Biases, Microaggressions, and Stereotype Threat and Their Impact on Learning

by La’Kendra Bell, PharmD, PGY1 Community Pharmacy Practice Resident, University of Mississippi School of Pharmacy

As an African American woman, I have had a front-row seat to the many microaggressions, biases, and stereotypes that come with being black. I, however, did not let it hinder my growth, as I aspired to be a healthcare professional and make a difference in communities that look like me. This essay focuses on how biases, stereotypes, microaggressions, and stereotype threats can negatively impact learning and the strategies educators could use to prevent and manage them. Let’s first make sure we agree on some definitions:

• Bias: An inclination of temperament or outlook. A personal and sometimes unreasoned judgment¹
• Stereotype: something conforming to a fixed or general pattern.¹
• Microaggression: a comment or action that subtly and often unconsciously or unintentionally expresses a prejudiced attitude toward a member of a marginalized group (such as a racial minority)¹
• Marginalized populations: groups and communities that experience discrimination and exclusion (social, political, and economic) because of unequal power relationships²

Growing up in a mostly separated community, I avoided most of these encounters, as most students went to a school with other students of the same race. Therefore, I did not experience microaggressions, biases, and stereotypes from my peers. However, I had to face them with teachers. Being in a low-income, rural area, many teachers would come to our school for a short period of time and did not stick around to invest in our education and development. For them, it was an opportunity to “pay back their loans.” Feeling unwanted by teachers was the first step in the broken system. From time to time, there were statements that made me feel like I couldn’t make it and that I wasn’t good enough. These were subtle statements and attitudes from people with physical characteristics different from me and sometimes even from those who looked like me.

As I went off to college and then became a pharmacy resident, there were other instances where I felt bias and stereotypes were influencing people’s statements and behaviors; but at this point, I am a professional and must behave appropriately. For recipients, microaggressions can be distracting, exhausting, and painful. One must try to figure out the meaning and intent of the microaggression and then decide whether and how to respond.³

For me, figuring out how to respond is very challenging because I want to avoid coming off as aggressive. When educators and other individuals understand microaggressions, they are in a better position to be sensitive to how a person might perceive comments, create a culture where microaggressions are openly discussed, and support students when they experience them.³

Examples of microaggressions: ⁴

Theme	Microaggression	Hidden Message
Alien in own land. When Asian Americans and Latino Americans are assumed to be foreign born.	“Where are you from?” “Where were you born?” “You speak English?”	You are not American. You are a foreigner.
Ascription of intelligence. Assigning intelligence to a person of color on the basis their race.	“You are a credit to your race.” “I wasn’t expecting you to do so well.” Asking an Asian person to help you with a math problem or science problem. Asking a black person if they played sports. “Are you my nurse?”	It is unusual for someone of color to succeed All Asians are good in math or science All black people play sport or are athletic Assuming a female can only be a nurse and no other healthcare professional
Criminality/ assumption of criminal status	Clinching purses as someone approaches you. A store owner or employee follows you around the store	You are a criminal You are going to steal and assuming you don’t have money
Denial of individual race	“I’m not racist. I have several black friends “I do not see race”	I am immune to racism because I have friends of color Dismissing one's background

Stereotype threat is a disruptive psychological state.³ Underrepresented minority students may be affected by the notion that they are not motivated, capable, and/or academically prepared for higher education. When a student experience stereotype threat, they avoid behaviors that might affirm the stereotype.  For example, a Latino student might not seek help from the Writing Center on campus because it would reinforce the stereotype that they don’t speak or write English well. Or a Black student might not speak up during class for fear they might be perceived as aggressive.  Many studies have demonstrated that stereotype threat can cause hypervigilance, impair working memory, and inhibit academic performance. When stereotype threat is triggered, the energy that could be spent on learning is lost to vigilance, worry, and anxiety. It can lead students to avoid communicating with instructors, studying, or coming to class, ultimately leading to increased student attrition.³

