Welcome to this edition of ASGE's Thursday Night Lights, Unconscious Bias Management Strategies. We're glad to have you join us this evening for this important discussion. This session is designed to be a safe, respectful space where we can learn and grow together. My name is Michelle Akers and I will be the announcer for this session. We encourage you to engage actively by submitting your questions and comments throughout the event via the Q&A box and not the chat box. That will keep us organized. Your participation is invaluable to us as we explore practical strategies to recognize and manage unconscious bias in a meaningful way. A Q&A session will be held at the conclusion of each of Dr. Straus' and the panel's scenario role plays. Let's make the most of this opportunity to learn, share, and take actionable steps toward fostering inclusivity and understanding. A recording of tonight's session will populate your GILeap account when it is available next week so you can review the content anew or watch it with others. Now it is my pleasure to introduce our presenter, Dr. Allie Straus. Dr. Straus is a transplant hepatologist at Johns Hopkins University School of Medicine. She received her PhD with a certificate in health disparities from Johns Hopkins School of Public Health. Dr. Straus is currently funded by NIH on a K082 study, the use of data science for improving health equity for patients referred for liver transplantation. She currently serves as a member of the LGBTQ plus task force for the AASLD, the Diversity Inclusion Committee for ASGE, and the Quality Committee for AGA. I will now hand the proverbial floor over to Dr. Straus. Dr. Straus? Thank you, Michelle, and welcome, everyone. I'm now going to introduce our panelists. We have Suha Abushama. She is an inflammatory bowel disease specialist at the Cleveland Clinic and an assistant professor of medicine at the Cleveland Clinic Lerner College of Medicine. She's a member of the Diversity Equity Inclusion Committee of the ASGE. I'd also like to introduce Christina Awad, who is the director of hepatology at the Brook Army Military Medical Center. She is the co-chair of the GME Subcommittee on Diversity, Equity, and Inclusion. And Dr. Awad is also the director of the Gender-Based Violence Course with the Defense Institute for Medical Operations, where she teaches how to combat gender violence all over the world. Ken Obie is a partner at Rome Gastroenterology and Associates in Rome, Georgia. He completed his internal medicine residency at the University of Michigan in 2012 and gastroenterology fellowship training at The Ohio State University in 2016. His clinical interests include general gastroenterology, IBD, and Barrett's esophagus. Dr. Obie is a member of the ASGE ACG and the Georgia Gastroenterologic and Endoscopic Society. So now we'll go ahead and get started with our presentation. Okay, so first off, I'd like to introduce you to a two-player game that we all have probably found ourselves in at one point or another. There's player one, where someone might say something unintentionally or intentionally. They might perform a microaggression, discrimination, or use some uninformed language in the workplace, and they may not even realize that it occurred or the impact that it's had on others. Then there's player two, where this is someone else who's witnessed that player one say or do something, and they're not really trained how to respond in the moment or afterwards, and their response might be difficult based on complex interpersonal or environmental aspects of the situation. So the important thing here is that we are all not necessarily always player two in that situation, and we all have room to grow. So we might have found ourselves as player two and offended, and we might have also maybe unintentionally offended someone else. So by the end of this webinar, I would like for you all to be able to differentiate between microaggressions, discrimination, and uninformed language, deploy techniques in the moment to react from a place of professionalism and advocacy, and consider when and how to follow up on a negative experience. Now let's start by understanding some concepts. On the left here, you'll see internal or historical phrases, words, concepts, and on the right, you'll see behaviors that are a result of those internal or historic situations. So first we'll talk about power. So power is the ability to influence or control the behavior of others and access to resources, opportunities, or being in some way a decision maker. So in the healthcare setting, a physician's power might be their ability to make critical decisions about a patient's care or influencing hospital policy. The second one you'll see here is privilege. So privilege is advantages or rights granted to people based on certain aspects of their identity, such as race, gender, socioeconomic status, and an example of this would be a white physician might have experienced privilege through easier access to professional networks or fewer questions about their competence compared to a physician from a marginalized population. The last one at the top there on the left-hand side is lived experience. So this is the personal knowledge that is gained through direct involvement in everyday events and activities. It reflects how an individual understands and navigates the world based on how they identify as themselves and based on their background. And so all of these internal, those three internal things lead into some biases and they might be implicit or explicit. So the bottom left, you'll see implicit bias, and this is