Simulation Training to Address Health Care Inequities 

October 2022

For residents training in specialties such as internal medicine, pediatrics, and emergency medicine, hands-on training is vital when it comes to practicing skills like stabilizing an airway or taking a patient’s medical history. When it comes to diversity, equity, and inclusion, however, training often occurs in a classroom or online, rather than with real-world experience.

To address that training gap, Jacqueline Ward-Gaines, MD, assistant professor of emergency medicine, in collaboration with the Center for Advancing Professional Excellence (CAPE), created an immersive simulation to teach emergency medicine residents the basics of health equity, from microaggressions and implicit bias to language barriers and mistrust of doctors.

In the program, residents are confronted with situations they are likely to face in the real world — treating a transgender patient using the correct pronouns, using a translator to communicate with a patient who only speaks Spanish — receiving feedback from instructors and peers on their performance directly after the simulation. 

“We wanted to develop a curriculum on all of the things that were traditionally missed in health care, and as part of that curriculum, we wanted to give the residents an opportunity to actually exercise those skills that they've learned,” Ward-Gaines says. “We tell people how to upstand and how to battle microaggressions, but they never get a chance to practice that. In any true curriculum, you have to have the ability to practice skills.”  

The curriculum Ward-Gaines developed is expanding further within the CU School of Medicine with a $20,000 grant from the Alliance for Academic Internal Medicine, the American Board of Internal Medicine (ABIM), the ABIM Foundation, the American College of Physicians, and the Josiah Macy Jr. Foundation.

“We’re going to pilot this with a larger group of residents and inter-professional students, Our big goal is to create something for the entire CU Anschutz Medical campus,” says Julie Venci, MD, associate professor of medicine who oversees the grant. “We’re trying to figure out how to get not only residents involved, but medical students, nursing students, physician-assistant students — all the people who are actually patient-facing providers.”  

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