Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

Hi, Karen. Hello, George. How are you? OK, I'm good. Thank you. How are you? Thank you so much for joining us. No, that's okay. That's plain pleasure. Thank you for considering me. I I like your your scrub tops. Yeah. Yeah. And we were scrub tops. Uh, you know. Yeah. Yeah, I should say are Liverpool. You know, hospital. And you know the name. Yeah. Promoting Liverpool and the Congress is in Liverpool. Yeah. Thank you so much for joining us and taking No, that's okay. That's okay. That's okay. Yeah. So we're officially starting at a quarter past, so I'll just give people a few minutes in case they've gone to get a coffee. Yeah. Yeah, sure, Sure. Yeah. So what? The plan would be to have a small talk in the beginning? Because it is a workshop. Then after that, would be, uh we'll have a small break, and then we'll have a workshop. And in the workshop, we'll have three scenarios. Uh, and they can discuss. So then they will go out into breakout rooms. I've spoken to Sue at and fill. They'll go out into breakout rooms. There are about 20 of them. I understand So I've asked her to make four breakout rooms, so they five of them can each five a group of five can be in each breakout room. Then they can discuss the scenario and come back. And each breakout room will elect one person to represent that group so that they can come and then they can. All the leaders can join on the state, and they can discuss the scenario so that it is a workshop. So in where we are not telling them what to do, they are telling us, you know what they think, and we all learn in that process. Excellent. That sounds great. A bit of interaction, uh, to get the discussion going to be great. I'm glad you've spoken to Sue to organize that. Yeah, because otherwise it'll it'll be a bit of a confusion at the last minute. Yeah, Yeah, it's a great platform. I wouldn't be able to do that, But thank you for speaking with her about it. Yeah, yeah, yeah. Um, if you have any questions, you want us to, um, to ask as well. We can also use the pole function on on our chat. Uh, yeah, yeah, yeah. No, no, that's you know, I have a questionnaire, and I will, uh there is a QR code, and I hope they'll be able to, uh, there'll be a pre workshop questionnaire and a post workshop questionnaire. I want to see how beneficial is this workshop in improving the understanding of microaggressions. So, uh, it is an, uh, technically anonymized because to compare pre and post, they need to just tell us, uh, the day of their birthday day and also, uh, the first two letters from their surname. So John Smith, born on the 21st of May 1963 would B S m 21. So I will only know sm 21 I'll match the sm 21. There'll be some data which suppose there are two John Smith's born on the 21st of something similar. You know, uh, I may miss, but otherwise I'll just match that, and then I'll know the pre workshop in the post workshops court. Okay, so I don't need to know their names or anything. First two, uh, you know, digits in their surname. And the first two, uh, and so until at the end of this, So that we can match it. And once it is matched, that's fine. Yeah, OK, great. Thank you. Um, remind people of doing that as well. Yeah. No, no. I can tell them not a problem. Yeah, OK, great. Uh, so it is quarter past, so I think we can make a start. So welcome back to our, uh, the final presentation for our d. I training course for both to Congress, uh, gives me great pleasure to introduce you to Mr George AM Pat. He is a consultant orthopaedic surgeon in Liverpool with a special interest in managing muscular skeletal problems without surgical intervention, where possible Alongside his work for NHS. Mr. And Pat is a clinical teacher at the School of Medicine at University of uh, and also the secondary care director of the British Society of Lifestyle Medicine. In addition, he's also the medical advisor for air tracks, um, incorporations, as well as he participates widely in research and has authored five books published in peer reviewed medical journals and lectures, both nationally and internationally. Outside of his work, Mr Ample enjoys his free time with his wife and two daughters. Tilletia and Jemima Talita has, uh severe quadriplegic cerebral palsy remains a source of joy for her family. And Mr Amplats personal inspiration. Mr. Amp attends church regularly as believes that religion provides him with hope and positivity. And it gives me great pleasure to invite him to present his microaggression workshop to you today. Thank you, Karen. Thank you for giving me this opportunity. Uh, thank you, guys. Thank you for listening. So what I'll start is I will start with my share my screen, and you just have to tell me whether the you are able to, uh, see my screen. Can you all see my screen? If someone can just let me know? Karen, are you able to see the screen? Yes, I can see the screen. Brilliant. And is it changing? Yes. Brilliant. Good. Thank you, everybody. Thank you. So I'm George Am Pat. I work at Liverpool and, uh, to contact me the list on the left. But what we're going to do today is initially I'm going to give you a little bit of an interaction. What I'm doing now, then I want to do a survey, see what is the knowledge of Microaggression. And then after we do the survey we will do, uh, do a little talk on what is microaggression, and after that we'll have a 10 minute break and then we'll have the workshop. The plan is to divide you into four smaller groups, so you'll be going into breakout rooms during the workshop and potentially if each group of five that will be four or five each. So four groups of five each and one person be elected to come back and come on to the stage and voice the opinion of that group. So that way, because it is not for me to tell you what to do. What we want is to collectively coming together, interacting and learning how to live better without microaggression. And then, in the end, we'll have a post workshop survey and there'll be a debrief at the end. So that's the intentions. But before we start, let me tell you, there's no one is perfect. We have all made mistakes in the past, but knowingly and unknowingly. And the purpose of this workshop is not to place any blame, but rather we all need to educate ourselves. That's a purpose behind this workshop. We ask that in discussion you know you can tell your own personal experience, but do not disclose anyone else's details. If you want to give out your personal details, that is fine. Or what happened to you. That is fine. But please do not disclose anyone else's details. That's what we request. And we're all working together to educating ourselves. That is a purpose so that we all live in harmony and justice for all. And it is