Yale Psychiatry Grand Rounds: October 13, 2023

October 13, 2023

Information

"The Getting Racism Out of Our Work (GROW) Initiative"

Speaker: Amber W. Childs, PhD, Assistant Professor of Psychiatry, Yale School of Medicine

ID10858

To CiteDCA Citation Guide

00:00Morning everyone.
00:01It is great here to be here with you all.
00:04I'm just going to pull this slide up quickly.
00:08Actually let me do that once more just
00:09to make sure I got the sound on because
00:11you're not going to want to miss this.
00:12It's very key to hear the sound. OK.
00:31All right. So before we move forward,
00:33I just want to share that I don't have any
00:35relevant financial disclosures to report.
00:38So I'm so pleased to be here this
00:40morning with you all to share about
00:42the GROW program or the Getting
00:43Racism out of our Work program.
00:45I will just say right here at the top
00:47that all credit goes to Doctor Rebecca
00:49Miller for coming up with that incredibly
00:51beautiful name and aspirational name
00:53that I think describes the work of
00:56our initiative so, so perfectly.
00:59I will never forget when I walked into
01:03the shared office space that I had
01:06with my postdoctoral supervisor almost
01:0810 years ago now in Hartford, CT.
01:11I was working on a psychiatric
01:13inpatient unit for my full postdoc year.
01:16And I specialize in child and adolescent
01:18work, as you heard at the top.
01:20And I said to the supervisor in
01:22this tiny little cramped office,
01:24I said, all right,
01:25I'm going to head onto the unit so
01:27that I can see my first patient.
01:28You've already been onto the unit.
01:30Do you have any idea of where he might be?
01:32Have you seen him there?
01:34And without even looking up,
01:35she quickly threw over her shoulder and said,
01:39yeah, he's out there on the basketball
01:42court jumping around like a little monkey.
01:45Now,
01:46this patient of mine was under 10 years old,
01:50had experienced significant and
01:53perpetual familial and community trauma,
01:56and was psychiatrically hospitalized
01:58related to some of those experiences.
02:01And also that patient was black and
02:04the immediate rush of OK,
02:07did she really just call this patient
02:09a little monkey?
02:10Am I overthinking this?
02:12Am I overreacting?
02:13Maybe she didn't really mean that
02:15those questions started to populate
02:17to the front of my brain as they
02:19ordinarily would when she would
02:21make these kinds of remarks or
02:23engage in these kinds of behaviours.
02:25But there was something different as
02:26I started to walk toward the unit,
02:28A sense of dread that really,
02:30really hit me and that I will never
02:33ever forget.
02:33Because it was at that moment that I
02:36knew that what I had believed to be
02:38true about the supervisor engaging in
02:41this racist behaviour was in fact true.
02:43So two reasons why this happened to me.
02:45I think the 1st is that I had
02:47been socialized to question any
02:50experience of micro aggressions.
02:51That no, you are overreacting Amber.
02:54You are misreading that little off handed
02:56comment that that person might have said.
02:58You are blowing this out of proportion
03:00and that is part of the socialization
03:03to really disregard racist experiences
03:05that have happened and really allows
03:07them to perpetuate and proliferate.
03:09And the second reason I think this
03:11happened was out of self preservation.
03:13I really didn't want to believe
03:15that those experiences were in fact
03:17the experiences that I was having.
03:19So this morning I'm going to share
03:21with you about a program that
03:23without even realizing it,
03:25has been a program that in some ways I have
03:28developed for myself.
03:29That Amber 10 years ago,
03:31who really needed her supervisor to be
03:33able to have the knowledge and skills
03:36to confront some of these challenges.
03:38This program is for you and this program
03:41is for the next generation of people
03:43who come throughout our discipline.
03:45So in a lot of ways,
03:47this has been a corrective experience
03:48for me over the past couple of years.
03:50So the agenda is displayed here.
03:52I'm going to talk a little bit about
03:55the relevance of Grow's mission to our
03:57clinical and educational mission within
03:59our department and also what we think
04:01matches or mirrors the School of Medicine.
04:02I want to talk to people in
04:04the audience who might not be
04:06familiar with the GROW program.
04:07But for those of you who have
04:09been following our journey and
04:10have participated in the journey,
04:11want to share with you about the status of
04:13some of our current evaluation efforts.
04:15And then all together,
04:16we'll talk a little bit about the
04:18forming of the GROW initiative because
04:20we've really moved this beyond a
04:22curriculum program to really form
04:24what we think is something much
04:26bigger and talk about the future
04:28directions of the initiative overall.
04:29I'm going to try to leave some room for
04:32reflections at the end of this talk,
04:33as well as some questions.
04:34I'm going to quickly display the
04:36learning objectives for you here.
04:38You're able to see them elsewhere.
04:39I'm going to describe the context and
04:41development of this program to really
04:43help supervisors gain skills and
04:45knowledge regarding culture and diversity.
04:48I'll talk a little bit about some of
04:49the commonly cited challenges that
04:51folks encounter during the program and
04:52then some of the barriers of potential
04:55facilitators to try to incorporate
04:57these opportunities in the training
04:58that we provide and in in we in in
05:00the education that we think about.
05:02Now before I I go any further than this,
05:04I want to just make sure that I
05:07really note and acknowledge my
05:09two friends and also colleagues,
05:10both of whom are Co founders of
05:12the Grow Initiative doctors,
05:14Rebecca Miller and Cindy Crusto.
05:16I'm honored to be able to speak
05:17on behalf of our work together and
05:19I just want to make it very clear
05:21that this has been a collaborative
05:23effort through and through.
05:24We have met almost every single Friday
05:27morning for the the past several years.
05:29I'm pleased that they're both
05:30here this morning.
05:31They'll be able to support
05:32some of the Q&amp;A toward the end.
05:34There are a number of other
05:35acknowledgements that I'll do at
05:36the end of this talk because this
05:38has really been an all hands on
05:40deck effort within the department,
05:42within the school and even within
05:45the university.
05:46So supervision has been called
05:47the signature pedagogy within the
05:49mental health profession and for
05:51good reason because it is a multi
05:54faceted and complex relationship.
05:55It serves as a mechanism for
05:57critical clinical governance,
05:58attainment of competencies
06:00and it's really a cornerstone
06:02of training, professional
06:03development and well-being.
06:04So a lot is happening in supervision.
06:07In this taxonomy of what
06:09makes exceptional supervision,
06:11it's really for when supervisors go
06:13above and beyond simply being qualified
06:15or having potentials in the discipline
06:17for which the Supervisee seeks training.
06:19But they're really engaging in some of
06:21these behaviours that you see displayed here.
06:22They're reliable and give clear expectations.
06:25They're monitoring clinical
06:26services to protect the public.
06:28They are collaborative and
06:30engage the trainee with humility,
06:33respect and flexibility.
