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PLoS One ; 16(8): e0255936, 2021.
Article in English | MEDLINE | ID: covidwho-1381277


OBJECTIVE: To understand racial bias in clinical settings from the perspectives of minority patients and healthcare providers to inspire changes in the way healthcare providers interact with their patients. METHODS: Articles on racial bias were searched on Medline, CINAHL, PsycINFO, Web of Science. Full text review and quality appraisal was conducted, before data was synthesized and analytically themed using the Thomas and Harden methodology. RESULTS: 23 articles were included, involving 1,006 participants. From minority patients' perspectives, two themes were generated: 1) alienation of minorities due to racial supremacism and lack of empathy, resulting in inadequate medical treatment; 2) labelling of minority patients who were stereotyped as belonging to a lower socio-economic class and having negative behaviors. From providers' perspectives, one theme recurred: the perpetuation of racial fault lines by providers. However, some patients and providers denied racism in the healthcare setting. CONCLUSION: Implicit racial bias is pervasive and manifests in patient-provider interactions, exacerbating health disparities in minorities. Beyond targeted anti-racism measures in healthcare settings, wider national measures to reduce housing, education and income inequality may mitigate racism in healthcare and improve minority patient care.

Asia Pacific Scholar ; 6(3):14-23, 2021.
Article in English | Academic Search Complete | ID: covidwho-1323526


Introduction: The Coronavirus-19 pandemic has had profound effects on health professions education (HPE) posing serious challenges to the continued provision and implementation of undergraduate, postgraduate and continuing medical education (CME). Across these HPE domains, the major disruptions included the exclusion of undergraduate learners from clinical learning environments, restricted intra-, inter-institutional and overseas movement of medical professionals, termination of face-to-face learner-educator interactions, deployment of postgraduate learners into non-scope service settings, and CME postponement. Methods: In this review we report on how in Singapore various adaptive measures were instituted across the 3 HPE domains at institutional and national level to maintain adequate resources at the frontline to meet service exigencies, promote healthcare professionals' wellbeing and safety as well as mitigate the spread of the pandemic. Results: We identified several strategies and contingencies developed to address these challenges. These involved the use of online learning platforms, distributed and asynchronous learning, an undergraduate Pathway Programme, and use of innovative hands-on technology like simulation. Robust, well pre-planned pandemic preparedness, effective communication, as well as provision of psychological support resources ensured maintenance of service and academic continuity, trust and resilience within HPE. However, several challenges remain, namely the timing and manner of conducting formative and summative assessments, cybersecurity, and the indispensable hands-on, in-person experiential learning for surgical training. Conclusion: Strong leadership with vision and planning, good communication, prioritising learners' and educators' wellbeing and safety, and harnessing existing and emerging online learning technologies are crucial elements for effective contingencies for HPE disruption during pandemics. [ABSTRACT FROM AUTHOR] Copyright of Asia Pacific Scholar is the property of Centre for Medical Education (CenMed) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Med Teach ; 42(7): 762-771, 2020 07.
Article in English | MEDLINE | ID: covidwho-245790


Background: The Corona Virus Disease-19 (COVID-19) has been declared a pandemic by the World Health Organization (WHO). We state the consolidated and systematic approach for academic medical centres in response to the evolving pandemic outbreaks for sustaining medical education.Discussion: Academic medical centres need to establish a 'COVID-19 response team' in order to make time-sensitive decisions while managing pandemic threats. Major themes of medical education management include leveraging on remote or decentralised modes of medical education delivery, maintaining the integrity of formative and summative assessments while restructuring patient-contact components, and developing action plans for maintenance of essential activities based on pandemic risk alert levels. These core principles must be applied seamlessly across the various fraternities of academic centres: undergraduate education, residency training, continuous professional development and research. Key decisions from the pandemic response teams that help to minimise major disruptions in medical education and to control disease transmissions include: minimising inter-cluster cross contaminations and plans for segregation within and among cohorts; reshuffling academic calendars; postponing or restructuring assessments.Conclusions: While minimising the transmission of the pandemic outbreak within the healthcare establishments is paramount, medical education and research activities cannot come to a standstill each time there is a threat of one.

Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Betacoronavirus , Burnout, Professional/prevention & control , COVID-19 , Clinical Competence/standards , Competency-Based Education , Cooperative Behavior , Education, Medical , Educational Measurement/standards , Humans , Internship and Residency/organization & administration , Learning , Mental Health , Mentors , Organizational Innovation , Pandemics , SARS-CoV-2 , Teaching