unconscious attitudes or stereotypes that affect understanding and your actions and decisions that are made. And it's in an unintentional way. So an example is a physician might unconsciously assume that a non-English speaking patient is less educated or less compliant, which could actually influence their treatment decisions. Then the other version of bias might be explicit bias. So this is conscious beliefs, attitudes, or stereotypes about a group. So a physician explicitly believes that older people are less likely to benefit from certain treatments, leading them to withhold options that might actually be beneficial. So all of these internal or historic aspects that make you, you lead into behaviors that we or others might do. So starting at the top, we have uninformed language or microaggressions, and I've sort of separated these two out because there's a little bit of a difference here. And uninformed language means using language that reflects a lack of awareness or sensitivity towards someone's identity, and it's often unintentional. So this is referring to a transgender person by the wrong pronouns, which may not be intended to harm, but it reflects a lack of understanding. The other one is microaggression. So this is a subtle unintentional or accidental verbal or nonverbal behavior that actually convey a derogatory or negative message to a person based on their identity. So a slight difference there. A person, an example would be a physician telling a woman in a leadership role, you're surprisingly assertive for a woman, which diminishes her abilities by framing them as sort of unusual for their gender. And then these might build to something that looks like discrimination, which is unfair or unequal treatment of people based on their identity. Often discrimination can manifest as policies, practices, or behaviors, and it's sort of a general term for an action that is discriminatory. So it can be about race, LGBTQ related things, disabilities, age, many things. So an example would be a clinic consistently choosing to overbook patients of a particular race. And then lastly, this could manifest more specifically as interpersonal racism, which is directly harmful actions or comments between individuals, that's what makes it interpersonal, reflecting prejudice or discrimination based on race. So an example would be a physician refusing to treat a patient of a certain race or making derogatory comments about their racial background. So I put this little schematic together to hopefully sort of disentangle the word soup that we sort of encounter when we're trying to understand the space of equity. And hopefully it also allows you a space to sort of understand what is a behavior and what is how I'm feeling or thinking. And you can start to understand yourself better and others. So what we're going to do is walk through a scenario based approach for the rest of the webinar. The reason that this is a little different than maybe what you're used to with me just continuing to give you slides is because that's what we usually are just sort of clicking through PowerPoint slides. A core reason for workplace diversity, equity, and inclusion issues is due to people just not understanding the lived experiences of others. So hopefully a scenario based approach will allow people acting it out to kind of step into someone else's shoes and allow us to have a conversation about it from many different perspectives. So these scenarios will hopefully give some time for separation of yourself from the scenario and time from the scenario to think about how that would make you feel, what you would think in that scenario, and what your attitudes would be sort of in the moment. And then also if you choose to do these again at your workplace, it's a good way to practice the words and techniques to use while you're actually in the moment as that player two hearing that player one say something offensive, sort of how to react because you had a chance to step into those shoes in a less high pressure environment. So since these are scenario based, I want us to sort of familiarize ourselves into another scenario training that we're very commonly used to, which is CPR training. So we learned about the CAB of CPR, compressions airway breathing. So I sort of am using this. This is something that I'm just made up as a way to walk to give you something easy to remember when you're in the moment and someone says something and you kind of want to jump out of your skin. These are just three simple things to remember. So first, they always say to check your own pulse when you're walking into one of those kinds of scenarios of where you're going to be about to be doing CPR. So for this case, it's check the pulse of the room, which is meant who's in the room, who witnessed what just was said, what just happened, who, what is my relationship with the other people in this room? Are they trainees? Is there a trainee that just saw what happened? Is my boss in front of me? So sort of check the pulse of the room. Next is ask them just a simple question. What do you mean by that can go a long way. So just remember that question. Someone says something, you feel offended in some way, you're not even sure how yet because you haven't had time to think, just say, what do you mean by that? And sometimes just having them repeat it, pause and think about it will sort of deescalate the moment and give them a chance to backstep, explain, maybe you did misunderstand them. And then lastly, B is for breathe. So as they're explaining to you what they actually just said, you just take a deep breath and