Neonatal Intensive Care Unit (NICU) Specific Anti-Bias, Anti-Racism, Upstander Education (108)

Abstract Text: There are significant racial and ethnic inequities in neonatal outcomes and family experiences within and among institutions. Potential mechanisms for inequity are racism and bias. Education can lead to cultural change. Upstander training provides strategies to respond in real time. Available curricula demonstrate a lack of focus on NICU populations.

Inequities in neonatal outcomes cannot be accounted for by quality of care alone. Biases impact clinical care and interpersonal interactions with families and coworkers. People demonstrate awareness of other people’s biases but not their own (Fraiman, 2023). Knowledge of documented inequities provides motivation to improve. Education on neonatal inequities, forms of racism and bias, and upstander training can provide both knowledge and skill to enact behavioral change.

A NICU-specific interactive anti-racism, anti-bias upstander training class includes; the history of race, defining race as a social construct, an overview of the different types of racism and bias, presentation of published data on racial and ethnic inequities in neonatal outcomes, and upstander training. The focus is on “making the implicit explicit.” Time is provided for each learner to complete the Harvard Implicit Association Test (IAT). The course guides the learner to a deeper understanding of their individual strengths and biases while connecting them with how those impact patient outcomes and family interactions. This is achieved through a variety of instructional approaches including presenting highlights of current research, group participation, videos, and sharing personal facilitator vignettes of racism and bias.

NICU specific equity training should be mandatory for all patient facing NICU staff.

Needs Assessment and Presentation Description: Inequities in neonatal outcomes and family experiences within and among institutions cannot be accounted for by the quality of care alone. Biases, both implicit and explicit, impact not only clinical care but interpersonal interactions with families and coworkers. Microaggressions (i.e., verbal, behavioral, or environmental slights) increase stress, decrease trust, impact collaboration, and may cause confusion in the plan of care. Education on the history of race, defining race as a social construct, an overview of the different types of racism and bias, presentation of published data on racial and ethnic inequities in neonatal outcomes, and upstander training will provide the knowledge and skills needed to enact change.