06:34They are aware and attentive
06:36to power differentials.
06:38They really promote supervisees
06:39growth and development.
06:41And the thing that we're really going
06:43to highlight and zone in on today is
06:45they seek to learn and apply a deep
06:48understanding and respect of the supervisees,
06:51cultural identities as well as the
06:54clients served cultural identities.
06:56Now,
06:56even though supervision plays such
06:57a critical role in this discipline
06:59and this is information that you
07:01all already know,
07:02so I'll move through this with some pace,
07:04but do you want to just clarify that
07:06many training supervisors lack the
07:08fundamental knowledge and skill sets
07:10required to engage in culturally and
07:13racially responsive supervision?
07:15There have been national sets of data
07:17that have come forward in 2020-2021
07:20and well before that time where
07:22trainees are highlighting and crying
07:24out for these gaps in their own
07:27knowledge of race and culture as it
07:29relates to clinical practice and as
07:31it relates to just being people in
07:33the world and their supervisors as
07:34they're willing to bring it into supervision.
07:36And it won't surprise you that
07:39those implications and that that
07:41experience is really amplified among
07:43reports of trainees of color.
07:45So often times trainees are reporting,
07:47experiencing or witnessing instances of
07:50identity based harassment and discrimination
07:52within the trainee supervisory dyad,
07:54as well as within their clinical care
07:57settings that these things often
07:59recur and often times go unaddressed.
08:01Think about the sort of professional
08:03risk and raising to your supervisor.
08:05You know that that didn't sit right with
08:07me or that didn't sit well with me.
08:10When this happens,
08:11trainee satisfaction suffers,
08:13And you might say to yourself, well,
08:14trainees are not here to be satisfied,
08:16and partly that that might be true.
08:17But here's what else suffers?
08:19Clinical practice suffers.
08:21Trainees lose confidence,
08:23and this is shown in the literature in the
08:25clinical services that they're providing.
08:27They are less willing and they are more
08:29hesitant to raise critical patient
08:31issues within supervision to get the
08:33guidance that is needed and necessary.
08:35And their professional development suffers,
08:37including whether or not they
08:39choose to remain in the field.
08:42I sat on the front porch of my apartment
08:45almost 10 years ago here in West Hartford,
08:48and I remember a phone call to
08:49my dad where I said to him,
08:50Dad, I think I have to quit.
08:53I don't think I can go back to
08:55that placement one more day.
08:57So I thought very seriously about quitting,
09:01and that would have been years
09:03of really pouring into all of the
09:04work to try to get to this place.
09:06And if we are trying to change the
09:09composition of our discipline to really
09:10reflect what looks like the world,
09:12this has devastating potential
09:14implications for that work.
09:16So the bottom line here is that
09:18these gaps in knowledge can cause
09:20harm and training is an imperative.
09:22So we've heard about these data nationally.
09:24I'm going to flash before you some of the
09:26data that we've seen here within our own
09:28psychology doctoral internship program,
09:30the Diversity,
09:31Equity and Inclusion program,
09:32which was Co founded years ago by Doctor
09:35Cindy Crusto and Doctor Jack Teebs.
09:38It was really supported in an overarching
09:40way by some of the work that Michael
09:42Hogey had done in his role as Director
09:44of the training program in bringing
09:45in the diversity concentration,
09:47was doing comprehensive quality
09:49improvement work and really to look and
09:52examine about the climate related to
09:54culture and diversity in our training
09:56program and in regards to supervision.
09:58So in 2019 and 2020,
10:00what we found is that trainees were
10:01in the same way that we saw in
10:03that national literature reporting
10:04these perceived gaps in knowledge.
10:06So I want supervisors to have more
10:08training and issues regarding DEI.
10:10Supervisors are engaging in microaggressions
10:13with patients and with fellows.
10:15The next year,
10:17what we saw was very similar findings,
10:19but a different thing happened
10:21for us in the internship program.
10:23Typically,
10:23trainees will report moderate to
10:25high levels of satisfaction overall
10:27with the climate,
10:28and they would talk about some of these
10:31nuanced changes or nuanced challenges
10:32that they were experiencing that they
10:34would want to perhaps be different.
10:36This year,
10:37half of the trainees actually reported
10:40being dissatisfied with the training
10:42experience in regards to culture,
10:44and what was different about
10:45it was not the knowledge gaps.
10:47Those still persisted,
10:48but trainees started to report
10:50on their subjective distress in
10:52the face of those knowledge gaps.
10:55So trainees reported that supervisors were
10:57not acknowledging racism and power dynamics,
10:59that they were engaging in
11:01microaggression and assumptive behaviors.
11:03And then finally,
11:04there was this experience of a feeling
11:06disheartened about the the perception
11:08and consistency right in terms of how
11:10the program was responding to some of
11:13its own cited values and initiatives.
11:14We saw the same kinds of things
11:17reflected when we asked specific
11:19questions about supervisors
11:20theoretical and empirical knowledge.
11:22So not just what is the climate,
11:24but when you're in supervision,
11:25how much do you feel that your supervisor
11:27is helping you to refine your own
11:30theoretical and empirical knowledge?
11:31And to what extent are these
11:33issues being raised in supervision?
11:35So trainees talked about this idea that
11:37sometimes this modelling is happening,
11:39but we want to have direct,
11:41explicit conversations.
11:41Another thing that was interesting is
11:44that these discussions were a lot less
11:47likely when both the supervisor and
11:49Supervisee Diad both identified as white,
11:51and those knowledge gaps of course persisted.
11:55So at the same time,
11:57when supervisors who are themselves
11:59clinical leaders often are able to
12:01engage in racially and culturally
12:03responsive supervision, everybody wins.
12:04You see displayed here some of
12:07the key supervisory skills and
12:09characteristics that capture racially
12:12and culturally responsive supervision.
12:14Supervisors are self aware.
12:15They think about power and privilege
12:17inherent to the role of the supervisor.
12:20They are open and willing to engage
12:22in these direct critical discussions.
12:24And then the benefits of trainees are
12:26almost the opposite of what we see.
12:27Some of those challenges being
12:29that trainees actually report
12:30feeling more confidence in their
12:32clinical skills and abilities.
12:33They're more willing to disclose
12:35and get needed support.
12:36They have positive professional
12:38development attitudes.
12:39So this is really the data that
12:42sits behind our thinking of putting
12:44together this initial offering.
12:46So I'm going to use Kern's six
12:49step curriculum development as
12:50an overarching framework here.
12:52I'll just refer to it once,
12:53but I'm going to really step you through
12:55the process of how we put together our pilot.
12:57So you just heard about the problem
13:00identification that happened over 2 years,
13:02was rooted in the literature,
13:03was rooted in a lot of our data.
13:05And what we found was that we
13:07were hearing a lot from trainees,
13:08but in our targeted needs assessment,
13:10which was the next step.
