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Understanding Microaggressions

Definition and Types of Microaggressions

Microassaults

Microinsults

Microinvalidations

Impact of Microaggressions on Patients and Employees

Emotional Impact

Psychological Impact

Physical Impact

Case Studies and Examples of Microaggressions in Healthcare and Government Settings

Understanding Unconscious Bias

Definition and Types of Unconscious Bias

Affinity Bias

Confirmation Bias

Conformity Bias

Halo Effect

Horns Effect

Impact of Unconscious Bias on Decision Making and Interpersonal Relationships in Healthcare and Government Settings

Strategies to Mitigate Unconscious Bias

Self-Awareness and Reflection

Education and Training

Implementing Bias Interrupters

Case Studies and Examples of Unconscious Bias in Healthcare and Government Settings

Developing a Culturally Competent Healthcare and Government Environment

Importance of Cultural Competency in Reducing Microaggressions and Unconscious Bias

Strategies for Developing Cultural Competency

Training and Education

Diverse Representation

Encouraging Open Dialogue

Case Studies and Examples of Culturally Competent Practices in Healthcare and Government Settings

Conclusion

Recap of Microaggressions, Unconscious Bias, and their Impact in Healthcare and Government Settings

The Necessity of Continued Education and Training

Encouragement for Personal Reflection and Growth in these Areas.

Microaggressions and Unconscious Bias in Healthcare and Government Settings

Microaggressions in everyday life and in healthcare. Racial microaggressions and all microaggressions are brief and commonplace daily verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults toward people of color. Perpetrators of microaggressions are often unaware that they engage in such communications when they interact with racial/ethnic minorities. A taxonomy of racial microaggressions in everyday life was created through a review of the social psychological literature on aversive racism, from formulations regarding the manifestation and impact of everyday racism, and from reading numerous personal narratives of counselors (both White and those of color) on their racial/cultural awakening. Microaggressions seem to appear in three forms: microassault, microinsult, and microinvalidation. Almost all interracial encounters are prone to microaggressions; this article uses the White counselor--client of color counseling dyad to illustrate how they impair the development of a therapeutic alliance. Suggestions regarding education and training and research in the helping professions are discussed.Responding to Microaggressions and Unconscious Bias
Microaggressions are the everyday verbal, nonverbal, and environmental slights, snubs, or insults, whether intentional or unintentional, that communicate hostile, derogatory, or negative messages to target persons based solely upon their marginalized group membership.

There is not a single “best way” to respond when we witness a microaggression in an interaction between two people, or when we observe actions or hear comments that seem to demonstrate unconscious bias. For people whose identities are not directly targeted by the words or actions, we have a responsibility to take action in solidarity and find ways to use whatever privilege we have to take action and influence the person who did the harm. At times, that action may simply be calling out unacceptable behavior or naming the impact those words or actions had. 

If we are committed to help shift another person’s thinking and behavior in the long term, we must take a few things into consideration, such as: 

What is my relationship with this person? To what extent do we know and trust one another, and how might that impact this conversation? 

What might I need to consider about how this person may experience me, given who I am and who this person is (age, race, gender, sexuality, role, experience, etc.)? 

How might I get some sense of permission or authentic agreement from the person to engage this issue (now or over time)? 

What assumptions and beliefs am I holding about this person that might get in the way of a productive conversation? How can I hold on to some “grace” with them (connecting to empathy for who they are, not projecting my distress onto them, acknowledging that it will ultimately be their choice whether to make a change)?

 How might I approach the conversation in a way that will actually get this person to open up to a new understanding and change their behavior?

Some suggested strategies and sample responses:

Take a breath and take care of yourself. Avoid getting reactive, which will only increase the person’s defensiveness. Consider if now is the time to respond; if not, commit yourself to when you will return to the conversation.

Consider getting permission: “Can we talk about what just happened?” or “What just happened didn’t sit right with me – are you open to talking about that?” or “Can I share a different perspective on what you said?”

Clarify what was said to check your own assumptions. “I think I heard you say              , is that right?” 

Be sure to focus specifically on the person’s exact actions or words they used, rather than who they are as a person. When people hear judgement or accusations about who they are (especially if called out in front of others), their defenses go up and they usually cannot take in new perspectives or learning. 

Draw out the speaker further to get more information: “Can you tell me more what you mean by              ?” or “What led you to say / believe              ?” or “What leads you to that conclusion?” 

Acknowledge the feelings the person may be having / express some empathy: “It seems like you’re feeling frustrated about              ” or “I can understand that you’d be upset if you felt disrespected when             .”

Whenever possible, reflect any positive intentions: “It sound like you were intending to express             ” or “I’m sure you didn’t mean to convey             .”