then that'll give you a moment to think about how you want to respond. So our outline for the rest of this webinar is we're going to go through two scenarios. We have our excellent panel members who are going to put on their acting shoes and we'll be going through some questions and answers after each of the scenarios. And the goal here is just to create real world scenarios that you all can see, think about also creating a safe space. So any questions you guys ask here and hopefully we can all maintain a safe space and professional atmosphere. All right. So we can unshare the slides that way we can see our actors. Okay, perfect. So we're going to get started. Our first scene is in the endoscopy suite. So I want you guys to picture yourself. You're in the endoscopy suite in the middle of a day of scopes and you've already done five of them. You've got half a day still ahead of you and you're in the middle of the colonoscopy. The patient's on the table where we're walking into that scene. And now I'm going to let each of our characters introduce themselves. Hi, I'm Dr. Awad, I have been working at this hospital for a year or so. I'm married, actually my husband works in this hospital. I don't know a lot of people here. I don't really know the anesthesia department that well. Hey, hello, I'm Dr. Obi, I'm a senior anesthesiologist, I love my job, love having fun at work. You know, why work when you can have fun, you know? So I'm hoping we can have a great day of endoscopy with this new GI physician I'm not too familiar with. Hi, I'm Suha, I'm a GI tech, and I've worked here for a while, about 10 years. I know Dr. Obi pretty well, but not Dr. Awad since she had recently started, and I love working with Dr. Obi because he's fun, he tells it as it is, and he's a no-nonsense kind of guy. Great. So you guys know the scene, we're in the endoscopy suite, you've met the characters, action. Guys, so I just consented the next patient, and I have to warn you all, it's a bit of a he-she situation, if you know what I mean, honestly, I couldn't even tell what it was, it's like a real missed out fire situation out there. Oh wow, yeah, that movie is great. Close, open, close, cut. You guys remember that movie, right? Come on. Missed out fire? Remember Rogan Williams dresses up like a woman, right? Maybe, all your time, but it was just like these patients, you know, who look like they could be a John, but you don't want to call them Jessica. I mean, how are we supposed to know, you know? You guys know what I'm saying? Can we just skip the biopsy for steps, please, for this polyp? I'm just saying, it's going to be an interesting one. And scene. All right, great job, guys. Great acting, getting warmed up here. So now we're going to open up the polls and ask you guys two polling questions. 100% of people thought that that was inappropriate. And the second question is, how would you have responded as the endoscopist? So one is pause scoping and confront the anesthesiologist in the moment. Two is confront the anesthesiologist after the procedure is over. And three is ignore the comment and keep scoping. All right, so we're 100% for confront the anesthesiologist after the procedure is open. Thanks, Michelle. All right, so let's talk more about that. So, Christina, you were sort of the junior, representing the junior attending in the awkward situation. What do you think about when to address what's going on? I think this scenario probably highlights kind of some challenges. I guess the first challenge, right, is she's new. She doesn't know the environment very well. Probably in the back of her head, she's trying to establish who she is. And wants to probably get along. She just started there and doesn't know the anesthesiologist who seems like he's been there a while. People like him, want to work with him. And she probably just wants to, you know, have a good professional action. She also has a patient in her endoscopy suite. So she's worried about that as well. So there's like a lot of factors, you know, if, you know, think about that versus like she's been there a long time. People know who she is. She already established herself. That's probably a big factor there. So my opinion probably for her, probably she probably would need to kind of talk to this anesthesiologist. Probably privately after she's taken care of the patient that she has on the table. But I guess one thing also to think about is, you know, what if she has a trainee? What if someone else there kind of really took that personally? And maybe she would need to do it, you know, in front of the team. Perhaps once the case that she has right now is over. But it's just kind of a lot of things, a lot of factors to think about in her situation. Yeah, yeah. Ken, Suha, do you guys have anything to add? I think what I would add also is, just like Christina was talking about, the power dynamics of this situation kind of make it difficult as well. Because as the endoscopist, typically we're taught that we are the leader in the room. At that point, as the proceduralist, even the procedure actually is always listed under our name and the anesthesiologist's name is always second or so forth. But being a new junior physician and not knowing people well would make it difficult to kind of embody that leader role. So even if she knows, and obviously she does, know that the comments are inappropriate, she just might not feel the confidence at that point to address it because of the power hierarchy with the senior anesthesiologist. I agree with what everybody has said. And basically, this might be a situation where someone