Responding to Families Who Express Biases: An Adaptable Standardized Participant Communication Simulation to Train Upstander Pediatric Providers

Date of Review: July, 2026

This resource trains pediatric residents, faculty, and neonatology fellows to respond as “upstanders” when a family member expresses bias (including racism and transphobia) toward a member of the care team, in front of a pediatric patient. It uses a 60-minute simulation with trained standardized participants playing an escalating biased parent, followed by facilitator/peer/SP debriefing, and was evaluated with anonymous pre/post Likert surveys analyzed via Fisher’s exact test. Strengths include its use of realistic, immersive SP encounters rather than peer role-play (reducing embarrassment and improving psychological safety), its adaptability across learner levels (residents, faculty, fellows), and its inclusion of a scripted de-escalation language tool adapted from prior published frameworks. A limitation is the small sample size (34 participants at a single institution) and reliance on self-reported, unlinked pre/post data rather than observed skill demonstration. –Jane Aruma, MD, NCEAS

Corresponding Author’s Email:

kelly.corbett@hitchcock.org

Institution:

Geisel School of Medicine at Dartmouth

Where was the Curriculum Implemented:

Lebanon, NH

Relevant Specialty:

Pediatrics

Outcomes that Have Been Reported for the Curriculum:

Self-reported learner attitude

Measured learner attitude

Outcome and Study Design:

Pre/Post

Level of Learner Assessment

Demonstration of skill in a controlled environment (OSCE, Simulation)