Navigating these stereotypes and biases can be difficult, as they can be based on gender, race, socioeconomic status, religion, and more. Microaggressions negatively impact one's ability to concentrate, solve problems, and learn new material.⁵ Studies suggest that hostile racial climates perpetuated through microaggressions on college campuses disrupt students’ ability to participate in class discussions. Moreover, experiencing microaggressions in the classroom has been linked to feelings of invisibility, isolation, and self-doubt, all impairing one's ability to focus on tasks and solve problems.⁵

What can educators do to prevent and manage these threats to the learning environment? If an educator realizes after the fact that they have just said or witnessed a microaggression, the easiest thing to do is to simply apologize to the hurt individual.

Ways to apologize

Purpose

If committed in your presence but did not address the situation when it occurred: Ten minutes ago/yesterday/last week, a statement was made in class that I did not address at the time but want to do so now.6 If you committed a microaggression: [Student], I want to apologize for the comment I made yesterday. My intention, although poorly articulated, was to say [this]. I understand, however, that my words conveyed incorrect and harmful assumptions about you. Please know that I intend to be more mindful and reflective about what I say in the future.6

Apologize for the delay and acknowledge that by not responding immediately, you (as the instructor) may have given the impression that you condone the behavior and comments that caused. 6 Identify the problematic statement(s) that caused the high emotions. 6   State your commitment to responding to incivilities more quickly and desire to better support the learning and well-being of all students.6

As a student in a health professions program, I sometimes felt that I couldn’t be my authentic self because I did not want to affirm others' negative beliefs or be seen as unprofessional. Though some may not have experienced bias, microaggressions, or stereotype threat, I think it’s important to understand how they can negatively impact learning.  These issues are complex, multifaceted, and layered, but raising awareness is a critical first step.

References:

1. Dictionary by Merriam-Webster: America's most-trusted online dictionary. Merriam-Webster, 2011.
2. Glossary of Essential Health Equity Terms. National Collaborating Centre for Determinants of Health
3. Ackerman-Barger K, Bakerjian D, and Latimore D. How Health Professions Educators Can Mitigate Underrepresented Students’ Experiences of Marginalization: Stereotype Threat, Internalized Bias, and Microaggressions. J Best Pract Health Professions Diversity 2015; 8(2): 1060–1070.
4. Sue DW, Capodilupo CM, Torino GC, et al. Racial Microaggressions in Everyday Life. Am Psychol 2007; 62 (4): 271–286.
5. Torino GC, Rivera DP, Capodilupo CM, Nadal KL, Sue DW. Microaggression theory: influence and implications. Hoboken, NJ: Wiley Publishers 2019. pp 11-12.
6. Huston TA and DiPietro M. In the eye of the storm: Students’ perceptions of helpful faculty actions following a collective tragedy. To Improve the Academy 2017; 25 (1): 207-224.

Co-Learning: Students and Faculty Learning Together

by Victoria Goodman, PharmD, PGY1 Community Pharmacy Practice Resident, University of Mississippi School of Pharmacy

As someone who graduated from a professional degree program and returned from the workforce to complete a PGY-1 pharmacy residency, I feel there were few opportunities to truly collaborate with my professors/preceptors until after graduation. There were set roles; I was the student, and they were the teachers. This dynamic was emulated throughout schooling at most institutions. It felt like there was a stark divide between the faculty and students. But upon graduation, students are expected to flip a switch, spring into their professional role, and even teach others.

This style of teaching and learning, where there are strict roles and responsibilities, is common in many fields, including the health professions. The typical class consists of a faculty educator standing and delivering a lengthy presentation that the students are expected to commit to memory. Information flows in one direction to students as they attempt to absorb as much as possible. Unfortunately, this is not the most effective method of retaining knowledge. In recent years, many courses have incorporated active learning strategies.  This is certainly an improvement but can we improve the learning process by building more connections between our educators and students? One potential technique is a concept called co-learning.

