In Stage IV of Diversity Dialogue, participants convene as a large group to share highlights of the themes discussed in their small groups.
At the end of the large group reflection, par- ticipants are invited to spend a few moments thinking about a personal intention, or next step, they wish to set for themselves as they leave the Dialogue. Several years after attending a Diversity Dialogue, one clinical director said
“We made some programmatic changes to our staff meetings as a result of my going through the Diversity training you ran. These were aimed at ensuring that all present speak up and that their contributions are valued...I changed my aware- ness/behavior as a leader following your session.
I have seen that others have as well.”
Post-Dialogue Evaluation Stage
At the end of Diversity Dialogue, participants are asked to fill out a survey in which they reflect on their experience and point to high and low moments in this workshop (see Appendix).
Comments offered in these surveys are carefully studied and incorporated in future Dialogues.
Additionally, an evaluation meeting is held
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immediately after the Dialogue for facilitators and the leadership team of the client group; other participants are also invited to stay. First impres- sions of the dialogue are gathered and logistical issues such as timing, the location and size of the space are also discussed.
Post-Dialogue surveys routinely indicate high satisfaction among participants, with a majority citing the introduction hour and small group dis- cussions as being the parts of the Dialogue they most value. It is not uncommon to hear partici- pants say they have worked in the same depart- ment for years but never before known anything personal about each other. Many participants indicate that learning about the concept of micro- aggressions has given them a new perspective on their own behaviors and past experiences.
Closing Comments
Americans frequently cite their first amendment right to freedom of speech, particularly when say- ing something that is hurtful or when speaking without listening. Author Brenda Ueland wrote
“Listening is a magnetic and strange thing, a cre- ative force. The friends who listen to us are the ones we move toward. When we are listened to, it creates us, makes us unfold and expand” [55].
Diversity Dialogue, designed and piloted by the Center for Diversity, Department of Psychiatry at Massachusetts General Hospital, offers the opportunity for healthcare professionals to tran- scend barriers of authority and power, relinquish the concept of the “other” and listen to each other in ways that are new and meaningful. It is built upon the principle of diverting away from dichot- omous or either/or thinking processes and allow- ing polarities and diverse perspectives to reside within a given discussion, provoking feelings of discomfort and eliciting change through sharing stories and opening to new thought patterns.
Diversity Dialogue does these using tools that have been associated in the literature with suc- cessful diversity efforts. These include Pre- Dialogue meetings to assess client training needs and eliciting leadership support in tangible ways prior to the dialogue. Cognitive learning on topics
such as microaggression is included in the struc- ture of the dialogue. At our institution this is rein- forced with hospital wide programming on topics related to racism and stigma throughout the year.
The structure of the Dialogue allows for partici- pants to do most of the talking, another feature cited in studies that look at successful diversity initiatives. At the end of Diversity Dialogue par- ticipants are invited to make a commitment to themselves for a “next step” that will reinforce an aspect of the Dialogue they found meaningful.
In 2014, a stated goal of Diversity Dialogue was “to increase tolerance of and curiosity about diversity and to ultimately assure the best quality of care for all patients” [1]. While this goal remains, in 2018 the polarization of society that has occurred in the last 2 years gives greater urgency to this work and to the ongoing personal commitment of participants. Tolerance and curi- osity about diversity are no longer enough.
Healthcare professionals must actively embrace learning about these concepts, to understand the varied and unique perspectives of patients from all parts of our society who come to them for care. They must strive to understand their own unique cultural identity and how this impacts their interaction with patients. This is particularly true for white clinicians who may not yet feel comfortable with discussion of the history of white culture and racism in our society. Or, those who may wrongly feel they need to project a color-blind attitude which ignores the day-to-day reality of oppression in patients’ lives and the impact this has on health.
Lastly, in order to create diverse workplaces where the racial and ethnic demographics of cli- nicians will begin to approximate those of patients, efforts to broaden knowledge about top- ics related to diversity must be coupled with efforts that acknowledge how biases and oppres- sion impact equity and inclusion in the workplace and in the delivery of healthcare. Diversity Dialogue offers a framework in which partici- pants can begin to communicate about these complex and often uncomfortable topics, despite differences, and to build the relationships needed for working together over the long term to make meaningful change.
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Appendix: Post-Dialogue Evaluation Survey
Department Staff Admin
Gender: female male trans other
Q1 Diversity training is relevant to my current practice
strongly
disagree somewhat disagree
neither disagree
or agree somewhat agree strongly
agree
1 2 3 4 5
Q2 Diversity training is relevant to my professional relationships
strongly
disagree somewhat disagree
neither disagree
or agree somewhat agree strongly
agree
1 2 3 4 5
Q3 I feel confident dealing with patients \ people of a background different than myself
strongly
disagree somewhat disagree
neither disagree
or agree somewhat agree strongly
agree
1 2 3 4 5
Q5 I am a culturally confident clinician\person
strongly disagree 1
somewhat disagree 2
neither disagree or agree 3
somewhat agree 4
strongly agree 5
Q6 My professional training has adequately trained me to participate in the care of patients of diverse backgrounds
strongly disagree 1
somewhat disagree 2
neither disagree or agree 3
somewhat agree 4
strongly agree 5 Q4 Compared to other trainings / lectures, diversity / cultural
sensitivity is as important
strongly
disagree somewhat disagree
neither disagree
or agree somewhat
agree strongly agree
1 2 3 4 5
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Q8 Have you had diversity / cross cultural trainings in the past?
No Not sure Yes
Q7 My department\supervisors\ colleagues encourage cultural discussions
strongly disagree 1
somewhat disagree 2
neither disagree or agree 3
somewhat agree 4
strongly agree 5
Q9 Why & how is understanding diversity important?
Q10 What did you expect from today's dialogue and were your expectations met?
Q11 Was this diversity dialogue useful and which part of it was most helpful?
What stands out for you that you heard\learned today?
Q12 How could we make this dialogue more relevant and helpful to your experience in your Department?
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© Springer Nature Switzerland AG 2019
R. Parekh, N.-H. T. Trinh (eds.), The Massachusetts General Hospital Textbook on Diversity and Cultural Sensitivity in Mental Health, Current Clinical Psychiatry,
https://doi.org/10.1007/978-3-030-20174-6_2