Supporting medical students who experience discrimination: perspectives of General Practice tutors in primary care.

Abstract

It is well documented that the current NHS environment has a high prevalence of discrimination [1], and this also adversely impacts on the clinical learning environment for medical students [2]. As UK medical undergraduate curricula move towards increased community-based education [3], the General Practice (GP) setting and GP tutors are increasingly important in these critical discussions of how to address discrimination. GPs are uniquely placed to develop inclusive and respectful learning environments and support medical students when they are faced with discrimination. Understanding the training needs of GP tutors is key in addressing discrimination and creating supportive inclusive clinical learning environments. There is a lack of consensus on the best form of training in this area, with mixed evidence on the success of approaches such as unconscious bias or active bystander training [4]. We therefore took a needs-based approach when developing training for the GP tutors at Imperial College London, and conducted a survey exploring GP tutors’ perspectives and training needs in addressing discrimination. We received 89 responses. 45% of GP tutors reported that they had experienced discrimination in their medical education role, which mirrors the high prevalence reported by the primary care workforce more widely in clinical, management and administrative roles [1]. We found that although 93% of GP tutors felt confident recognising discrimination and 83% felt confident discussing it with medical students, 62% were unfamiliar with the medical school support systems for issues related to discrimination. Specifically, GP Tutors were unfamiliar with the medical school’s process for either staff or students to report discriminatory behaviours and how to access the available specialist support. GP tutors who had previously received training on discrimination reported greater self-confidence in addressing it, highlighting the importance of faculty training in this area. Furthermore, most GP Tutors did express an interest in having additional training on discrimination particularly in an online format. Topics that GP tutors stated would be useful to cover included: strategies to identify and address discrimination, raising self-awareness and types of discrimination. These results have implications for wider training in primary care, in areas such as raising awareness of local reporting systems and identifying and addressing discrimination when it happens. We would encourage others involved in faculty training to utilise a similar needsbased approach when developing resources for their educators.