13:11We really wanted to hear from our faculty.
13:13What do they say they need,
13:15and do they agree or disagree?
13:17And in if so, in what ways?
13:20So Becca,
13:20Cindy,
13:21and I really put our heads together.
13:23We were really thinking about a lot
13:24of what had been done previously
13:26in the DEI committee,
13:27and we developed a targeted
13:28needs assessment to really try
13:29to understand things further.
13:31So we asked the faculty of our
13:33psychology internship program at that
13:35time to just report their understanding,
13:38knowledge and comfort level,
13:40discussing various concepts and identities.
13:42And we also asked them to rate what
13:44are the topics that you feel that you
13:46are most interested in learning about
13:48and that you would find post high yield.
13:51And what you see displayed here,
13:52I think largely reflects what you
13:54just heard about the top topics.
13:5794% of our respondents,
13:59we had 34 completed surveys out
14:01to 76 supervisor said,
14:03I want to know how to discuss
14:04race and racism.
14:05I want to know how to do supervision
14:07with different race and ethnicity dyads,
14:08how do I support my trainee who
14:10experiences race or racism in
14:12the context of clinical services?
14:14Another theme that sort of arose
14:16in some of the qualitative data out
14:18of that survey was how do we manage
14:20racist information that we hear about
14:23other supervisors from our supervisees.
14:27We also did a revised version of the
14:29Multicultural Supervision Inventory,
14:31which was originally developed to ask
14:34Supervisee perceptions of their supervisors.
14:36And we refined it and adjusted it
14:38because this is a little bit wild,
14:40but there aren't very good empirically
14:43validated measures asking for
14:45supervisor assessment of their own
14:47perceptions. And even of those,
14:49those surveys themselves have
14:51some biased language in them.
14:53So Doctor Miller did an incredible
14:54job of of crafting something so that
14:56we could really get a clear sense.
14:58And what we found out of these two data or
15:01out of these data points were that when
15:04we thought about supervision strategy.
15:06So I encourage my supervisees to think
15:09about cultural issues when working with
15:11clients and multicultural knowledge.
15:13These were the two things that arose
15:17as rated much lower in terms of
15:19faculty's confidence and competence.
15:21Discussing these things in supervision so
15:23knowledge would be knowledgeable about
15:25groups who are different from me culturally.
15:27So we knew that we were really on to
15:29something in terms of thinking about
15:32knowledge and also skills incorporation.
15:33So the goals and desired outcomes of
15:36our pilot were pretty simple, simple.
15:38We wanted to give faculty a similar
15:42foundation, language,
15:42and knowledge of current research
15:45and best practices.
15:46But we didn't want faculty just
15:48to learn theoretical knowledge.
15:50We wanted them to learn personal
15:51knowledge about culture and diversity.
15:53So who am I as a cultural being in this
15:56work to improve their supervisory practices?
15:59We wanted to increase their ability
16:01to incorporate these skills within
16:03their supervision and teaching
16:05so that they could improve their
16:07supervisory practices overall.
16:08So we wanted to proactively help
16:11folks address training experiences
16:13of racial bias and increased ability
16:15to address racism in clinical care.
16:17Another goal that you don't see listed here,
16:19but that was certainly there is using
16:21a lot of these data and leveraging
16:23them within the internship program
16:25to make improvements.
16:27And then as you'll see when we
16:28get to grow two point O,
16:29we really expanded that beyond just our
16:31own internship program and wanted to
16:32participate in a national conversation
16:34and into the national model around how
16:36we can get this done across the discipline.
16:39So just to Orient you to some of how
16:43we arrived at the specific program
16:46that you're going to hear about.
16:47We had our general and targeted
16:49needs assessment data,
16:50but we also had a number of
16:52collaborations and consultations.
16:53So we used our our collective subject
16:56matter expertise really took a deep
16:58dive into the literature and also
17:01collaborated with the the School of Medicine,
17:03Clinical Research and Education Librarian
17:05team to make sure that we had the most
17:08contemporary research in that regard.
17:10We developed a proposed
17:11structure of the curriculum.
17:13And then we had a series of focused
17:15consultations with the experts at the
17:17Porvu Teaching and Learning Center
17:18to really help us think about the
17:21curriculum design to make sure that it
17:23included inclusive teaching practices,
17:24was responsive to participants at varying
17:27levels of starting knowledge and foundation,
17:29and that it was really going to align with
17:32some of the outcomes that we had identified.
17:35We also didn't.
17:36What I've learned is called
17:37designing at the whiteboard,
17:39which is where you basically
17:41have this amazing idea.
17:42You wipe, I have a whiteboard in my office.
17:44You put it all in this whiteboard,
17:45you go out and you build it
17:46and then nobody comes to it.
17:48We wanted to make sure that we
17:49were engaging with key stakeholder
17:51groups that we knew we were
17:53building this for so that we could
17:54make sure that people would come.
17:55If you, if you build it,
17:57they will come type of vibes.
17:58So within the psychology internship program,
18:00we liaised with the DEI committee.
18:03We had many conversations with
18:05the Executive training committee,
18:06which is the governance body
18:08of of the internship.
18:09We had conversations with our internship
18:12core faculty did presentations on
18:14those data that you yourself just saw
18:16and really sought to get people's
18:18feedback about what what kinds
18:20of things would be highest yield.
18:22We also had consultation within
18:24the residency and the department.
18:26So had some really I think impactful
18:29conversations with the long term
18:31care clinic residents or or long
18:33term care clinic leadership,
18:34the psychiatry residency leadership,
18:37which we're really I think fruitful.
18:39Those discussions happened at the
18:41very beginning of our efforts
18:43and also our education faculty
18:45and clinical subcommittee,
18:46Co chairs of the ARTF were also
18:49invited to be participant observers
18:51to the curriculum materials online,
18:54provide feedback and to really think
18:55about whether there were synergies
18:56with the work that was happening
18:58or the recommendations that would
18:59be coming out of those committees.
19:00So we really tried to think broadly.
19:02I'm going to show you now there's
19:04there's no sound for this.
19:05I'm just going to narrate over it.
19:06But one of my biggest pieces is
19:08to really get, hi,
19:09I'm Becca Miller and I'm the
19:10Co chair of the Diversity,
19:12Equity and Inclusion Committee.
19:13And I'm so excited to offer you this
19:15curriculum that we've put together.
19:17This curriculum is really built
19:18on the work and accomplishments
19:20of the DEI committee,
19:21which was not just rely
19:22on information in emails,
19:24not just rely on information in
19:27bulletins or journal articles,
19:28but to really think about how
19:30we're actually recruiting.
19:31And so this was one of our strategies.
19:33We had a professionally developed video
19:35by Doctor Cindy Christo and Doctor Jack.
19:38Some of the accomplishments of
19:40the committee include things like
19:42bringing more DEI focused Grand
19:43Round speakers to the department,
19:45offering opportunities for supervisors of
19:47color to connect with trainees of color.
