They Don't See a Lot of People My Color: A Mixed Methods Study of Racial/Ethnic Stereotype Threat Among Medical Students on Core Clerkships.

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Tytuł:: They Don't See a Lot of People My Color: A Mixed Methods Study of Racial/Ethnic Stereotype Threat Among Medical Students on Core Clerkships.
Autorzy:: Bullock JL; J.L. Bullock is a first-year resident in internal medicine, University of California, San Francisco, School of Medicine, San Francisco, California.
Lockspeiser T; T. Lockspeiser is assistant dean of medical education-assessment, evaluation, and outcomes, and associate professor, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.
Del Pino-Jones A; A. del Pino-Jones is associate professor, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado.
Richards R; R. Richards is director, Office of Diversity and Inclusion, and assistant professor, Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado.
Teherani A; A. Teherani is director of program evaluation and professor, Department of Medicine and Center for Faculty Educators, University of California, San Francisco, School of Medicine, San Francisco, California.
Hauer KE; K.E. Hauer is associate dean for competency assessment and professional standards and professor, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California.
Źródło:: Academic medicine : journal of the Association of American Medical Colleges [Acad Med] 2020 Nov; Vol. 95 (11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 59th Annual Research in Medical Education Presentations), pp. S58-S66.
Typ publikacji:: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Publication: Philadelphia, PA : Published for the Association of American Medical Colleges by Lippincott Williams & Wilkins
Original Publication: [Philadelphia, Pa. : Hanley & Belfus, c1989-
MeSH Terms:: Clinical Clerkship*
Racial Groups*
Stereotyping*
Students, Medical/*psychology
Adult ; Female ; Humans ; Male ; Self Report ; United States
References:: Colbert CY, French JC, Herring ME, Dannefer EF. Fairness: The hidden challenge for competency-based postgraduate medical education programs. Perspect Med Educ. 2017; 6:347–355.
Hafferty FW. Beyond curriculum reform: Confronting medicine’s hidden curriculum. Acad Med. 1998; 73:403–407.
Teherani A, Hauer KE, Fernandez A, King TE Jr, Lucey C. How small differences in assessed clinical performance amplify to large differences in grades and awards: A cascade with serious consequences for students underrepresented in medicine. Acad Med. 2018; 93:1286–1292.
Stegers-Jager KM, Steyerberg EW, Cohen-Schotanus J, Themmen AP. Ethnic disparities in undergraduate pre-clinical and clinical performance. Med Educ. 2012; 46:575–585.
Brosnan C, Southgate E, Outram S, et al. Experiences of medical students who are first in family to attend university. Med Educ. 2016; 50:842–851.
Rojek AE, Khanna R, Yim JWL, et al. Differences in narrative language in evaluations of medical students by gender and under-represented minority status. J Gen Intern Med. 2019; 34:684–691.
Beagan BL. Everyday classism in medical school: Experiencing marginality and resistance. Med Educ. 2005; 39:777–784.
Bullock JL, Lai CJ, Lockspeiser T, et al. In pursuit of honors: A multi-institutional study of students’ perceptions of clerkship evaluation and grading. Acad Med. 2019; 94(11 suppl):S48–S56.
Woolf K, Cave J, Greenhalgh T, Dacre J. Ethnic stereotypes and the underachievement of UK medical students from ethnic minorities: Qualitative study. BMJ. 2008; 337:a1220.
Lee KB, Vaishnavi SN, Lau SK, Andriole DA, Jeffe DB. “Making the grade:” Noncognitive predictors of medical students’ clinical clerkship grades. J Natl Med Assoc. 2007; 99:1138–1150.
Low D, Pollack SW, Liao ZC, et al. Racial/ethnic disparities in clinical grading in medical school. Teach Learn Med. 2019; 31:487–496.
Xu G, Veloski JJ, Hojat M, Gonnella JS, Bacharach B. Longitudinal comparison of the academic performances of Asian-American and white medical students. Acad Med. 1993; 68:82–86.
Ackerman K, Latimore D, Drake C, Bay E. Stereotype threat susceptibility among minority health professions students. J Best Prac Health Prof Div Edu Res Policy. 2016; 9:1232–1246.
Erwin DO, Henry-Tillman RS, Thomas BR. A qualitative study of the experiences of one group of African Americans in pursuit of a career in academic medicine. J Natl Med Assoc. 2002; 94:802–812.
Aronson J, Fried CB, Good C. Reducing the effects of stereotype threat on African American college students by shaping theories of intelligence. J Exp Soc Psychol. 2002; 125:113–125.
Steele CM. A threat in the air. How stereotypes shape intellectual identity and performance. Am Psychol. 1997; 52:613–629.
Spencer SJ, Logel C, Davies PG. Stereotype threat. Annu Rev Psychol. 2016; 67:415–437.
Pennington CR, Heim D, Levy AR, Larkin DT. Twenty years of stereotype threat research: A review of psychological mediators. PLoS One. 2016; 11:e0146487.
Burgess DJ, Warren J, Phelan S, Dovidio J, van Ryn M. Stereotype threat and health disparities: What medical educators and future physicians need to know. J Gen Intern Med. 2010; 25(suppl 2):S169–S177.
Spencer SJ. The effect of stereotype vulnerability on women’s math performance [Doctoral thesis]. Ann Arbor, MI: University of Michigan. 1993.
Lamont RA, Swift HJ, Abrams D. A review and meta-analysis of age-based stereotype threat: Negative stereotypes, not facts, do the damage. Psychol Aging. 2015; 30:180–193.
Aronson J, Lustina MJ, Good C, Keough K, Steele CM, Brown J. When White men can’t do math: Necessary and sufficient factors in stereotype threat. J Exp Soc Psychol. 1999; 35:29–46.
Creswell JW, Plano-Clark VL. Choosing a mixed methods design. Creswell JW, Plano-Clark VL, eds. In: Designing and Conducting Mixed Methods Research. Thousands Oaks, CA: Sage Publications. 201153–107.
Stenfors-Hayes T, Hult H, Dahlgren MA. A phenomenographic approach to research in medical education. Med Educ. 2013; 47:261–270.
University of California, San Francisco Office of Diversity and Outreach. Fall 2018 demographic data. https://diversity.ucsf.edu/reports-data/diversity-data. Accessed April 2, 2020.
University of Colorado, Anschutz Medical Campus. Reports & policy briefs. https://www.cu.edu/oaa/reports-policy-briefs. Retrieved April 2, 2020.
Quintana SM. Racial and ethnic identity: Developmental perspectives and research. J Couns Psychol. 2007; 54:259–270.
Nelson J. Using conceptual depth criteria: Addressing the challenge of reaching saturation in qualitative research. Qual Res. 2017; 17:554–570.
Larsson J, Holmström I. Phenomenographic or phenomenological analysis: Does it matter? Examples from a study on anaesthesiologists work. Int J Qual Stud Health Well-Being. 2007; 2:55–64.
Berger R. Now I see it, now I don’t: Researcher’s position and reflexivity in qualitative research. Qual Res. 2015; 15:219–234.
Ortlipp M. Keeping and using reflective journals in the qualitative research process. Qual Rep. 2008; 13:695–705.
Birt L, Scott S, Cavers D, Campbell C, Walter F. Member checking: A tool to enhance trustworthiness or merely a nod to validation?. Qual Health Res. 2016; 26:1802–1811.
Taylor E, Antony JS. Stereotype threat reduction and wise schooling: Towards the successful socialization of African American doctoral students in education. J Negro Educ. 2000; 69:184–198.
Young JQ, Van Merrienboer J, Durning S, ten Cate O. Cognitive load theory: Implications for medical education: AMEE guide no. 86. Med Teach. 2014; 36:371–384.
Sewell JL, Maggio LA, ten Cate O, van Gog T, Young JQ, O’Sullivan PS. Cognitive load theory for training health professionals in the workplace: A BEME review of studies among diverse professions: BEME guide no. 53. Med Teach. 2019; 41:256–270.
Beilock SL, Rydell RJ, McConnell AR. Stereotype threat and working memory: Mechanisms, alleviation, and spillover. J Exp Psychol Gen. 2007; 136:256–276.
Schmader T, Johns M. Converging evidence that stereotype threat reduces working memory capacity. J Pers Soc Psychol. 2003; 85:440–452.
Caverzagie KJ, Goldenberg MG, Hall JM. Psychology and learning: The role of the clinical learning environment. Med Teach. 2019; 41:375–379.
Tsai J, Crawford-Roberts A. A call for critical race theory in medical education. Acad Med. 2017; 92:1072–1073.
Dixson AD, Rousseau Anderson CK, Donnor JK, eds. Critical Race Theory in Education: All God’s Children Got a Song. 2nd ed, New York, NY: Taylor and Francis. 2016.
Torres MB, Salles A, Cochran A. Recognizing and reacting to microaggressions in medicine and surgery. JAMA Surg. 2019; 154:868–872.
Espaillat A, Panna DK, Goede DL, Gurka MJ, Novak MA, Zaidi Z. An exploratory study on microaggressions in medical school: What are they and why should we care?. Perspect Med Educ. 2019; 8:143–151.
Wheeler DJ, Zapata J, Davis D, Chou C. Twelve tips for responding to microaggressions and overt discrimination: When the patient offends the learner. Med Teach. 2019; 41:1112–1117.
Glaser J, Pfeffinger A, Quan J, Fernandez A. Medical students’ perceptions of and responses to health care disparities during clinical clerkships. Acad Med. 2019; 94:1190–1196.
Fernandez A. Further incorporating diversity, equity, and inclusion into medical education research. Acad Med. 2019; 94(11 suppl):S5–S6.
Entry Date(s):: Date Created: 20200810 Date Completed: 20201217 Latest Revision: 20211204
Update Code:: 20240105
DOI:: 10.1097/ACM.0000000000003628
PMID:: 32769459
: Czasopismo naukowe