may need to, as a junior attendee, you may need to find an ally in someone a little bit more senior who may be able to, if you don't feel comfortable in this situation, addressing the anesthesiologist, maybe finding someone who has been there for a while to say, hey, this is a situation, can you maybe work with me so that we can address this together with this anesthesiologist? Someone who has some rapport with that person. This way, as a young endoscopist, you don't burn your bridges on day one of your day there, you know? So something to think about. Yeah, good point. I'm hearing a lot about the dynamic, making it difficult as a junior faculty, and then sort of when to address it being not with the patient, right, mid-procedure, but probably afterwards. Is there any one of you guys, or can you imagine a different scenario or a way where you would actually address it in the room, and how you could do that professionally? Or are you guys pretty much all on board with it, maybe after the case is over? I think I'm on board. Oh, sorry. Go ahead, Ken. So I'm on board with addressing it afterwards, but also I'm on board with stopping the anesthesiologist, because he just kept going on and on, and especially with me being the tech, finding maybe some of the comments amusing, and that kind of encouraged him to keep going. But maybe as the endoscopist at that point, instead of, you know, obviously, you know, Christina was shocked, and we would all be in that moment, but maybe a way to kind of stop the anesthesiologist, other than confronting him and saying what you had taught us in the beginning, or maybe, you know, Ali, in terms of asking him what you meant or anything like that, we could just say, let's stay focused on this patient, please, like the patient right in front of us. And then maybe that would cut him off and kind of stop his comments. Great, great. Yeah, good points. I wanted to throw in another question for you guys that would sort of change the scenario a little bit, but what if there was a trainee in the room as well? What kinds of things would you think about and would that change anything about how you handle the situation, generally? Let's say the trainee is, you know, you know them well, because you work with them a ton, and you know that they're a member of the LGBTQ community. So you can kind of get a sense that, you know, they're uncomfortable. I think, again, more of the same, which is a lot of times the, I think the anesthesiologist a lot of times are passing through, in the sense that they don't stay for the whole case. It's one of those situations where, like you said, at the beginning of the presentation, you know, check the pulse of the room. First of all, you don't want to, you know, destroy the whole mood of the room right off the bat, because clearly this anesthesiologist is trying to make a light-headed joke. However, if you have a trainee, I think once that anesthesiologist leaves, okay, because typically they're not going to stay, hopefully they leave at some point, then it might be a time to actually say to the trainee, you know, that this is not, we don't tolerate that kind of word choice or sentiment. I will plan to address it with that anesthesiologist at a later time after this case is concluded, just so that they know that you have their back and that you're going to do something about it. Okay, great. Okay, and in terms of addressing it after the case, do you feel like it's going to make the rest of the day awkward if you say something to them, or would anyone wait until the end of the day? I think, Ken, you kind of alluded to getting a higher-up involved, so maybe that would have to wait a little longer. Yeah, I think if you're going to be scheduled to work with that same anesthesiologist all day, I guess it all depends on how the rest of the day goes. I think it makes sense to kind of, especially to keep the mood of the room, you can still address it right after that case so that the rest of the day goes a little bit smoother and there are less of those effects, as opposed to waiting until the end of the day. But, again, it all depends on your level of comfort. Some people may need an ally to help them in that approach, but I think doing it maybe after the particular case may make sense, just outside that particular room, after that patient has been taken care of. Okay, great. I think it's just, I think it's important to know that these conversations are usually awkward, they probably get defensive, probably make it awkward, and I think it's really important to know that that will probably happen and be okay with that, you know, and not expect him to be like, I am so sorry, oh my word, that will never happen again, and the two of you become best friends, you know what I'm saying? But it's unfortunately, not always, obviously, some people learn from these and it's becoming a really pleasant interaction, but part of the reason we do these role plays is understanding that yes, it is awkward, and yes, it'll probably not end super well, you know, and that's okay. Yeah, that's fair. Do you have any tips on how to approach those awkward conversations, things that have worked for you, and maybe a similar but different situation, an actual like verbiage and words that you would say when you say like, hey, Dr. Obi, can you come over here, I just want to talk to you about something, like what is the opening? Well, I think it's key probably not to never attack the person, right, you just talk about things, like be very clear that you're talking about the incidents, and not attack his person and say, I think you're