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Am J Orthopsychiatry. 2014 Sep;84(5):590-6. doi: 10.1037/ort0000026.

Dialogue as skill: training a health professions workforce that can talk about race and racism.

Author information

1
Betty Irene Moore School of Nursing.
2
ProActive Communications.
3
Division of General Internal Medicine, University of California Davis School of Medicine.
4
Kaiser Permanente East Bay.
5
Department of Graduate Medical Education and Primary Care, Oakland Children's Hospital.

Abstract

Efforts in the field of multicultural education for the health professions have focused on increasing trainees' knowledge base and awareness of other cultures, and on teaching technical communication skills in cross-cultural encounters. Yet to be adequately addressed in training are profound issues of racial bias and the often awkward challenge of cross-racial dialogue, both of which likely play some part in well-documented racial disparities in health care encounters. We seek to establish the need for the skill of dialoguing explicitly with patients, colleagues, and others about race and racism and its implications for patient well-being, for clinical practice, and for the ongoing personal and professional development of health care professionals. We present evidence establishing the need to go beyond training in interview skills that efficiently "extract" relevant cultural and clinical information from patients. This evidence includes concepts from social psychology that include implicit bias, explicit bias, and aversive racism. Aiming to connect the dots of diverse literatures, we believe health professions educators and institutional leaders can play a pivotal role in reducing racial disparities in health care encounters by actively promoting, nurturing, and participating in this dialogue, modeling its value as an indispensable skill and institutional priority.

PMID:
25265221
DOI:
10.1037/ort0000026
[Indexed for MEDLINE]

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