Table 1.
Strategies to Reduce Stereotype Threat for Minority Patients and Minority and Majority Trainees
| Target of strategy | |||
|---|---|---|---|
| Interventions that reduced stereotype threat | Minority patients | Minority trainees | Majority trainees |
| Self-affirmation exercise76–79 | Teach providers to elicit the patient’s values and strengths in clinical encounters | Provide opportunities to affirm values and strengths during medical education | Provide opportunities to affirm their egalitarian values before activities that may activate fears about own racism (such as cultural competency training) |
| Performance feedback that communicates high standards with assurance that the individual is capable of meeting those standards80 | Teach providers to invoke high standards and assurance of the patient’s ability to meet those standards | Teach medical school faculty to provide feedback to trainees that invokes high standards and assurance of the trainee’s ability to meet those standards | |
| Encouraging individuals to attribute anxiety and/or difficulty to external causes81 | Teach providers to provide external attributions for patients’ anxiety and difficulties | Create opportunities for trainees to attribute difficulties to external causes | |
| Education about the possible effects of stereotype threat on performance82 | Educate minority trainees about the effects of stereotype threat on academic performance | Educate white trainees about the effects of stereotype threat on communication with minority patients | |
| Cues indicating an identity-safe environment (e.g., high minority representation, valuing of diversity)/absence of cues indicating an identity threatening environment (e.g., indications of sexism; low minority representation; “color blind” philosophy) 83,107 | Provide cues that diversity is valued and ensure respectful treatment by all staff | Provide cues that diversity is valued and recruit/retain minority faculty and students. Reduce discrimination, harassment, verbal abuse, and disrespectful treatment | |
| Cues indicating “fair practices” (auditing practices to guard against discrimination)83 | Provide cues (e.g., signs) indicating that the clinic is committed to fair and equal treatment | Put into place and make students aware of procedures to monitor potential instances of discrimination | |
| Exposure to role models who exhibit counter-stereotypic behavior85–91 | Recruit and retain minority providers | Recruit and retain minority faculty | |
| Having individuals identify their demographic characteristics at the end rather than the beginning of test.111,112 | Modify test instructions to reduce stereotype threat | ||
| Promote interracial friendship and communication29,73,127 | Structured interracial “dialogue groups”113–115 | Structured interracial “dialogue groups”113–115 | |
| Adopt a promotion rather than a prevention focus128 | Frame interracial interactions as opportunities to learn rather than situations in which one will be judged32 | ||