this and that and this, but maybe say, hey, when you say things like this, that makes people feel this, and you know, make it about how the words made other people feel versus how you are, because once you do that, he's already on the defensive side, and he's not even listening to what you're saying. So I don't know, I think probably the key is not to say that. I would say, probably if I started to say, hey, Dr. Obi, I appreciate working with you today, I just want you to know, like, you know, some of the comments you said about our patient that we're taking care of, or, you know, it's not, you know, the way you made it as a joke, you know, that's really offensive. And not funny, actually. You just see what he says. But yeah, it's really awkward, I'm sure. But like I said, it's okay. It's a tough conversation either way, right? You can't make light of something that's upsetting to people, you know. Thanks for sharing that, Christina. I'm going to ask them another question, but just for anyone in the audience, if you want to ask any questions, follow up, you have advice on what to say in these situations, anything to share at all, please put it in the Q&A box, and we'd love to share it with the group, or if you have a question, we're happy to answer those. Did you guys have any tips for verbiage? Otherwise, I had another question for you. So it's funny. One question I was saying that I actually thought about something, you know, I guess if you wait till the end of the day, this might be a situation where the person may not even remember what happened earlier in the day. So this might actually be a situation where addressing it, not in the room still, but after that case, so that it's present in their minds. Oh, you mean that joke I just told? Yeah, that joke you just told was offensive, and you know, people did not receive it very well. If you could please, next time, you know, be mindful of other people in the room, that would be much appreciated. And like I like the approach you said, not to attack the person's character, but just addressing the actual event and keeping it to that. Great. Last question for you guys. In that scenario, you know, the GI physician was not a member of the community that the joke was about. So I was curious if you guys could talk about scenarios you've been in where you were personally offended because someone was, you know, offending your community, or versus when you've been in situations where you're not in the community, but you still feel like it wasn't right what they said, and you want to say something. Can you just talk through how those experiences have been for you? And what makes them different and how you feel and want to respond? Um, so in my GI lab, I can give an example in my GI lab, there are certain, um, so typically it's going to be the tech or the CRMA that's going to be playing a lot of the music. Okay. Uh, and so everybody knows that I listen to Coldplay and I just like to keep it clean and, you know, and, and so in some scenarios, some people want to throw in some, some rap or hardcore things that are not going to be, maybe the language is not conducive to a professional environment. Um, and so I've been in that situation where I'm like, okay, we can't be rapping along to this kind of wording now. Um, and so in those scenarios, it pertains to, you know, um, like that, uh, the race and things like that. So I do step out and say, Hey, you know, let's keep it clean guys. Let's make sure that the music that we're playing is clean or no music at all. So it just goes back to something very basic and neutral. So that's a small case, but, um, again, as the endoscopist, a lot of times we have the authority in the room, you know, with the leaders in the room. And so we have the power to do what we need to do to make sure that everything goes according to plan. Um, scenario two, we are going to step into a Zoom room. We're at a meeting, um, where it's people meeting to talk about at a, at a practice of people where they are interviewing someone while they just finished interviewing with someone and looking over someone's application. Um, and they're talking about whether or not they want to hire this person to their practice. So this is a Zoom call of the few different positions at the, at the practice, whether it's academic or private. Um, and the bosses of the practice or group are there as well. So I'll let the characters for this scene introduce themselves. Hi, I'm Dr. Abushama and I'm the lead physician of this group. Hi, I'm Dr. Awad. Um, I've been here for 20 years. Um, not really from a racially or ethnically, um, marginalized population. Hi, I'm Dr. Obi. I just started at the practice recently. I'm happy to have my dream job and I'm hoping to work hard so I can get a promotion. All right, great. So you've met everyone. We're on a Zoom call, uh, action. Hey everyone. So I've looked over all the applications and honestly, this candidate is clearly the best trained of the bunch. They've got impressive credentials and strong recommendations. Well, you know, I think it definitely will, uh, improve our, um, uh, what's that thing? DEI, uh, DEI numbers, you know, for sure, you know. Okay. All right. Right. And beyond that, their clinical experience is top-notch, particularly in advanced procedures. We would really benefit from that. Yeah, for sure. You know, they're actually like pretty smart, actually. All right. Not this again. All right. Let's move forward with scheduling the next round of interviews. Thank you, everyone. Okay. Well, I gotta go. Bye. Um, Dr. Abushama, can I talk to you for a moment? Of