19:50Looking at what DEI offerings are in
19:53our seminars, in our clinical work,
19:55in our supervision and really making
19:57sure that we're meeting the needs of
19:59our trainees and training the best
20:01next generation of psychologists,
20:03the Diversity Equity and Inclusion
20:05Committee really began.
20:06OK, so you've already seen enough of me,
20:08but there's a teaser there.
20:10If you're interested to see this
20:12longer fuller video,
20:13please do get in touch with me,
20:14I'll,
20:14I'll let you know what that looks like.
20:15But that's that's a theme that
20:17you'll see throughout as we really
20:18tried to think about how do we,
20:21how do we engage our stakeholders differently
20:24to the some of the usual methods.
20:27All right, So what were the core design
20:28principles for the curriculum itself?
20:30And I promise you,
20:31I'm going to tell you about the curriculum,
20:32but really want to share with you the,
20:34the complexity of the thinking that
20:36went behind what you're going to see.
20:37We wanted to make sure that
20:39the learning was planful,
20:40sequenced, graded in complexity.
20:42So really thinking about evidence
20:44based approaches to teaching,
20:46we had expected competencies and learning
20:48objectives that were clearly clearly
20:50defined and assessed at multiple points.
20:53We wanted faculty to play an active role
20:55in self reflection and assessment so
20:57that they could identify their strengths,
21:00their personal learning needs
21:01and objectives and allow some of
21:03this work to be learner driven.
21:05We also wanted to reduce the burden
21:08on our internal subject matter
21:10experts who are often called upon
21:12to do this work repeatedly.
21:14But we also knew that that was
21:16important for us to bring in external
21:18people to reduce that burden,
21:19but also to facilitate some of the honest,
21:22difficult and I think ultimately
21:24transformative discussions that
21:26would be so key to having this work.
21:28We also wanted people to be able
21:29to learn in community.
21:31So if we're asking people to
21:32learn something about themselves,
21:33part of that immersive experience is
21:35being within and among your colleagues.
21:37And so we wanted to make sure that
21:38there was immersive discussion
21:40and engagement with faculty peers
21:41moving beyond that content knowledge
21:43to personal knowledge.
21:44And then practicality was something
21:46that we consider deeply,
21:47and it's certainly not something
21:48that we have solved for entirely,
21:50But we wanted to be thoughtful
21:52about time commitment.
21:53We wanted to be thoughtful about flexibility,
21:55so synchronous and asynchronous
21:57learning opportunities.
21:58And then we also thought about incentives,
22:00so continuing education credits,
22:02branded items and books research
22:04and professional development funds.
22:07I I actually eliminated our quarterly
22:09core training faculty meeting in
22:12lieu of having these trainings.
22:14So really trying to be thoughtful
22:16around that.
22:17We started this out on an incredibly,
22:21an incredibly small budget and we're
22:22so grateful to have been sponsored
22:24originally by the American Psychological
22:26Association and matched by the department.
22:29But when I say very small C grant,
22:30I mean $7000.
22:31That is how we started this program
22:33that you're going to see before
22:34you and we have really grown and
22:36developed this much, much further.
22:38But this is what we were able to get done.
22:40We also were able to secure some
22:42additional small funds from the
22:43teaching and Learning Center and
22:45then we collaborated with Dean
22:47Lattimore within the office of DVI.
22:50So the pilot curriculum is what you see here.
22:52It had four core content domains each
22:55drawing on three major elements.
22:57So the first were core workshops,
23:00the second was Co small Co learning
23:02groups and the third were self-paced
23:04supplemental offerings.
23:05So the content domains that you see
23:07there are really aligned with this
23:09idea of getting foundational knowledge,
23:10skills integration.
23:11And then the final two domains
23:14really try to amplify 2 specific
23:17areas of content knowledge,
23:19so intersectionality and
23:20structural competence.
23:21So the program was designed
23:23to be highly interactive.
23:24There were two to our live virtual
23:27workshops that were delivered by external
23:29subject matter experts who we reached
23:31out to people all across the country,
23:33met with every single one of
23:36those people individually.
23:37There was, there was perhaps over 20 or
23:4025 different contacts that were made.
23:43We wanted to make sure that
23:44structurally the curriculum
23:45was delivered at a good pace.
23:46So the intention was to have it
23:48go over about six months with
23:50those core seminars or those core
23:53workshops about every other month.
23:55And participants received
23:57electronic reminders.
23:58They had the ability to log into Canvas,
24:01which was the learning tool that we
24:02used to make sure that they had access
24:04to all the supplemental materials.
24:05And I'll show you that here in just a second.
24:08We had small Co learning groups
24:09because as I said at the top,
24:10we wanted to make sure that
24:12there was peer community and
24:13immersive discussion opportunity.
24:14So as we had,
24:15you know a large group of people
24:17coming together for content knowledge,
24:18we wanted people to have
24:20that process opportunity.
24:21But we made these optional just because
24:23we were trying to really get a good
24:24sense of what was going to work well.
24:26But we did design A workbook
24:28to really guide people through
24:29some of those initial stages,
24:31with recommendations about how
24:33they could form their groups,
24:34recommended materials for them to read,
24:36and then certainly guidance about
24:38different questions or prompts that
24:40they might talk to each other about.
24:42But we didn't. We didn't sort of prescribe.
24:44This is what you'll what you'll do.
24:47This is don't break out a microscope.
24:49This is a glamour shot of
24:51our learning objectives.
24:52You're not intended to read these.
24:53I just want you to know that
24:54they are exist and that they're
24:56anchored in the literature.
24:57Here's zooming out on 2 examples
24:58of the learning objectives from
25:00the practical application domain.
25:02So skills,
25:02integration.
25:03Can you identify 3 strategies to
25:05manage the challenges and anxieties
25:07related to discussing race and
25:09forms of racism and supervision?
25:11So that would be an example of one
25:13of those concrete learning objectives
25:14that we had for faculty in that pilot.
25:17A couple glamour shots of
25:19the workbook for the pilot,
25:21just to really show you here.
25:22You're not intended to be able to read this,
25:24but this is our really original
25:27workbook and as you can see here,
25:29this was largely learner driven,
25:30so there were open-ended questions.
25:32Participants were really intended
25:33to guide their own learning with
25:36recommendations about prompts and
25:37different book chapters from us to read.
25:40So what you're going to see here now
25:42is a sneak peek of the Canvas website
25:44that was designed in collaboration
25:45with the digital education team at
25:47the Teaching and Learning Centre.
25:49So we had
25:51our our our professionally
25:52developed video that was here.
25:55Faculty were also given a special
25:56video to walk them through how to
25:59use the Canvas paging website.
