Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 5;10(1):20.
doi: 10.1186/s41077-025-00346-2.

Did we create brave spaces? A realist evaluation report on simulation-based faculty development workshop in equity, diversity, inclusivity, and Indigenous reconciliation

X Catherine Tong  1 , Sonaina Chopra  2 , Hannah Jordan  3 , Matthew Sibbald  2   4 , Aaron Geekie-Sousa  5 , Sandra Monteiro  2   4
Affiliations

Did we create brave spaces? A realist evaluation report on simulation-based faculty development workshop in equity, diversity, inclusivity, and Indigenous reconciliation

X Catherine Tong et al. Adv Simul (Lond). .

Abstract

Background: Creating Brave Spaces (CBS) workshops are designed by an interprofessional team of health professions educators to empower faculty members to disrupt microaggressions in the clinical teaching environment using simulation-based education design, where actors were trained to portray sources of microaggressions.

Methods: The CBS team delivered eleven workshops addressing five categories of biases in various contexts during 2020-2024 engaging hundreds of participants. The team recruited participants to conduct semi-structured interviews. Records from team meetings and facilitator focus groups were collected and reviewed. The dataset was subjected to thematic analysis focusing on the participants' experience in the workshop. Themes were presented in Context-Mechanism-Outcome statements informed by the realist evaluation framework. Subsequently, the results were verified with participants.

Results: Nine participants volunteered to be interviewed 2 to 12 weeks after attending the workshop. The interview scripts, totaling about 60,000 words, provided a rich picture of faculty members' backgrounds and experiences. Thematic analysis yielded the following results. Simulation-based education design empowered faculty members to overcome barriers and progress in their skills. During the immersive experience, participants benefited from a rare opportunity to practice aligning their values with their actions. Those who experienced microaggressions as victims or passive bystanders in their past experienced heightened emotions. Faculty members agreed that disrupting microaggressions is an important part of their work. They navigated the tension between "calling in" the source of the microaggression, being mindful of power dynamics in the simulated cases, and "calling out" the harm of microaggressions by holding the source accountable. Some recounted successes in managing subsequent incidences of microaggressions in their clinical teaching environment. The results were validated by a member-checking process, and further supported by recorded conversations during team meetings and facilitator focus groups.

Conclusions: Health sciences institutions' stated strategic goals in inclusive excellence, although widely accepted by faculty members, are challenging to operationalize in the moment of a microaggression. Participants practiced this skill using simulation-based education design and reported significant and positive impacts.

Keywords: EDI; Faculty development; Indigenous reconciliation; Simulation-based education.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study proposal was reviewed by the Hamilton Integrated Research Ethics Board (HiREB-15339) in September 2022. It falls within quality improvement/program evaluation, and as such was granted a waiver from a full review. Consent for publication: Not applicable. Competing interests: Dr. X. Catherine Tong is an associate professor at the Department of Family Medicine (DFM) at McMaster University and receives stipends from McMaster University for various roles in medical education. Dr. Tong was supported by the MERIT Faculty Fellowship in 2022-2023. She is the lead author on the MERIT Scholar Research Grant and the Gender and Heath Grant. In 2025-2027, Dr. Tong is supported by DFM Education Research Fund to investigate faculty development needs using qualitative methods. Sonaina Chopra is a Research Assistant at McMaster Health Education Research, Innovation & Theory (MERIT) program at McMaster University. Ms. Chopra is a collaborator on the MERIT Scholar Research Pilot Grant and the Gender and Health Grant. Hannah Jordan is the Standardized Patient Trainer/Coordinator for McMaster University’s Waterloo Regional Campus. Ms. Jordan is a collaborator on the MERIT Scholar Research Pilot Grant and the Gender and Health Grant. Dr. Matthew Sibbald is an associate professor at McMaster University and receives stipends from McMaster University for various roles in medical education. Dr. Sibbald is a collaborator on the MERIT Scholar Research Pilot Grant and the Gender and Health Grant. Aaron Geekie-Sousa is the Program Manager for McMaster University’s Midwifery Graduate Program and a collaborator on the Gender and Health Grant. Dr. Sandra Monteiro is an associate professor at McMaster University and receives salary support from the Faculty of Health Sciences and the Department of Medicine. Dr. Monteiro is currently funded by the Medical Council of Canada to conduct an investigation of online exam test security and fairness. Dr. Monteiro is the senior author on the MERIT Scholar Research Pilot Grant and the Gender and Health Grant.

Figures

Fig. 1
Fig. 1
Study participant characteristics
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Smith WR, Betancourt JR, Wynia MK, et al. Recommendations for teaching about racial and ethnic disparities in health and health care. Ann Intern Med. 2007;147(9):654. 10.7326/0003-4819-147-9-200711060-00010. - PubMed
    1. Edgoose J, Brown Speights J, White-Davis T, et al. Teaching about racism in medical education: a mixed-method analysis of a train-the-trainer faculty development workshop. Fam Med. 2021;53(1):23–31. 10.22454/FamMed.2021.408300. - PubMed
    1. Lupton KL, O’Sullivan PS. How Medical Educators Can Foster Equity and Inclusion in Their Teaching: A Faculty Development Workshop Series. Acad Med. 2020;95(12S):S71–S76. 10.1097/ACM.0000000000003687. - PubMed
    1. Indigenous Health in Specialty Postgraduate Medical Education EDUCATION GUIDE, Indigenous Health in Specialty Postgraduate Medical Education Steering Committee, Royal College of Physicians and Surgeons. Published May 2021. https://www.royalcollege.ca/content/dam/document/about/indigenous-health.... Accessed 3 Sep 2024.
    1. Lemire F, Fowler N, Kitty D. Anti-racism: listening, learning, and taking action. Can Fam Physician. 2021;67:712 (Eng), 711 (Fr). 10.46747/cfp.6709712. - PMC - PubMed

LinkOut - more resources