Quick facts

• Year: 2023

• Country: East of England

• Institution: PSW NHSE East of England (March 2023- March 2024), Herefordshire and Worcestershire ICB

• Learners: Pre-qualifying trainee pharmacists, postgraduate doctors in training (foundation, GP trainees and specialty registrars, public health clinicians, SAS doctors, IMGs)

• Aims: To improve learner and educator understanding of racialised inequities in healthcare education by increasing awareness, recognition, and practical responses to race microaggressions.

Why was the education intervention developed?

The objectives of this intervention were:

• To develop racial literacy by introducing a shared language and framework for understanding race microaggressions.

• To validate the lived experiences of racially minoritised learners within psychologically safe learning spaces.

• To support educators and trainees to recognise their own positionality, biases, and roles within hierarchical systems.

• To equip participants with practical strategies for allyship, active bystander intervention, and non-confrontational challenge.

• To contribute to more inclusive learning environments and improved trainee wellbeing, belonging, and retention.

What was involved in the education intervention?

The intervention consisted of a two-hour facilitated virtual workshop delivered through the Professional Support and Wellbeing Service to doctors in training, trainee pharmacists, and their educators across the East of England.

The session was delivered as a standalone intervention, and learning took place online to maximise accessibility and allow cross-organisational participation.

The approach combined critical reflective learning, dialogic discussion, and experiential methods.

Teaching activities included:

• A structured introduction to race microaggressions (microassaults, microinsults, microinvalidations, environmental microaggressions).

• Use of real-world vignettes (e.g. name mispronunciation, “Where are you really from?”) explored in facilitated breakoutrooms.

• Anonymous group reflection using IdeaBoardz to reduce fear of disclosure and manage power dynamics.

• Whole-group synthesis focused on impact, intent versus harm, and practical responses.

Content included unconscious bias, stereotypes, intersectionality, allyship, and active bystander strategies, explicitly framed within healthcare hierarchies and training environments.

Significant consideration was given to psychological safety, including clear ground rules, validation of emotional responses, and optional levels of participation.

Educator positionality and power were explicitly acknowledged, and the facilitator’s role as an EDI Clinical Fellow and PSW case manager helped establish trust and credibility.

How was the education intervention evaluated? 

The intervention was evaluated using a mixed-methods approach focusing primarily on learner and educator experience and perceived impact.

Quantitative data were collected via post-session feedback surveys, including Likert-scale ratings of workshop effectiveness, relevance, and confidence gained.

A 70% response rate was achieved, with 90% of respondents rating the workshop 8/10 or above.

Qualitative data were gathered through:

• Anonymised breakout room reflections captured via IdeaBoardz.

• Free-text survey comments from trainees and educators.

Evaluation focused on:

• Changes in awareness and understanding of race microaggressions.

• Learner confidence in recognising and responding to racialised harm.

• Perceived psychological safety and validation of lived experience.

• Educator insight into their role in perpetuating or challenging inequities.

While patient or service-user outcomes were not directly measured, the intervention was embedded within a wellbeing and education support service, with anticipated downstream benefits for trainee retention, supervision quality, and learning environment inclusivity.

What was the impact of the education intervention?

The intervention resulted in clear positive outcomes for both trainees and educators.

Participants reported increased awareness of race microaggressions, greater confidence in identifying subtle forms of racialised harm, and improved understanding of how everyday behaviours impact racially minoritised colleagues.

For racially minoritised learners, the workshop provided validation, language, and psychological safety. Many reported feeling less isolated and more empowered to name experiences they had previously normalised or silenced.

White educators reported increased insight into their own positionality, unconscious biases, and the cumulative impact of “small” comments. Importantly, many described a shift from defensive responses towards curiosity, listening, and responsibility.

Educators highlighted improved confidence in addressing microaggressions non-confrontationally and supporting trainees when incidents involved senior staff or patients.

Themes emerging from qualitative feedback included:

• Recognition of the emotional and psychological toll of microaggressions.

• Increased appreciation of allyship and active bystander roles.

• Awareness of systemic and hierarchical barriers to speaking up.

While formal longitudinal outcomes were not measured, the intervention contributed to improved engagement with PSW services, ongoing conversations within training environments, and demand for expanded training.

Key learnings

• Psychological safety is essential when addressing racialised inequities; without it, learning is superficial.

• Anonymous reflection tools reduce power imbalances and encourage honesty.

• Participants requested more roleplay scenarios or simulation activities to consolidate future learning on this topic.

Challenges

• One-off sessions limit sustained behaviour change without organisational follow-through.

• Impact was primarily self-reported; objective behavioural or organisational measures were limited.

• Mixed-group learning (trainees and educators together) is powerful but requires skilled facilitation and group agreement. This was not trialled in these sessions.

Recommendations

• Embed microaggression education within formal curricula and educator development.

• Make training mandatory for supervisors and senior leaders.

• Pair education with clear reporting pathways and organisational accountability.

• Develop longitudinal evaluation to assess impact on progression, retention, and wellbeing of racially minoritised learners.