26:00They were able to see the
26:02full curriculum and schedule,
26:03but we also wanted them to know who
26:05the subject matter experts were that
26:07were coming into our space to talk to
26:09us and we wanted them to get a good
26:11sense of the caliber and level of
26:13national expertise and international
26:14expertise I would say that folks had.
26:15So you can see there that it was
26:17linking out to different websites,
26:19making sure that people had a good
26:21understanding of what the learning
26:22objectives were as well as a summary
26:24of each one of those sessions.
26:26There were also discussion
26:27boards that were available for
26:29people to use if they so chose.
26:31And you can see here again just
26:33where people are able to go in and
26:35access some of that supplemental
26:36content and what that might have
26:38looked like for a user in the pilot.
26:42We also had additional supplemental
26:44opportunities where we had an art tour,
26:47we had, there were video screenings
26:48that happened that were optional
26:50for folks to participate in.
26:51So you see here just a long running
26:53list of different materials
26:54made available to faculty.
27:00So enrollment we had about 44 folks
27:03enrolled and in the beginning as I said
27:04this was really targeted toward the
27:07psychology doctoral internship program.
27:08So the bulkhead of folks were
27:10coming from that program,
27:10but because we were really thinking about
27:13this as something that would that would
27:15scale up to the department more broadly.
27:17We were already having key conversations
27:19with the psychiatry residency
27:21leadership and together we identified
27:23a representative from each one of the
27:25clinical institutions to come and pilot
27:27the the program and give us their
27:30feedback back about the program and
27:32what perhaps if anything might need to
27:33be changed if we were to scale this up
27:35to the psychiatry residency faculty as well.
27:37We also had some really incredible
27:39participation from the long term care clinic.
27:40We actually came away with a wait list from
27:44the LTCC after we did that original pilot.
27:47You'll see here just some brief demographics
27:49that in large part the folks who came
27:51forward for the pilot reflect in many
27:53ways the composition of the department.
27:55We had a number of folks who were
27:57actually actively teaching within
27:58the psychology internship program and
28:00almost everyone who participated was
28:02engaging in individual supervision,
28:04at least of psychology or
28:07psychiatry trainees.
28:08So, but here is some workshop data.
28:11After each one of those live workshops
28:14we assessed to what extent did faculty
28:17find the workshop to be high quality,
28:18To what extent did they learn A lot,
28:21to what extent were they satisfied?
28:22And what you see here on a scale of one
28:25to five with five being the highest,
28:27is that overwhelmingly we had
28:29really positive feedback.
28:30And you'll have to remember that this
28:32was a voluntary group of people that
28:34were coming forward who said we want
28:36to learn about these issues and they
28:38were also saying like and we're finding
28:40them to be really high yield seminar.
28:41So you'll even see that the ratings
28:44increased throughout the sessions,
28:45particularly session 1:00 to 2:00
28:46because we were taking in feedback
28:48real time and making adjustments to
28:50those sessions as we went through.
28:52You will note that the attendance
28:54does start to a trip here and I'll
28:56talk a little bit about that when
28:58we get to a further slide.
29:00We did reassess some of those
29:02different domains of multicultural,
29:04supervisory behaviours.
29:05And what you'll find,
29:07what you'll see here is that we had really,
29:09really low response rates for
29:13our post program participants.
29:15So we had sixteen of our 44 folks
29:17actually fill out that survey.
29:19We also sent it out to a group of controls
29:21and we had only 11 people respond back.
29:23So we weren't able to do any
29:25statistical analysis or comparison.
29:27But what you will see here are
29:28mean scores and while they're not
29:30significantly different or they're
29:32not different in appearance from
29:34our our participants in the group,
29:37I'm going to show you some qualitative
29:39data that actually is discrepant from
29:41this and we'll just bookmark this here
29:43and know for the for grow two point
29:44O that we're going to try to have
29:46a much more robust evaluation,
29:47but I just wanted to show you that data.
29:50Here's where the really
29:51rich feedback came from,
29:52a lot of informal conversations but
29:54also formal assessment of supervisors
29:56perceptions and experiences.
29:58So the qualitative feedback really matched
30:01those high ratings for the workshops overall.
30:05And the qualitative feedback about
30:06the program overall was very similar.
30:08So we were hearing things like this
30:10material was rich and relevant.
30:11The session helped to convey
30:13confidence about the ability of
30:15supervisors to address these issues
30:17as they impact supervision.
30:19There was a positive theme and
30:20report of people being able
30:22to really engage in role play,
30:23so I felt like I was building actual
30:26skills and applying those concepts.
30:28Super supervise or presenters I should say,
30:30normalized the challenges that supervisors
30:33have while addressing race and culture.
30:36So really overwhelmingly positive
30:37feedback that we were getting
30:40from a qualitative standpoint.
30:42So what did we learn from this
30:44specific pilot, really taking stock,
30:46the workshop attrition.
30:47This is a real world implementation.
30:49We had clinical leaders with
30:51robust demands for their time.
30:54There were also our second set of sessions
30:56also happened during the Omicron surge.
30:58And so we had significant provider
31:00shortages as well as COVID absences.
31:03And then the meeting cadence didn't actually
31:05reflect what we had originally intended.
31:07It was about 8 months in total as opposed
31:09to those six months that we had aimed for.
31:12We heard some feedback about the formatting.
31:14Participants wanted more time
31:15with the subject matter experts.
31:17And I would have never thought that
31:19folks would say we actually want
31:20more time because as you just heard,
31:22like people were having a hard
31:23time making it to those sessions.
31:24But people were like, we need more,
31:26we need more from the subject matter experts.
31:29There were those logistical barriers that
31:30we did have the sessions at a fixed time.
31:32So people did raise that.
31:34And then we also had some
31:36feedback around the content.
31:37So we found that supervisors actually
31:40wanted like supervision fundamentals.
31:42How do we become a supervisor
31:43and how do we move away from,
31:45I'm just going to do what
31:47my really wonderful,
31:47amazing supervisors did and try to
31:49avoid what my not so great supervisors
31:51did to how do I engage in an evidence
31:55based practice of supervision.
31:57And then Amber,
31:58is there any way we can curate
32:00those supplemental materials?
32:02And so we, we had an answer to that.
32:05So I'm going to talk now about some
32:07of the GROW 2.0 efforts and GROW
32:09initiatives based on that original pilot.
32:12So I'll talk about the funding,
32:13I'll talk about collaborative
32:14partnerships and some of the expansion.
32:16So we were and y'all this metaphor
32:18really stretches. So we were growing.
32:20We wanted to really think about the
32:22opportunities within the psychiatry
32:24residency because those four folks
32:27that had participated in our pilot
32:29from each of the clinical institutions
32:31were like, yeah, I think that
32:32there's a lot of yield here.
32:33And in fact, there's not a lot changes
32:35that you need to make to have this be
32:37readily applicable to the faculty who are
32:40supervising our psychiatry residents.