course, Dr. Obi. What's on your mind? Uh, you know, I have to say this because I can't keep quiet anymore. You know, what they just said, you know, that wasn't okay. And it's not the first time, you know, they're constantly making comments like that. You know, it's really, really offensive. And it's not just me. You know, I know others that feel the same way, but no one speaks up. It's really frustrating because it seems like nothing has been done. And it feels like you almost agree with him, with them. Um, I didn't mean to dismiss your feelings. Um, I, I didn't realize it was, it was that serious. Um, maybe, maybe you could help by putting together some DEI educational material for the whole team, you know, we could all learn from this. You know, yeah, I'm happy to help with, you know, DEI efforts, but this isn't just about education, you know, this is about taking accountability. I hear you. Let's take this one step at a time. We can start with some education and then we'll go from there. Okay. All right. All right. And scene. Great job guys. All right. Let's do another poll to see where, uh, what you guys think, what do you guys think about when people make those kinds of comments about DEI being a joke? Uh, I mean, from my standpoint, and I get it, I hear it more often than you would think, because again, I'm here in the South, uh, and for one reason or another, I think DEI is almost, uh, I don't know if it's frowned upon or maybe not taken as seriously here. Um, but you know, there are multiple ways to look at it, but, um, I think, you know, um, but, you know, there are multiple ways to kind of take it, you know, sometimes I just kind of say, okay, it's no, I use it as, you know, motivation, you know, at the very least to say, okay, let it motivate you to, you know, do the best you can work harder, achieve more. Um, because the thing is, you're not going to change people's minds, you know, a lot of times, you can try hard, but if people think that DEI is a joke and they don't value the importance of diversity, um, a lot of times that comes from what you said, you know, about their lived experiences and their backgrounds and things like that. So you'd have to uncover a lot of stuff to kind of get them to where you are. So a lot of times just try to do the best job you can, and the person will then see that, wait a minute, this person is not like a token X or whatnot. They deserve to be here. They're more qualified, if not as qualified. And so sometimes just use it as motivation. Great, great. And, um, Suha, maybe you can speak to how the leader responded in this, in the situation, not when, um, pulled aside at the end of the meeting, but I think you were trying to portray them sort of responding and deflecting a little bit. Can you talk a little bit about how you think as a leader in the room, they reacted and what you think maybe they should have said? Yeah, I think the leader was being very defensive. I guess they felt like they were put on the spot by the junior GI physician. Um, and also I think the junior GI physician opened their eyes to something they weren't seeing. So the leader, unfortunately, in this situation was not trained to recognize that microaggression that came from the other senior GI physician. So, um, that's why I think the leader, you know, acted the way that they did in terms of just being defensive. So I think the way to combat this would be to train the leaders, actually, to recognize these microaggressions and also to recognize non-verbal cues, because Dr. Obie is the junior GI physician from the minority population was very clear in his non-verbal cues that he was uncomfortable. And as the leader, you should be more vigilant and pay attention to that. So I think the leader was just very defensive and, um, perpetuated the minority texts even further with Dr. Obie, just asking them to take the lead on that, to educate everybody else when it's not Dr. Obie's responsibility. It actually is the organization's responsibility. And I would say the leader's responsibility to do that. Great. You mentioned the minority tax. Can you say a little bit more on what that is for people that are not familiar with that term? Yeah. So it's when underrepresented minorities, um, like whether it's women minority or Black minority or gay minority, whatever it is, um, are burdened with increased responsibilities in either recruitment or mentorship or diversity efforts. Um, and then these tax duties may not be scholarship, leadership or promotion worthy. They're not compensated a lot of the time. There's no protected time. So eventually it could just lead to burnout for that minority position. Great. That's really helpful. And, um, I think it would be interesting. So how can you give us some, and any of you, not just, um, Dr. Obie, but how would you guys have approached your boss? Do you think that you would have done it as it was just depicted, or is there any way that you would have done it differently timing wise, or what words would you use to start off that conversation? I think probably in, for his position, probably what he did was probably the right, or not the right, but probably what most people would do just like, you know, in the intro, he talks about, he really wanted to do well. He wants to advance and probably get into conflict, public conflict with one of the senior physicians. They're probably might be hurtful in that case. Um, but I would say if he was more comfortable in that situation, he may be, maybe not confront her, but say things like, uh, could you, could you explain to me what that means about helping our