact information: Lauren Houshel (houshelk@mail.uc.edu), Danielle Johnson (johns6da@mail.uc.edu)
Key Words: Microaggression, macroaggression, implicit bias, explicit bias, medical student experience.
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