32:42So we had several meetings with the
32:44interim psychiatry leadership to
32:45align on priorities and to really
32:47think about the recruitment strategy.
32:49We talked a lot with clinical institution
32:51leadership at Yale Health, at the VA,
32:53Yale New Haven Hospital, CMHC.
32:55We were able to be invited to
32:58attend faculty meetings.
33:00We were able to collaborate with
33:01especially at Yelding Haven Hospital
33:03at the time faculty who would want
33:05to participate and try to identify
33:07potential opportunities for release time.
33:08We re invited the long term care clinic
33:10because as I said before there was a
33:12wait list that we wanted to free up
33:14and again we made this available to
33:16the psychology internship faculty.
33:18We also started to go outside
33:19the department again, right?
33:20So we had consultation from the APE,
33:23American Psychological Association CEO,
33:25the their Chief Diversity Officer and who
33:28is now the Chief Diversity Officer and
33:30Chief of Psychology in the public interest.
33:32And then we also had consultation
33:34with subject matter experts who
33:36had taught some of our workshops to
33:37really refine the content further.
33:39We also started to have a number of
33:42collaborative partnerships emerge.
33:43So our collaborative partnerships with
33:45the Teaching and Learning Centre continued,
33:47have really great conversations
33:50with Janet Heffler,
33:51with John and Candela about early outcomes
33:54and about refining our two point O design.
33:56We got in touch with the Gilder
33:58Lehrman Center for the Study of Slavery
34:00Resistance and Abolition Abolition,
34:01which I'll talk about in an upcoming
34:02slide because we realized history
34:04was a domain that was really missing
34:06and that came out of some of our
34:08conversations with the APAC suite.
34:09And then we really continue to
34:11engage with the office of DEI within
34:14the School of Medicine.
34:15We also had our first national partnership
34:18with the Northwestern University
34:20Counselling and Psychological Services,
34:22who sent eight of their clinicians
34:24to pilot our program in the hopes of
34:26expanding this offering to Northwestern.
34:27CAPS did a lot of pitching throughout
34:31the School of Medicine to a number
34:33of different stakeholder groups as
34:34well as in the university.
34:36We were able to be and and thank you
34:39to Doctor Crystal for I think the
34:41overwhelming support and engagement in
34:43the GROW program throughout its development.
34:46But at that time,
34:47we were able to get some funding
34:48from the Department of Psychiatry,
34:50Constantive Funding,
34:51funding from all of the sources
34:53that you see listed here.
34:54So we were getting funded
34:56within the department,
34:56but also within the university
34:58and within the School of Medicine.
35:02So what did you add, Amber?
35:03We added two modules.
35:04We added a module on history.
35:07If we can't as a department and
35:10as an institution and as a field,
35:12articulate the implications of racism
35:14and as they currently show up in a
35:16contemporary way in the clinical
35:17services that we provide and in the
35:19teaching and education that's happening,
35:21then are we really doing the work?
35:22So we added a module on history
35:24and we added supervision one O 1.
35:26We curated the supplements.
35:27So we heard, we heard the people
35:29and we heard the feedback.
35:30We actually created a curated journey.
35:32So as you went through,
35:33you didn't have to guess and
35:34you only had up to 10 items.
35:36And we really shortened the
35:38length of those items.
35:39We adjusted the small group.
35:40So how are we going to actually get
35:42people more contact with subject
35:44matter experts without increasing
35:45the amount of time that they
35:47have to spend in live workshops?
35:49To an unfeasible degree,
35:51we had the small group workshop
35:53or small groups become a required
35:56component and then we hired additional
35:58external facilitators to facilitate those.
36:01And then I developed a protocol,
36:03A workbook that really guided
36:04people step by step through.
36:06Here's what's going to happen
36:07in this session.
36:08Here's what are the role play efforts,
36:09and here are the learning outcomes.
36:11We also developed a much more
36:14robust evaluation plan with several
36:16different domains that I'll show
36:17you here in just a moment.
36:19So here's now the key content domains.
36:21What you'll just see here is
36:23those two additional domains that
36:25are slidden at the top.
36:26We continue to have our same format
36:28but now know that those small Co
36:30learning groups are facilitated
36:31and that they are now required
36:33and we really thought about the
36:34composition of those groups to make
36:36sure that the people who were in
36:39those groups were able to actually
36:40effectively learn from one another.
36:42We thought about rank of the participants,
36:44we thought about position,
36:45we thought about race,
36:47we thought about gender and really
36:49kind of so wanted to move beyond
36:52just are you all available to
36:54meet at the same time some samples
36:56of the learning objectives?
36:57I'm happy to send these slides around
36:59later so you don't have to memorize this,
37:01but I'm really thinking about how
37:02does history impact and what are
37:04some fundamentals of supervision
37:05that can be an evidence based model.
37:08To get that done,
37:10we came up with a much more
37:12robust measurement process.
37:14So we were measuring readiness for change.
37:17We were measuring personal
37:18self-awareness of race and culture.
37:20We were measuring whether or not
37:22people were engaging in multicultural
37:24knowledge and supervision as
37:26well as in clinical practice.
37:28We were asking people supervisors about their
37:31supervisory working alliance behaviors.
37:33We were asking also about impression
37:36management and socially desirable
37:37responding as well as demographics.
37:39So we really tried to survey much more
37:43broadly and much more tightly to some
37:46of our expected outcomes.
37:47Don't memorize this,
37:48but the main tweet here or the
37:50main I guess post if now if
37:52we're now thinking about eggs,
37:54is that overall learning
37:56satisfaction and overall usefulness.
37:59And that question of usefulness is like
38:01to what extent can is this session
38:04applicable to my professional practice
38:06continue to be incredibly high.
38:08And what you see here is that these
38:10numbers are actually much higher
38:11than the numbers in our pilot.
38:13And you'll also note that the attendance,
38:15we had about 50 folks registered
38:17for this pilot with a couple folks
38:19dropping off at the very beginning,
38:21but our attendance was very consistent.
38:23We had those sessions happen once per
38:24month and the small group sessions
38:26were happening also within the same
38:28month and they met twice per month.
38:30And our attendance rates for the
38:32sessions but also of the small
38:35group work were phenomenal.
38:37OK, so post program, just a couple things.
38:40How useful were the overall workshops
38:43from very to extremely useful?
38:4587% saying they're very useful.
38:47How useful were the small groups?
38:4985% saying very too extremely.
38:51How engaged were you in your small group?
38:54People were reporting that they were
38:56very engaged in their small groups.
38:58Amber,
38:58how useful were the supplemental materials?
39:00There's still some work to be done,
39:01but at least we're more than
39:02a coin toss here.
39:03We're at 65% in terms of usefulness
39:05of the supplemental materials,
39:06which is an improvement to
39:08what we saw in the beginning.