DEI numbers? I'm guessing, I'm not sure I understand that fully. Um, what does that exactly mean? Um, and you know, I mean, it's not like he's actually asking a question, but hopefully when he says a comment like that, it triggers, you know, in her mind that what she said was actually offensive, um, to him, uh, because obviously, you know, some questions, some of the questions is not really asking for a question and maybe will tell you kind of what she's thinking and why she said what she said. And going back to your comment about, um, you know, if we had, um, talk to people that thinks, you know, DEI is a joke. Um, I certainly have. And I think, um, one of the kind of lessons I learned is sometimes people make fun of DEI because actually they don't really know what it is. Right. Exactly. And a lot of the times they think, oh, it's supposed to be about inclusion. I don't feel included. And that was good for me as you know, the chair to be like, are my events and the way I publicize it, are they inclusive to everybody? Maybe that's why they feel it's a joke. Um, it certainly helped with some issues, but I think it's, it's important to, um, you know, try to do reach out to everybody, you know? Yeah, those are really, really good points. Um, and I love how you were bringing back the question of, you know, we said the CABs in the moment, so I had said the a was for ask. So what do you mean by that? So Christina put your acting hat back on since you were the person that was saying the offensive comments. So can you say your first offensive comment again, though? Well, it's definitely going to improve and I'm going to respond to you. Oh yeah. Um, keep and keep going with it with me, with me, with me. Sure. Yes. Yes. Um, you know, I think it surely will help our, that diversity thing. What's it called? D I O D I numbers. That's for sure. You know? Oh, Dr. Awad, what do you mean by that? You know, like, you know, like we're all like, you know, the same, like, it'd be good to have, like, you know, we're not all like, you know, the same. It's a melting pot, whatever. So you mean like we should just take them to boost the numbers? Like you don't think they deserve it? It doesn't, it's just like, sometimes it seems like, yeah, like seems like they just take people based on that, you know, to fit some sort of a quota or something. Hmm. And you also said that they're actually pretty smart. It almost seems like even though they're from these top notch places that you're surprised they're smart. What did you mean by that? Why were you surprised they were smart when we saw where they got all their training? Yeah. All right. So that's, just wanted to sort of make a point, you know, it doesn't feel, it doesn't feel like I'm attacking you. Right. It feels just like kind of asking questions, asking you more, making you think about it. You're probably a little uncomfortable. Like you could tell you were feeling that like, oh crap. Yeah. But, but so that's just an example in the moment. Check the room who's here. Oh, my boss is there. My boss is in that one square person's offending me in this other square. So, you know, I, but my boss isn't doing anything. So, okay. Let's check the room, ask a question, take a breath while they're responding. And sort of just that's sort of how you can work your way through this scenario. So thanks for, thanks for going with me on that on the spot. Did you guys have any other last questions or any, any audience members, please throw a question in the chat or any other comments you guys want to make before we wrap up the scenario. I like the way that you tackled that Allie. It feels a little bit like coaching as well. Cause I think that's what, cause you know, there's like difference between being a coach and being a mentor and a coach is supposed to bring out things in you that, you know, make you think and make you solve your, the problems yourself. So I feel like that was kind of what you, you, you've implemented here with Christina. So that was a really good tactic. Thanks. Yeah. Hopefully it's trying to Thanks. Yeah. Hopefully it's trying to get at getting people that first slide that I showed where it's the internal and the historics that people have been through. It's just trying to make them access that part of their brain on like, what is their privilege? What is their power? They have the power of hiring this person. They have the privilege that, you know, they are probably not the same race as this person that they're being offensive about. They're have their own implicit biases. So there you're by asking these questions, you're helping them to better understand themselves. So, yeah. Yeah. Thanks. So I think we're going to wrap it up there. I appreciate our excellent actors and actresses for helping get through those scenarios. Hopefully this was helpful for our audience members and future watchers of this webinar. Please reach out if you guys have any questions. You can contact me at Allie, A-L-L-Y at J-H-M-I dot E-D-U. And thank you so much for your attention. I'll let Michelle wrap it up. Drosten, we have come to the close of the presentation. As a reminder, a recording of the session will populate your G.I. Leap account when it's available. And you can visit ASGE.org for future Thursday Night Light sessions and other educational offerings. This concludes the presentation on Unconscious Bias Management Strategies. We hope this information is useful to you in your practice and have a good night.

unconscious bias

microaggressions

discrimination

power dynamics

implicit bias

healthcare

allyship

professional growth