Tackling discrimination in medicine head on: the impact of Bystander Intervention Training

Purpose: A mixed-methods study to evaluate Bystander Intervention Training (BiT), a simulation-based small-group training programme designed to teach skills to tackle discrimination.  

Materials and methods: Norwich Medical School delivered the intervention online between January 2020 and June 2023 to medical students, physician associate trainees, and qualified doctors. A sample of 569 participants was used in the main analysis. Participants completed pre- and post-training and follow-up evaluations.  

Results: Paired post-training scores were significantly different (all p < 0.001) from the pre-training scores for all 12 questions, in favour of the post-training scores. Of the 159 participants who completed follow-up questionnaires, 27 (17.9%) reported having the opportunity to be an active bystander; of those, 23 (85%) intervened. Scores in the follow-up questionnaire were significantly higher than those in the pre-training survey and significantly lower than those in the post-training questionnaire (p < 0.001). Participants had an increased sense of responsibility to be an active bystander and were empowered to challenge discrimination. Participants from marginalised groups expressed positive views about the training.  

Conclusions: Interventions that allow open discussion and carefully supported personal disclosure in safe spaces, where difficult and uncomfortable discussions can occur, with an opportunity to change behaviour, must be developed to tackle discrimination.