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Medical center uses theater-based training to help employees address bias, micro-aggression

Aug 12, 2019

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Health care providers and staff at the University of Rochester Medical Center recently participated in an interactive training project to help them to deal with racism, bias, and micro-aggression in the workplace.

The training was prompted by reports from employees that they were encountering extremely biased patients, according to Adrienne Morgan, senior director of URMC's Center for Advocacy, Community Health, Education, and Diversity.

"For example, I was talking to someone who said, 'A lot of times, patients tell me they don't want me to be their doctor because I wear a hijab,' " she said.

The training program was based on the Theatre of the Oppressed (TO) project.  The methodology was created in Brazil in the 1960s for citizens to rehearse ways of resisting the oppression of a totalitarian regime.  It has since been adapted across the world in training for prison inmates, youth offenders, and other marginalized groups. The training uses theater techniques and physical movements to dramatize real situations where participants act out their own creative responses to various scenarios.

Morgan says medical personnel aren't taught how to deal with prejudice and these exercises were a way to demonstrate different possibilities when responding to patients.         

"We're not going to change their mind in a five, ten, fifteen minute interaction," she explained. "What we can do is change the way that we approach that situation, whether that's 'I understand that you have these feelings, but in order for me to help you today, this is what we need to do,' as opposed to just walking out and saying, 'They want somebody else; what are we gonna do about it.' "

The program was facilitated by TO educator Carli Gaughf.  She said it is not a didactic program; trainers don't tell participants what to do in a certain situation. Instead, the exercises are designed to give people the chance to explore their own possibilities.

"It's not somebody lecturing and saying, 'This is what you should say; this is not what you should say,' " Morgan said. "It really gives that person the opportunity to come up with an authentic response that works for them."

Twenty University of Rochester Medical Center personnel were trained as trainers in this program, so they can offer similar workshops for their colleagues.

Doctors, nurses, and other medical professionals may appear to have an advantage because of their position of authority, but Morgan said facing bias in the workplace takes a toll on them, just as it would affect any person.

"They say micro-aggression is like death by a thousand cuts," she said. "Think about if this is continually happening to you because you're a person of color, because of your religion, your gender, your sexual identity. It really starts to wear on that person and it contributes to them losing their confidence."

The problem is not unique to Rochester, according to Morgan. "This is happening all over the United States and has become a major issue with providers," she said.