39:11Now we also asked people to
39:13again complete like what's your
39:15level of competence and to what
39:17extent are you engaging in these
39:19racially and culturally responsive
39:21behaviors within your supervision?
39:24We had 46 people complete that post survey,
39:2935 of those were participants
39:32and the remainder were controls.
39:34We over indexed a little bit on
39:36anonymity and so had a little
39:38bit of a difficult time matching
39:40participants to their pre and post data.
39:42Even though we had 30 participants
39:44in that the the program group that
39:47said they completed the pre survey,
39:49we were only able to ultimately
39:50match 17 people.
39:51But again,
39:52it was really important to us that
39:53we had anonymity and so I think we
39:55over indexed a little bit on that,
39:56but but for the 17 people that we were
39:58able to match, we saw significant.
40:01Improvement in the expected
40:02direction across each one of those
40:05previously assessed domains.
40:07And as you saw,
40:07we asked a lot more than that,
40:08but I just want to keep it consistent,
40:10significant improvement in those behaviors.
40:13We didn't see significant
40:14differences between people who went
40:16through the program and controls.
40:18But what we did find is that controls
40:21reported higher levels of socially
40:23desirable responding and lower levels
40:25of readiness for change than our
40:27grow participants who came forward.
40:29So more data on that to come and stand
40:32by as we continue to analyze that.
40:35We asked participants how competent
40:36they felt with the following
40:38things and what we found is that when
40:40we had program competence from somewhat
40:42competent to very competent, which we did,
40:44a four point liquid skill here,
40:4691% feeling somewhat to very competent,
40:49talking about race and racism,
40:51talking about social determinants of health,
40:53talking about power dynamics and supervision,
40:56thinking about the historical basis
40:59for disparities with trainees and being
41:01able to discuss that in supervision,
41:03being able to discuss instances of
41:05identity based harassment or discrimination
41:07and supervision increased to 94%.
41:10There's still some opportunities
41:11here for us in terms of supervisors
41:13being able to discuss racial identity
41:16development in the context of clinical
41:18service delivery and supervision.
41:20But we did see some improvement in terms
41:22of discussing power and privilege in
41:24clinical work with trainees as well.
41:29As a result of attending the GROW curriculum,
41:31I feel I have a better understanding of race
41:33and racism in my supervisory relationships.
41:36This was rated on a scale of one to five,
41:38with five being strongly agreed and what
41:40you see here is a four that people were
41:42feeling like they had a better understanding.
41:47I'll jog through this here,
41:48but the main summary is those
41:51first two columns are really
41:53asking about the impact of those
41:55facilitated small learning groups.
41:57People talked about the
41:59group cohesion and community.
42:00They talked about the topics
42:02being highly relevant.
42:04They talked about the utility of
42:06the group size and of the group members.
42:08Being able to identify with the different
42:10group members on different struggles and
42:12work through them meeting on a regular
42:14basis as being really key and critical.
42:16And then that these groups,
42:17the content and the process helped raise
42:20their awareness of racial identity.
42:22It encouraged them to engage in more
42:24anti racist work outside the context
42:27of their supervisory responsibilities.
42:28It increased compassion and honesty
42:30within themselves and within others.
42:33And I'm going to go through now some
42:35just really I think impactful quotes
42:37about the impact of the overall program.
42:39As we heard from the qualitative data,
42:41we had almost 100 different pieces
42:45of qualitative data that came out
42:47of that post program survey.
42:49We are wrapping up right now an
42:51additional study that's doing individual
42:53qualitative interviews for small group
42:56participants as well as individual
42:58interviews of our small group facilitators.
43:01So more data on that to come
43:02and and and stay tuned for it.
43:04So now I'm going to focus on the
43:06overall impact of the program.
43:07These are just a couple out of,
43:09again,
43:09almost 100 different comments
43:12that we got across.
43:13Each of those questions grow made
43:15me think about how to have a better
43:18standard of practice for inviting
43:20discussions of race and racism
43:21to be present in my supervision.
43:23I think previously I had relied
43:24on being a person of colour and
43:26that my people of colour trainees
43:28would feel comfortable,
43:30but was not thinking about how
43:32to encourage these conversations
43:33with my white trainees.
43:35I'm more confident that I would
43:37initiate a discussion or raise a
43:39concern in my clinical practice.
43:40I'm more confident about introducing
43:43inquiries about bias with patients of color.
43:45So you see here that it has the impact
43:48extends beyond what is happening within
43:51the context of clinical supervision
43:53also to the clinical practice of our
43:55clinical leaders and supervisors.
43:57This what I thought was really
43:59beautiful forgiveness and
44:00grace toward myself and others.
44:02This is an incredibly complicated
44:05topic or issue and topic.
44:07Oh,
44:07increased awareness.
44:08I'm just so much more aware and these are
44:11all different individuals by the way.
44:13I'm just so much more aware of the racism
44:15and structural racism all around me.
44:19I will actively address issues rather
44:21than leaving it to supervise these to
44:25bring these issues into the discussion.
44:28Grow impacted my supervision and
44:30clinical practices by renewing
44:31my commitment and enthusiasm for
44:33anti racism work in practices.
44:35I feel more confident,
44:37grounded and resilient.
44:38I feel more knowledgeable and
44:40skillful at conceptualizing and
44:42discussing intersectionality and
44:44structural analysis when working
44:46with clients or with supervisees.
44:49And then finally,
44:50I think the GROW program removed
44:52some of the fear of having
44:54discussions around race.
44:55The fear for this person was primarily of
44:58making white individuals uncomfortable,
45:00and they reported feeling less
45:01concerned about that.
45:02And I will say that that fearfulness,
45:05reduction of anxiety,
45:06that was also a theme that arose
45:07throughout many of these comments.
45:11So a couple things that we still need to
45:13solve for because there were still lingering
45:15concerns around grow two point O similar
45:17to what we heard in the pilot, clinicians
45:19and faculty still had limited time.
45:21There were people who were
45:22reaching out to me saying Amber,
45:23I want to participate, but you know,
45:25I can't get to those live sessions, I can't
45:27get to all of the small group sessions.
45:30And so this is certainly something
45:32that we need to continue to think
45:34about flexibility and scheduling,
45:36really thinking about to what
45:38extent can we combine asynchronous
45:39and synchronous components.
45:41But we also as a grow team
45:43started thinking a lot more about
45:45scalability and sustainability.
45:46Are we able to scale this
45:48because we can have, you know,
45:5050 participants in this program.
45:51But if we want to think about this
45:52as a national model or if we want to
45:54think about getting to the many, many,
45:55many faculty that we have involved in
45:57clinical services and involved in training,
45:59we need to think about how to make
46:01this bigger And it also costs money,
46:03right, to to do this.
46:04And so how can we do this
46:06in a sustainable way?
46:07We also have the issue of you know to
46:09mandate the training or not to mandate
46:10and we really had the position that
46:12mandating doesn't address some of these
46:13additional barriers that are laid out
46:15here in terms of limited time etcetera.
