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      Six ways to get a grip by calling-out racism and enacting allyship in medical education Translated title: Six stratégies pour lutter contre le racisme et pour promouvoir la solidarité dans l’éducation médicale

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          Abstract

          Actively addressing racism in our faculties of medicine is needed now, more than ever. One way to do this is through allyship, the practice of unlearning and re-evaluating, in which a person in a position of privilege and power seeks to operate in solidarity with a traditionally marginalized group. In this paper, we provide practical tips on how to practice allyship, giving educators and leaders background understanding and important tools on how to actively promote equity and diversity. We also share tips on how to promote inclusivity to more accurately reflect the communities we serve. Through six broad actions of being, knowing, feeling, doing, promoting, and acting, we can empower individuals to become allies and address racism in medical education and beyond. Creating psychologically safe spaces, educating ourselves on our complex histories and how they influence the present, recognizing racism, and advocating for change, augments awareness from which we can pivot conversations. Acknowledging potential feelings of shame, guilt, and embracing our loss of privilege, allow necessary, but challenging, personal growth to occur. Finally, dismantling the racist structures that exist within medicine, moving us beyond individual interventions, will address the systemic nature of racism in medicine. Everyone can find a starting place within this guide, as simple, consistent actions foster change in our spheres of influence; and the ripple effect of these changes will impact attitudes and behaviours broadly.

          Translated abstract

          Il est plus que jamais nécessaire de s’attaquer activement au racisme dans les facultés de médecine. Une des stratégies qu’on peut adopter à cette fin est celle de l’allié, désignée en anglais par le terme allyship. Il s’agit de la pratique du désapprentissage et de la réévaluation, par laquelle une personne en position de privilège et de pouvoir s’efforce d’agir en solidarité avec un groupe marginalisé. Cet article vise à proposer aux enseignants et aux responsables des conseils pratiques sur la façon d’agir en alliés, notamment en offrant les informations nécessaires à une compréhension générale de la problématique en toile de fond, ainsi que des outils importants pour promouvoir activement l’équité et la diversité. Nous partageons également des stratégies pour encourager l’inclusivité afin de représenter plus fidèlement les populations auxquelles nous offrons nos services. Grâce à une démarche à six volets (être, savoir, ressentir, faire, promouvoir et agir), nous pouvons donner aux personnes les moyens de devenir des alliées dans la lutte contre le racisme de façon générale et dans l’enseignement médical en particulier. La création d’espaces psychologiquement sûrs, la sensibilisation aux vécus complexes et à leur influence sur le présent des individus, la reconnaissance du racisme et le plaidoyer pour le changement contribuent à une prise de conscience qui permet d’orienter le dialogue. La croissance personnelle, aussi difficile que nécessaire, passe par la reconnaissance des sentiments de honte et de culpabilité et par la renonciation au privilège. Enfin, le démantèlement des structures racistes présentes dans le monde médical permettra de s’attaquer à la nature systémique du racisme dans le milieu de la santé, au-delà des interventions au cas par cas. Tout un chacun trouvera un point de départ dans ce guide, car ce sont les actions simples et cohérentes qui favorisent le changement dans les sphères d’influence; l’effet d’entraînement que produisent les actions individuelles se traduira par un changement général des mentalités et des comportements.

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          Psychological Safety: The History, Renaissance, and Future of an Interpersonal Construct

          Psychological safety describes people’s perceptions of the consequences of taking interpersonal risks in a particular context such as a workplace. First explored by pioneering organizational scholars in the 1960s, psychological safety experienced a renaissance starting in the 1990s and continuing to the present. Organizational research has identified psychological safety as a critical factor in understanding phenomena such as voice, teamwork, team learning, and organizational learning. A growing body of conceptual and empirical work has focused on understanding the nature of psychological safety, identifying factors that contribute to it, and examining its implications for individuals, teams, and organizations. In this article, we review and integrate this literature and suggest directions for future research. We first briefly review the early history of psychological safety research and then examine contemporary research at the individual, group, and organizational levels of analysis. We assess what has been learned and discuss suggestions for future theoretical development and methodological approaches for organizational behavior research on this important interpersonal construct.
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            Standing up for a change: reducing bias through interpersonal confrontation.

            Three experiments examined the effectiveness of interpersonal confrontations as a means for decreasing stereotypic responding. After making stereotypic inferences about Black individuals, participants were confronted and reactions were measured across various intrapersonal and interpersonal response domains. Confrontations varied in level of hostility (Experiment 1) and whether they were expressed by a Black or White person (Experiment 2). Results indicate that although confrontations (and particularly hostile ones) elicited negative emotions and evaluations toward the confronter, participants also experienced negative self-directed affect. Furthermore, regardless of who did the confronting or how much hostility was expressed, confronted participants subsequently were less likely to provide stereotypic responses (Experiments 1-2), and the effect of the confrontation generalized to reporting less prejudiced attitudes (Experiment 3). Copyright 2006 APA.
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              The coin model of privilege and critical allyship: implications for health

              Health inequities are widespread and persistent, and the root causes are social, political and economic as opposed to exclusively behavioural or genetic. A barrier to transformative change is the tendency to frame these inequities as unfair consequences of social structures that result in disadvantage, without also considering how these same structures give unearned advantage, or privilege, to others. Eclipsing privilege in discussions of health equity is a crucial shortcoming, because how one frames the problem sets the range of possible solutions that will follow. If inequity is framed exclusively as a problem facing people who are disadvantaged, then responses will only ever target the needs of these groups without redressing the social structures causing disadvantages. Furthermore, responses will ignore the complicity of the corollary groups who receive unearned and unfair advantage from these same structures. In other words, we are missing the bigger picture. In this conceptualization of health inequity, we have limited the potential for disruptive action to end these enduring patterns. The goal of this article is to advance understanding and action on health inequities and the social determinants of health by introducing a framework for transformative change: the Coin Model of Privilege and Critical Allyship. First, I introduce the model, which explains how social structures produce both unearned advantage and disadvantage. The model embraces an intersectional approach to understand how systems of inequality, such as sexism, racism and ableism, interact with each other to produce complex patterns of privilege and oppression. Second, I describe principles for practicing critical allyship to guide the actions of people in positions of privilege for resisting the unjust structures that produce health inequities. The article is a call to action for all working in health to (1) recognize their positions of privilege, and (2) use this understanding to reorient their approach from saving unfortunate people to working in solidarity and collective action on systems of inequality.
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                Author and article information

                Journal
                Can Med Educ J
                Can Med Educ J
                CMEJ
                Canadian Medical Education Journal
                Canadian Medical Education Journal
                1923-1202
                15 May 2021
                14 September 2021
                September 2021
                : 12
                : 4
                : 111-115
                Affiliations
                [1 ]University of Alberta, Alberta, Canada;
                [2 ]University of Toronto, Ontario, Canada;
                [3 ]Dalhousie University, Nova Scotia, Canada;
                [4 ]University of Maastricht, Maastricht, Netherlands
                Author notes
                Correspondence to: Lyn K. Sonnenberg 1-128A, Katz Group Centre for Research, 11315 87 Ave NW, Edmonton, Alberta, Canada, T6G 2H5; email: lyn.sonnenberg@ 123456ualberta.ca
                Article
                CMEJ-12-111
                10.36834/cmej.71566
                8463233
                34567311
                68810ac8-12b5-4088-a08e-a0e4da1abaf2
                © 2021 Sonnenberg, Do, LeBlanc, Busari; licensee Synergies Partners

                This is an Open Journal Systems article distributed under the terms of the Creative Commons Attribution License. ( https://creativecommons.org/licenses/by-nc-nd/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is cited.

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