Clarify the difference between intent versus impact : “While you didn’t intend to convey              the words you used can send a message that             ” or “Even though your intention was             , the person you were talking to may have experienced             .”

Share the impact it had on you: “When I hear things like that, I feel              ” or “That makes me think about              which is not ok / really upsets me.”

Share your own experiences of saying or doing things that had an unintended impact: “I am saying this because I’ve had similar experiences - I used to think / say             , and I learned that             . It felt awful to realize that I had upset someone, but I over time I realized I needed to focus on making it right instead of just defending my intentions.”

When relevant, challenge any stereotype that the person used or implied: “Actually, in my experience             ” or “I think that’s a stereotype – I’ve learned that             ” or “I know that you & I were not exposed to a lot of people / information / history like this, but there’s a lot more that we need to learn about             .”

Appeal to the person’s empathy: “You and I may not have experienced             , but imagine how this person might feel if they were regularly hearing things like             ?” or “How do you think you’d feel if you or someone close to you were regularly experiencing             ?”

When possible, appeal to core values: “I know you are someone who cares a lot about             . What I just heard doesn’t seem to live up to that, despite your intentions.”

Consider connecting them to people and/or resources that may shift their perspective: “Have you spoken to              about this? I think you might appreciate what they have to say.” Or “This (video / podcast / article / book) had a big impact on me – I’d love to talk with you about it if you’re open to that.”

If you are receiving feedback about your own words or actions (someone expresses that they experienced a microaggression or heard bias in something you said or did), consider these suggestions:

Take a breath and take care of yourself. Taking full breaths can help our bodies calm down and allow our brain to focus.

Listen carefully. Don’t interrupt and don’t justify. Let the person share as much of their experience as they want to share and try to take it all in. 

If someone is expressing that they have been directly harmed by something you said or did, listen to them and believe them. While you may think of your intent/words/actions in a different way, their experience of being upset is their real experience. Focus on understanding the impact you had.

Take responsibility: acknowledge and apologize for the negative impact you had. If you are clear about how you can make this right / avoid this / do better in the future, name that commitment.

Particularly in interactions across differences of identity (race, gender, sexuality, culture, etc.), you may not understand why what you did was problematic; you have not experienced what it means to live in the world with another identity. Try to stay curious to learn more about what you don’t know – but don’t assume this person wants to educate you about it.

Depending on the relationship and context, you might seek permission to talk more: “I want to be sure I’m fully understanding you. Are you open to talking more about this?” If they agree, start by asking clarifying questions – not challenging what they offered. 

Take time to sort out what you heard. Seek out people who you share some affinity with (similar identities to you) who may be able to offer helpful perspectives. Seek out people whom you trust who will not simply validate your position, someone with whom you can speak openly about what’s still confusing / challenging for you about what you heard and get some valuable insights.

Continue to do your own work and learning about counteracting bias and microaggressions (online resources, books, articles, podcasts, etc.).



Welcome to the course 'Microaggressions and Unconscious Bias in Healthcare and Government Settings.' This course is designed to help learners understand the concept of microaggressions and unconscious bias, their impact on patients and employees in healthcare and government settings, and strategies to create a more inclusive and culturally competent environment.

Microaggressions are subtle, everyday verbal, nonverbal, and environmental slights, snubs, or insults, whether intentional or unintentional, that communicate hostile, derogatory, or negative messages to marginalized groups. In this course, we will explore the different types of microaggressions, including microassaults, microinsults, and microinvalidations, and discuss the emotional, psychological, and physical impact they can have on patients and employees. We will also examine real-world case studies and examples of microaggressions in healthcare and government settings to help learners identify and address these behaviors.

Unconscious bias refers to the attitudes or stereotypes that influence our judgment and decision-making, often without our conscious awareness. In this course, we will explore the different types of unconscious bias, including affinity bias, conformity bias, and confirmation bias, and discuss their impact on decision-making and interpersonal relationships in healthcare and government settings. We will also provide strategies to mitigate unconscious bias, including self-awareness and reflection, education and training, and implementing bias interrupters. Learners will have the opportunity to examine case studies and examples of unconscious bias in healthcare and government settings.

Developing a culturally competent environment is essential in reducing microaggressions and unconscious bias. This course will provide strategies for developing cultural competency, including training and education, diverse representation, encouraging open dialogue, and implementing policies and practices that promote inclusivity. Learners will examine case studies and examples of culturally competent practices in healthcare and government settings.

In conclusion, this course will provide learners with a comprehensive understanding of microaggressions and unconscious bias, their impact on patients and employees in healthcare and government settings, and strategies to create a more inclusive and culturally competent environment. It is essential to recognize that continued education and training are necessary to address these complex issues, and personal reflection and growth are encouraged. By the end of this course, learners will have the tools and knowledge to identify and address microaggressions and unconscious bias in healthcare and government settings truly.