46:17And really we're still holding the position
46:19of wanting to be able to get the data
46:21to prove the effectiveness of the outcomes.
46:23And you know really thinking about some
46:25of the literature that talks about
46:26that there can be some potentially
46:28adverse consequences to to to mandating.
46:31So our response to that and this is
46:33a future direction has been a program
46:35that we're developing called Grow Seeds.
46:37So Grow Seeds is a an adaptation
46:40of our advanced core program,
46:42which is the Grow 2.0 program.
46:44It's designed to provide a practical
46:46point of entry for our supervisors.
46:48It includes 3 core content domains and
46:52the learning elements are asynchronous,
46:54so there's didactic content that's
46:56taken virtually asynchronously,
46:58the learning supplements and then
47:00self reflective practice.
47:01And we've also thought about a
47:03model of this that would include a
47:05small group cohort facilitation,
47:07so people could opt in to attending
47:09a small group that's facilitated
47:11by an external expert.
47:13But more to come on grow seeds.
47:15It's still in development and our hope
47:16is to launch that as soon as I get
47:19back from from having a baby next year.
47:21Our hope is to launch that at that time.
47:24So with the few minutes that
47:26I have remaining,
47:27I want to talk to you about where we
47:30are now with the GROW initiative.
47:31So you're going to see a video here
47:33that I'm going to narrate over.
47:35But our mission of the initiative
47:37is to Foster and sustain clinical
47:39and educational excellence.
47:41And here's how we're thinking
47:42about doing that.
47:43First is investing in skills.
47:44You already saw that with the
47:46programs that I just presented.
47:47We want to drive innovation by
47:49producing and sponsoring cutting
47:51edge research and scholarship and we
47:52want to give training opportunities,
47:54advanced trainees.
47:55Some of the accomplishments
47:57we've had three National Toxo,
47:59University of Michigan at the
48:02American Psychological Association.
48:04We have two training programs,
48:06which you just heard about our core
48:08training program and grow seeds.
48:09We have 3 sponsored research projects.
48:11We launched our website earlier this year
48:15and we have had ongoing collaborations.
48:17What you see here is a couple of
48:20pictures of us from the American
48:22Psychological Association.
48:23We did a symposium with Doctor
48:25Nadine Kaslow who is a nationally
48:27and internationally I would say
48:29renowned leader in supervision.
48:30You see here some of our colleagues
48:32that might be here in the space
48:34and there is a feature that's
48:35happening in the APA Monitor.
48:37We also wanted to really think about
48:39ongoing community and celebration.
48:41So you see here in May,
48:42we brought together our pilot group and
48:44our primary Grow Two Point O group to
48:47really celebrate their accomplishment.
48:48And this is a screenshot of the ARTF,
48:51which the ARTF celebration which Grow
48:54Co sponsored with a lot of branded
48:57materials and I Co sponsored that
48:59dancing line that you saw there.
49:01So I was able to get the people
49:02up on their feet.
49:03So we don't take credit
49:04for the ARTF celebration,
49:05but certainly for some of the
49:06dancing that was happening there.
49:08And then I'm also really proud to
49:10showcase some of the funded and sponsored
49:12work that has come out of the initiative.
49:14We had a fellow faculty research
49:17scholarship that was funded for
49:19the two folks that you see here.
49:20Doctor Cartagena,
49:21who actually has just joined the
49:23faculty who was a psychology
49:25doctoral intern within our program,
49:27and Doctor Jennifer Kilkas,
49:28they're doing a project called
49:29Switching the Code,
49:30Understanding Professionalism.
49:31Doctor Angela Haney was able to
49:34benefit from one of our professional
49:38development scholarships.
49:39And then we have current psychology
49:41doctoral interns doing their
49:42scholarly projects with us.
49:44We had postgraduate research associates
49:45working with us and we also we have
49:48two trainees from the University of
49:49Georgia who are supporting us in our
49:51Grow Two Point O evaluation initiative.
49:55So I want to wrap up here and give us
49:58a couple of minutes more for questions
50:02by saying thank you to the entire GROW team.
50:06And I'm going to ask if we can have
50:08the link to the website put into
50:10the chat so that you all can see.
50:12There are many,
50:13many,
50:13many people who I won't be able to name.
50:15And in fact,
50:16I don't trust myself to remember
50:18every single person and don't want
50:20to omit someone inadvertently.
50:22But we had workshop presenters,
50:24small group facilitators,
50:26we had conversations in passing.
50:29All of these things contributed to the
50:31work that you see here before you today.
50:33I do want to thank
50:35many of the folks across the School of
50:37Medicine and across the university who
50:39really partnered with us around this.
50:41From a funding standpoint.
50:42I want to thank all of our
50:45grow fellows and trainees.
50:47I want to name Latasha Neal,
50:49they were our original trainee
50:51who worked with us and and now
50:53many of you may know Latasha Neal
50:55from the Anti Racism Task Force.
50:57But a lot of those glamour shots
50:59that you saw from the Grow Workbook,
51:00they were really partnering
51:01with us around that work.
51:03A couple other key folks that I want to
51:05name John Crystal for ongoing support,
51:08funding support,
51:08but also really helping to link and
51:11network us with really key folks across
51:13the department but also across the school.
51:16And I also want to thank Frank Fortunati,
51:18who had significant contributions,
51:20lots of conversations with me,
51:22and then also supported us from
51:24a funding standpoint to make sure
51:26that some of my time was able
51:28to be dedicated to this work.
51:30Thank you also to all of our supporters,
51:32which includes you, you,
51:33for being here this morning,
51:35and many of you who came through
51:37the program and participated.
51:39This program belongs to us
51:41and it's built for,
51:43it's built by us and for us.
51:45So thank you all for being here and
51:47participating in the conversation.
51:48Thank you for all of our grow,
51:51our grow program participants,
51:53for your openness,
51:55your honesty,
51:56your willingness and also for a lot
51:58of the good work that you've done
52:00to continue these conversations
52:01within your own clinical institutions
52:02and beyond the department and
52:04beyond the work that you do here.
52:06So with that,
52:07I'm going to stop and see
52:09if there are any questions.
52:10I think I've left us a pretty good
52:12margin of time for questions.
52:14There is the link in the chat if
52:16you want to go in and take a look
52:18at some of what we've got going
52:19on and brewing there.
52:20There is also a contact page
52:22that is on the website.
52:24So if you are interested
52:25in reaching out to us,
52:26seeing what we're working on or
52:28you want to refer us to different
52:30groups that we're happy to do that.
52:31So with that, I'm going to stop talking.
52:34I'm going to say that I,
52:36Cindy and Becca are here to collectively
52:39field any questions or comments,
52:40and I'm going to now go over into the
52:44chat because I haven't looked there yet.