Combating Racism in Hospitals

9 March 2023

Credit: aChord Center

Racist harassment of hospital staff is a deeply pervasive issue in the Israeli health system. Racism emerges in overt forms, such as physical assault, or more covertly, when patients refuse to be cared for by Ethiopian nurses or demand to be treated in separate spaces from Arab patients.

People at all levels of the system, from the Ministry of Health to individual staff members, are calling attention to the way individual instances of racism feed into a larger culture of violence, which has clearly emerged. Physical attacks from patients have escalated in the past few years, and medical staff are seriously concerned for their safety and wellbeing.

All this is to say: the need for an impactful and innovative anti-racism strategy in the medical field is clear. 

Seeing the urgency of this need, Shatil and NIF grantee aChord — which uses social psychology research to improve intergroup relations have spent the last year developing a groundbreaking intervention around racism specifically aimed against staff from Ethiopian and Arab backgrounds. While racism is also directed at patients, or between staff, this project focuses on patient-to-staff harassment. Based on extensive socio-psychological research, focus groups, and long-form interviews, the workshops employ the cutting edge tool of virtual reality simulations to equip staff with the motivation, knowledge, and tools to address racism in their respective roles.

In recent years VR has emerged as a crucial tool for a variety of simulations – such as understanding the dynamics of how Israeli soldiers and Palestinians interact at a checkpoint. With VR, participants are fully immersed in a vivid experience. Because the environment feels so realistic, it generates higher emotional engagement, explained Carlos Sztyglic, Shatil’s associate director. 

For this specific training, participants “witness” several realistic scenarios where staff are experiencing a spectrum of racist incidents — anything from outright harassment or humiliating statements to microaggressions. “The trainings place the participant as a third-party observer,” continued Carlos, “because the research demonstrates that the bystander perspective is the most effective for developing empathy and understanding.” VR also has the added benefit of collecting extra data a participant might not be able to relay themselves, such as who they looked at in a particular moment during the experience. 

But the workshops aren’t just the VR experience; the conversations before and after the simulation are crucial to increasing awareness of racism and raising motivation of participants to act when they see harassment in the future. During the debriefs following the simulations participants can share their personal experiences, explore the implications of different levels of power, and talk through different actions they can take the next time they experience a racist incident.

The project is currently in the pilot phase at two major hospitals, where it has been very enthusiastically received. “Participants in the workshops shared that the experience was very realistic and relevant to the reality of their work. It allowed them to share their thoughts and listen empathetically to the difficult experiences of others,” explained Dr. Michal Shuster from aChord

In such a short time, networks of support are already being built up and a sense of solidarity is emerging among staff. Hospital managers know that racism is an important issue for their staff, and are welcoming the opportunity to address it systematically. One department manager contacted the rest of his team as soon as the workshop ended offering support or assistance to anyone who experiences a racist incident going forward. 

For the participants who have previously experienced racism, the trainings were meaningful because they made them feel heard and seen in their workplace. Overall, participants were grateful that there was a specific time and place to address these issues, rather than attempting to deal with it on an ad-hoc basis.

Going forward, the team is planning an extensive empirical study of the efficacy before moving on to full implementation. And this is just the beginning. The project is planning an expansion to other hospitals, hoping to transform the experience of medical staff nationwide and help develop a culture in which they feel safe. 

For Shatil, the best part is that these tools can be applied to many other civil society initiatives, making this project a real opportunity for learning and growth across the field of social change.