Co-learning is the act of grouping individuals to share the workload of a given learning task or share perspectives in a conversation. Group members learn from each other's unique insight and provide a mechanism for each participant to be accountable for contributing to the learning process.¹

The concept of co-learning is not new, but the practice of co-learning among educators and students is underutilized.^2,3,4 When including the educator in the co-learning group, the teaching strategy is similar to Socratic teaching with students and teachers engaged in dialogue and learning from one another. The educator is not the only person speaking or delivering knowledge; instead, students are encouraged to pose questions and further the conversation.

The Cornell University's Center for Teaching Innovation webpage on Collaborative Learning details the benefits of co-learning between faculty and students.  This includes building rapport, improving faculty-student relations as well as increasing retention rates, experience, idea sharing, and organizational involvement.^2,3 All of which lead to more meaningful learning experiences and strengthen the program.

Rapport Building/Deepening Connections. The opportunity is provided for students and educators to interact in a learning setting that opens doors. The traditional roles can be disbanded, allowing for new bonds to be forged. This is called “flattening the hierarchy” of the power differential between students and teachers.²

Increased Frequency and Quality of Faculty-Student Interactions.  Once the lines of communication are paved, this allows for more frequent and higher-quality interactions between the students and educator. Talking about areas of uncertainty are more likely to be discussed and this increases the confidence in both learners and teachers alike.²

Improved Retention Rate.  The practice of nurturing positive relations between students and educators will naturally begin to build positive and uplifting morale throughout the institution. Having a more understanding and embracing work/school environment will help each member of the institution to feel a higher sense of belonging and value within the program.

Sharing Ideas and Perspectives.  Through open and honest communication, everyone will have the opportunity to share the perspective they have on the situation or subject matter.^2,3

Greater Organizational Involvement. Exposing students to professional organizations through the perspective lens of the faculty member will help the learner gain a better understanding and appreciation for these organizations during their tenure and post-graduate.^2,3 Serving alongside each other would be less of a foreign idea and more of an ushering experience.³

Here are some helpful ideas a teacher can use to foster a co-learning model. Activities aimed at increasing social awareness, cultural competency, and connectedness often work well.⁴ Activities such as storytelling to get to know each member, role-playing to gain an understanding of diversity within the group, and then debriefing at the end of each activity to explore the perspectives about the activity itself.⁴

Another activity might involve one member of the group interviewing another member to complete a survey on socio-demographic information.⁴ The other members of the co-learning team can be assigned as observers of the interaction. The purpose of this is to demonstrate support, empathy, and cultural sensitivity. If it’s not possible to divide students into small groups, each with an educator as a participant, the practice and observation activity could be performed on a larger scale with larger classes. This activity will require members of co-learning teams to interact and analyze information in real-time to come together as a group to decide. Group members engage in open discussion and respect one another’s perspectives.

Dialogue and shared decision-making activities, which include the teacher as a group participant, are ideal - allowing greater time and fostering intimate connections within the group. Experiential learning is where co-learning between students and preceptors often occurs.  Using a similar model in the classroom, teachers and students can discuss and grapple with real problems that don’t have easy solutions, making learning relevant, meaningful, and transformative.

Happy Learning.

References

1. Co-learning in education works wonders for future generations [Internet]. Inventionland Education. 2018 [cited 2023 Mar 26].
2. Haddock L, Rivera J, O'Brien B. Learning together: Co-learning among faculty and trainees in the clinical workspace. Acad Med 2023; 98 (2): 228-236.
3. Collaborative Learning [Internet]. Center for Teaching Innovation, Cornell University. teaching.cornell.edu. [cited 2023 Mar 23]
4. Nguyen-Truong CKY, Fritz RL, Lee J, Lau C, Le C, Kim J, et al. Interactive co-learning for research engagement and education (I-coree) curriculum to build capacity between community partners and academic researchers. Asian Pac Isl Nurs J 3(4):126–38.