Dr Toby Merriman is a Medical Education Fellow in NHS Lothian
Have you ever witnessed a microaggression at work and not known what to do? Microaggressions are the slights, snubs and insults that convey discriminatory, derogatory or negative messages to individuals with protected characteristics. They may be verbal, non-verbal or environmental and may or may not be intentional. These behaviours are pervasive at work. They have a damaging effect on the wellbeing and sense of belonging of those subjected to them and on the psychological safety of our workplace cultures.
For me, the answer to my opening question is an emphatic yes. There is one particular occasion that has stayed with me. I was having a conversation at work with one junior colleague and two senior colleagues. We were talking about the care of a transgender patient and my seniors persistently misgendered the patient. I felt very uncomfortable, and I could see that my junior colleague felt the same way. I knew I should do something. I could have been an active bystander, challenged them, and informed them of the patient’s correct pronouns. Instead, I froze. I did nothing, and by doing so I tacitly suggested that I felt that behaviour was acceptable at work.
I still regret this. I have since spent a lot of time reflecting on why I did nothing. I knew some active bystander approaches; I just didn’t use them. Without doubt, one reason for my inaction was my discomfort challenging up the hierarchy. But more important than that, I just didn’t know what I would actually say.
I am not alone in this experience. Most active bystander training helps you recognise microaggressions and gives you the knowledge of the bystander interventions available. However, it does not let you think about or practise the words and phrases you might use when confronted with a microaggression. If you haven’t had an opportunity to practise these skills, you are less likely to feel confident using a bystander intervention.
When I saw an opportunity to do some work that would help people develop these skills, I jumped at the opportunity. Working with my colleague, Thom, and the team at the NHS Lothian Medical Education Directorate, we have designed and rolled out the ‘Beyond Bystander’ workshop. Using an innovative design of ‘stacked’ low immersion simulation activities, we give participants an opportunity to think about, write down and then say the words and phrases that they could use to respond to a microaggression. We create a relaxed and respectful environment where participants have an opportunity to work out what approaches work best for them.
Prior to the workshop, only 21% of participants agreed that they felt confident with the words they would use to address a microaggression. After the workshop, 90% of participants agreed. 95% of participants agreed that it was a safe space to discuss issues around microaggressions at work.
Thinking back to my experience, I wish I’d had an opportunity to practise what I would say in that moment. If I had, I would have felt empowered to take action in a way that I didn’t at the time. By offering this workshop, we hope to empower others to use a bystander intervention if they witness a microaggression. In turn, we hope that more and more people will feel comfortable demonstrating that discriminatory behaviour is not acceptable in the workplace and we can move towards a more diverse and inclusive workplace culture.
Reflective Challenge: What are the words or phrases that you could use if you witnessed a microaggression at work?
We’d like to thank Toby for writing this guest blog which is part of the Leading to Change Diversity Blog Series. We want to highlight and promote the voices and experiences of diverse leaders at all levels including those working at frontline / grassroots levels. We aim to celebrate diverse leaders who can act as role models for other aspiring, diverse leaders.
Dr Toby Merriman
Role:
Medical Education Fellow in NHS Lothian with a clinical background in Acute Medicine
As part of the Medical Education Directorate (MED), Toby has been considering how educators can use simulation to prepare staff to address unprofessional workplace behaviours such as incivility and microaggressions, while ensuring that the learning environment is safe and respectful. As part of this effort, he has collaborated with his colleague, Thom O’Neill, to develop the Beyond Bystander workshop.
Toby’s other educational interests include supporting local trainers and educators, peer mentoring and promoting effective feedback. He is undertaking a Masters in Medical Education, through which he has researched professional identity formation in physicians. He is always happy to be contacted to discuss any of these topics and collaborate on supporting learning in our colleagues.
If you are interested in learning more about the workshop, or arranging an opportunity to attend, please contact andrew.merriman@nhs.scot
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