Simulation for Teaching on Racial Microaggressions and Bystander Intervention — A Theory-Based Guide for Health Profession Education

Microaggressions are words or behaviour that “subtly and unconsciously express a prejudiced attitude”, and racial microaggressions express these attitudes towards people from racial minority groups. The “Bystander Effect” is when the presence of other people means that an individual is less likely to offer assistance or get involved in a situation — bystander intervention training aims to inform about the best ways to avoid this, equipping students with the necessary strategies. In health profession education, teaching on microaggressions and bystander intervention can be done with the use of simulation. Simulated patients (SPs) and environments would be the most appropriate modality of simulation to use, as roleplay would be central. This guide focuses on how to use simulation for teaching on racial microaggressions and bystander training for healthcare students including tips on preparing the students and SPs, planning for the implementation of the simulation training, setting ground rules, showing different scenarios, checking student understanding throughout, using debriefs and course evaluation feedback, and signposting students to available support afterwards. These are topics which are particularly relevant because there have been calls in recent years for healthcare education to be more inclusive and representative of current issues, as the COVID-19 pandemic and resurgence of the Black Lives Matter movement have highlighted curriculum gaps. So teaching students about this early is a good start, and simulation is an effective teaching method to help with this.