New York — New research presented today at the American Psychiatric Association’s Annual Meeting finds that a new training based in theatre and improv concepts helped empower Asian American, Native Hawaiian, and Pacific Islander (AANHPI) medical students to recognize and respond to racial bias in the clinical setting.

Researchers sought to improve physician well-being and reduce burnout among AANHPI healthcare trainees when they encounter racism in the clinical setting. “Historically, we have lacked systematized curricula addressing how to support ethnic and racial minority students facing microaggressions and structural racism in the clinical environment,” said Elizabeth Li, M.D., who presented the group’s research.

The team developed a webinar-based training to teach AANHPI participants how to navigate experiences of bias, prejudice, and stereotyping. Their aim was to evaluate the program’s feasibility and acceptability, impact on implicit bias recognition, and participant attitudes toward cultural dilemmas in the clinical setting.

Each Acting Together webinar consists of three modules: 1) improvisation to create a sharing and non-judgmental framework, 2) interactive theater to act out the example cultural dilemma, and 3) a panel discussion post-webinar. Skits depicting cultural conflicts are inspired by lived experiences with racial trauma; however, creating a space for make-believe “imparted a sense of psychological safety, [which] provided the freedom to explore responses, make mistakes, and identify solutions to challenging situations,” Li said.

To recruit study participants, trainees interested in creating inclusive clinical training environments and self-identified AANHPI healthcare trainees were invited via institutional listservs, affinity group listservs, and word of mouth, for a total of 112 attendees. Study participation involved pre- and post-program surveys as well as an optional focus group discussion.

Surveys included demographic questions, the Implicit Bias Attitude Scale, the Medical Improv Curriculum, and the Feasibility and Acceptability Scales. Most participants reported significant benefits, including enhanced:

• Engagement (81%) Proactivity in their professional career (81%).
• Adaptability (76%) Communication skills (71%).
• Wellness (68%).
• Confidence (68%).
• Peer connection (68%).
• Ability to seek support when cultural dilemmas occur (68%).
• Ability to recognize implicit bias (68%).

Furthermore, 90% of participants indicated that Acting Together was easy to adapt to their respective training program, 83% would join the program again, and 90% would recommend the program to their colleagues.

The authors conclude that the study data supports Acting Together’s feasibility and acceptability as a training module.

Study authors include lead author Eunice Yuen, Ph.D., M.D., Yale University, Elizabeth Li, M.D., MHS, Stanford University, Ingrid Chen, M.D., Kaiser Permanente East Bay, and Alicia Leong, Icahn School of Medicine at Mt. Sinai. Additional Co-PIs who helped conceptualize and lead this project include Neha Sharma, D.O., Tufts Medicine, Steven Sust, M.D., Stanford University, and Xiaoxi (Jessica) Ouyang, M.D., Georgetown University.

American Psychiatric Association

The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 38,900 physician members specializing in the diagnosis, treatment, prevention, and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information, please visit www.psychiatry.org.