評(píng)論
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And then, “What should I teach myself and the medical students?” ’Cause at the time it was just—medical students was my audience.
那“我應(yīng)該學(xué)到什么，又該教給醫(yī)學(xué)生什么呢？”因?yàn)楫?dāng)時(shí)我的聽眾只有——醫(yī)學(xué)生。
And they, they said, “Just apologize.” And I was like, “I’m sorry, what?” They were like, “Just apologize.” And I was like, “Oh—I can teach that! I can do that,” right?
然后他們說，“道個(gè)歉就行了。”我說，“不好意思，你說什么？”他們說，“道個(gè)歉吧。”我當(dāng)時(shí)想，“哦——我可以教人們這么做！我可以做到的，對(duì)吧？”
And so it, it, of course, evolved from there, but we did a, a focus group study with Black and Hispanic patients in English and Spanish across New York City, across the socioeconomic spectrum, and over and over again they were so generous with us.
一切就是從這里開始的，但我們確實(shí)進(jìn)行了一項(xiàng)焦點(diǎn)小組研究，研究對(duì)象是紐約市的黑人和西班牙裔患者，他們使用英語和西班牙語，各種經(jīng)濟(jì)背景的人都有，他們一次又一次地對(duì)我們非常包容。
They said, “We know you’re human; we don’t need the encounter to be perfect and no bias, etcetera, but once it happens we can’t have it ignored,” ’cause that second insult was a real attack on their, like, their, their core, their dignity.
他們說：“我們知道你也是人；我們不奢求相遇是完美的，沒有偏見，等等，但一旦它發(fā)生了，我們就不能忽視它，”因?yàn)榈诙挝耆枋菍?duì)他們的核心，他們的尊嚴(yán)的真正攻擊。
And sometimes we may also—they may also perceive bias—we, too, when we’re patients—we also may perceive bias when actually it’s a routine question ... Sure.
有時(shí)他們也可能察覺到偏見——我們也是，當(dāng)我們是病人時(shí)——我們也可能察覺到偏見，其實(shí)這是一個(gè)很常見的問題……確定。
But based on our lived experiences, right—being followed around in stores, being accused of wrongdoing, being questioned about our identity, etcetera—we may take it as bias.
但是根據(jù)我們的生活經(jīng)歷，比如在商店里被跟蹤、被指控做錯(cuò)事、被質(zhì)疑身份等等，我們可能會(huì)認(rèn)為這是偏見。
And that can be hard as a physician or a medical student, being like, “I’m supposed to ask you this.”
作為一名醫(yī)生或醫(yī)科學(xué)生，這可能很難，“我應(yīng)該問你這個(gè)問題。”
And so we teach skills to step back and depersonalize it so that you can, again, partner, apologize if necessary or explain why and be able to move forward together.
所以我們會(huì)教一些技巧，讓你退后一步，去人格化，這樣你就可以，再說一次，在必要時(shí)道歉，或者解釋原因，然后繼續(xù)下一步。
But it’s the ignoring part that was really, really hard for patients. Sure.
但是，對(duì)患者來說，真正非常困難的是被忽視。當(dāng)然。
Well, and I think a, a lot of folks who are familiar with implicit bias, you know, thanks to a great surge in research over the last few years, they might think that most of the battle is just becoming aware that we all have implicit bias because that’s really revelatory and difficult for a lot of people ... Sure.
我想，很多熟悉隱性偏見的人，由于過去幾年研究的激增，他們可能會(huì)認(rèn)為，大部分的斗爭(zhēng)只是意識(shí)到我們都有內(nèi)隱偏見，因?yàn)檫@對(duì)很多人來說真的很有啟發(fā)性，也困難……確定。
But it sounds like that is very much just the first step in actually mitigating it. Would you say that’s right?
但這聽起來像是真正緩解它的第一步。你覺得是這樣嗎？
Absolutely. And so there’s been a lot of talk in the literature, and in the lay press as well, about awareness being enough, right?
是的。在文獻(xiàn)中，以及在非專業(yè)媒體中，有很多關(guān)于意識(shí)是否足夠的討論，對(duì)吧？
Because if we become aware, then our good intentions will prevail.
因?yàn)橐坏┪覀円庾R(shí)到了，我們的善意就會(huì)占上風(fēng)。
If it were that easy, I would happily be studying something else, right?
如果真有這么容易，那我早就開開心心地改行了，是吧？
And so I think that, for us, it’s becoming aware, and then—but it’s not fair to have people be aware and then say, “Go be better,” you know, because, of course, they were trying to be their best at the very beginning.
我覺得，對(duì)我們來說，是要意識(shí)到，但讓人們意識(shí)到之后就要求他們“以后要做得更好”是不公平的，因?yàn)樗麄円婚_始就想要做到最好的。
And so that’s where the skill comes in.
這時(shí)候就需要用到技能了。
But what happens when someone is resistant to the idea that this is something they need training for?
但是，如果有人抵制這種想法，覺得并不需要為此接受培訓(xùn)，會(huì)發(fā)生什么呢？
For implicit bias, I think that you have to have safe places to fail.
對(duì)于隱性偏見，我認(rèn)為必須有安全的失敗空間。
And in the educational literature that’s called a critical incident, and in a critical incident you may practice something and then have that internal aha! moment, and internal aha! moments happen in private–that you get this reaction that you don’t like when your actions don’t match your values.
在教育文獻(xiàn)中，這被稱為關(guān)鍵事件，在關(guān)鍵事件中，你可能會(huì)實(shí)踐一些東西，然后內(nèi)心會(huì)有那種“啊哈”的感覺！而這種頓悟會(huì)在私下里發(fā)生——當(dāng)你的行為與你的價(jià)值觀不匹配時(shí)，你會(huì)有這種不喜歡的反應(yīng)。
If you could have that privately, right—maybe with a interactive computer case, for example—then you’re more likely to change your actions to match your values.
如果你能在私下里擁有這種感覺，比如跟一個(gè)交互式的電腦，那你就更有可能改變行為去匹配你的價(jià)值觀。
If you have it publicly, you’re actually at risk of changing your values to match your actions ’cause you feel the need to save face.
如果你公開表明了立場(chǎng)，實(shí)際上就有可能為了保全面子而改變自己的價(jià)值觀，使其與你的行為相匹配。
How do you go about measuring implicit bias in, in a clinical setting? Is there a way for you to see how much work there is to do?
在臨床環(huán)境中，您如何衡量隱性偏見？有沒有辦法能讓你知道還有多少工作需要做？
There are tests, like the Implicit Association Test; it’s a free and publicly available test.
有一些測(cè)試，比如隱性聯(lián)想測(cè)試；這是一個(gè)免費(fèi)的、公開可用的測(cè)試。
There are other tests, and they’re what’s—what are called latency response tests, meaning they see how quickly you react to two opposite concepts—joy, evil; male, female; just thinking about possibilities—down to the millisecond.
還有其他測(cè)試，被稱為潛伏期反應(yīng)測(cè)試，是指它們會(huì)觀察你對(duì)兩個(gè)相反概念的反應(yīng)速度——快樂、邪惡；男性、女性；各種反義詞——時(shí)間會(huì)精確到毫秒。
So see how quickly you react to different concepts. And that is supposed to measure your implicit bias.
看你對(duì)不同概念的反應(yīng)有多快。這可以用來衡量你的隱性偏見。
They’re interesting, and I don’t use ’em diagnostically.
這些測(cè)試很有趣，但我不會(huì)用它們來做診斷。
They tend to mirror what we would expect in terms of the way we’re socialized. Sure.
它們往往反映了我們對(duì)社交方式的期望。嗯嗯。
