Author: Megan Lieb, DNP, RN
Title: Assistant Proefessor
Institution: Ohio Northern University
1) Assess own level of bias related to care of varying populations (gender, age ethnic, cultural, and social backgrounds) (skill).
2) Verbalize the impact of providing patient-centered care with sensitivity and respect for the diversity of human experience (skill).
3) Value seeing health care situations “through patients’ eyes” (attitude).
Developing Empathy is a teaching strategy developed to illustrate the concepts of common sensory deficits related to tactile, visual, or auditory changes in all populations, including older adults. The strategy utilized an Implicit Association Test to assess attitudes and beliefs related to age (Project Implicit- Harvard University). The test may determine that age bias is present that the student was not aware of.
For this activity, students were introduced to common sensory deficits, including macular degeneration, cataracts, glaucoma, hearing loss, and decreased tactile sensation. Lecture format or online modules were used to complete the introduction which covered the types of conditions, assessment, diagnostic procedures, treatment, and patient education.
Students were assigned a variety of “deficits”. Visual deficits were simulated through the use of simulation glasses (can be ordered through Chronic Care Challenges or made using standard lab goggles). Goggles were assigned to simulate the central loss of vision (black dot taped to the middle of goggles), opacity of the lens (layers of plastic wrap around the goggles), or decreased peripheral vision (tape sides of goggles). Hearing impairment was simulated by gently inserting cotton balls into the outer ear. The decreased tactile sensation was simulated using gloves.
Students were then asked to complete a range of activities on campus. Examples included having coffee with a friend, returning library books, doing homework, completing errands. If students are distance learning, supplies could be picked up or household items utilized (old sunglasses and plastic wrap from the kitchen). Activities could include folding laundry, changing batteries in a smoke detector, or dinner with family.
Debriefing can be completed in-person or virtually. Students should reflect on their initial age bias assessment. The use of reflective journaling may also be used if synchronous time is not possible. Students should reflect on:
1) Their own level of age bias
2) The lived experience as a person with sensory deficits common to older populations
3) What strategies they, as health care providers, could use to promote patient-centered care for the patient with sensory deficits
Students should be encouraged to contemplate how these experiences may be similar or dissimilar to healthcare experiences. The facilitator should expand on how bias may be related to a variety of differences including gender, skin color, social background, or sexuality. Project Implicit (Harvard University) offers many different Implicit Association Tests to assess attitudes and beliefs related to those differences.
Chronic Care Challenges Simulation Glasses:
Students can be encouraged to complete the Implicit Association Test again to see if implicit bias has changed. Students should be asked to reflect on the experience or what it is was like to see day to day activities “through the patient’s eye”. Students anecdotally reported feeling left out because they did not want to burden others with moving more slowly and carefully or having to ask others to repeat what they were saying to follow along with and engage in the conversation. Others self-reported they withdrew from others because they felt unwanted (due to their deficits) or that things would be “easier if they did not participate”. In general, students reported an improved ability to share the feelings of others and that they would be more cognizant of the sensory deficits of patients and consider ways to improve patient care.