Purpose: Stereotype threat is an important psychological phenomenon in which fear of fulfilling negative stereotypes about one's group impairs performance. The effects of stereotype threat in medical education are poorly characterized. This study examined the prevalence of racial/ethnic stereotype threat amongst fourth-year medical students and explored its impact on students' clinical experience.
Method: This was an explanatory sequential mixed methods study at 2 institutions in 2019. First, the authors administered the quantitative Stereotype Vulnerability Scale (SVS) to fourth-year medical students. The authors then conducted semistructured interviews among a purposive sample of students with high SVS scores, using a qualitative phenomenographic approach to analyze experiences of stereotype threat. The research team considered reflexivity through group discussion and journaling.
Results: Overall, 52% (184/353) of students responded to the survey. Collectively, 28% of students had high vulnerability to stereotype threat: 82% of Black, 45% of Asian, 43% of Latinx, and 4% of White students. Eighteen students participated in interviews. Stereotype threat was a dynamic, 3-stage process triggered when students experienced the workplace through the colored lens of race/ethnicity by standing out, reliving past experiences, and witnessing microaggressions. Next, students engaged in internal dialogue to navigate racially charged events and workplace power dynamics. These efforts depleted cognitive resources and interfered with learning. Finally, students responded and coped to withstand threats. Immediate and deferred interventions from allies reduced stereotype threat.
Conclusions: Stereotype threat is common, particularly among non-White students, and interferes with learning. Increased minority representation and developing evidence-based strategies for allyship around microaggressions could mitigate effects of stereotype threat.

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