possible we may be discussing some topics. It may be sensitive, and it is possible some of you will be affected by that. Uh, these are I mean, I have no training on counseling, but I can give you some guide. Uh, and these are some of the, uh if you need signpost into any help, These are some of the people who may be able to help you. Or if you find this difficult to read, you can take a screenshot or you can come back to me. And I can, uh, sign posted to any appropriate help that you may need. But if it affects you significantly, obviously you may need to, uh, see your G p or go to accident and emergency. Uh, so Let's start off with the pre workshop survey. I'd like you all to participate because I want to know how effective this workshop is Now. I don't need your name or date of birth, but I need to match. There is a pre workshop survey and a post workshop survey. So I need to match your score before and after. So I may I please request you? What you need to do is you need a cord and the code forms. It'll be two letters followed by two numbers. So the two letters will be your surname. The first two digits of your surname. Say the characters of your surname. So if you're John Smith, the the in that court, the four character code will be S M will be the from your Cernan. The first two characters of your surname and the last two characters will be the digits of your date of birth the day of your date of birth. So John Smith, born on 21 3 1985 would be S m 21 and I would be because I'm George and I was born on the 15th. I would be G e 15. So Similarly, you need to have a coat. So if you can use this, uh, QR code and and, uh, enter the survey, I'd be extremely grateful. So I can wait for a few minutes till, uh, you finish that survey. And if someone can tell me that you have done, then I can move over to the next slide. I humbly request you to participate in the survey because it is important to see whether this workshop makes a difference. And I'm grateful to all of you who participate in the survey. So to our participants, I've just added a poll on to our chat function. So once you've completed your survey, um, or you don't want to participate in the survey, but we really encourage you to to make the most out of this session. Um, please let us know, uh, through the post. The port that we just launched on the chat. Thank you. You're helping. That survey is, uh, you know will really help us. That's why, in addition, it will help with, um because we'll be breaking out into work into breakout rooms. Uh, shortly. And so we try to make the most out of the to understand what we maybe we'll be doing and assessing the effectiveness of the workshop. We we encourage you to complete it. Uh, the pre and post one eight people have entered. Thank you for that. But if the rest can also enter, I'll be extremely grateful. Thank you. If the the QR code doesn't work, you can just, you know, uh, put in that short code that I put at the top. If anyone is still feeling the survey, you can just put in the chat box. Otherwise, we have had nine responses so far, and I'm grateful for those nine responses. Okay. Okay. So let's anyone else still or shall I move on to the next park? Karen, Should I move on? Or I think so. I think we can move on, Mr. Thank you. OK, thank you. So this is what Chester, He's black psychiatrist in the US He said this freedom is not freely given and the privileged seldom give up their privileges willingly, and, uh, that is very true. Once you have the privilege, you want to keep that privilege you want don't want to go leave that privilege. And Gerald Wing. So he wrote this book. There was a 2010 edition, and there was another recent edition in 2020 and he defined the microaggression. Microaggression is something which we may not clearly understand. Even I did not know about Microaggressions. So his definition is, and we'll go through this a bit more. His definition is this. Microaggressions are brief and commonplace daily verbal, behavioral and environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory or negative racial gender, sexual orientation, religious slides and insults to the target Personal group Perpetrators are usually unaware that they have engaged in an exchange that demands the recipient of the demeans, the recipient of the communication. And that is the definition. By Darrell Wing Sue. We'll go through that in a bit more detail, So if we look at the different types and forms of microaggression, we can understand it a bit more better. So there is. It's a conscious or another. There are two parts of it. There is a conscious part in an unconscious part. The conscious part may not be actually derogatory. It is the unconscious part that is delegated, and I'll come to that so it actually may be praising someone, but actually it is derogatorily praising someone. So the conscious part is the praise. But the unconscious part is the derogation that comes to the praise, and I'll explain that to you. So that could be a micro assault, a micro insult and also a micro invalidation. So let's look at micro assault. This may actually be on the cusp of being a real assault, which can have a complaint. So in a microaggression, technically, it is so small that you can't go to your chief executive or you can't go to your head chopped person and say this has happened. If someone has made a racial slur against you, yes, you can go to the head chart or to the chief executive and complain. But in many microaggressions, it is not you. You know you don't have an opportunity to do that, and I'll explain why that is. But here in the micro assault you maybe it is maybe yes, it is possible it could be a macro assault and you could complain, like making a joke about a gay person and then saying I was only joking. That is a micro assault, A micro insult is to have, you know, to give a place to a woman who has got a job to say. You got this job if you Because though you're a woman, you got this job or you got this woman as as a woman is amazing is a micro aggression, or even to say that you are articulate. See, I'm an Indian. I'm from India. Someone telling me yes, you're so articulate makes it seem to me that they don't expect me to speak proper English. So when I'm speaking proper English, they are amazed at it. They're surprised at it. So you are so articulate for an Indian, that is what they are meaning when they tell me you're so articulate. So that is how it becomes a microaggression. They may be trying to praise me by saying they're being articulate, but equally they are surprised by that. And that is where the derogatory part comes. So and it could be a micro invalidation, like I don't see color. So you know, you need different people have different color and different characteristics, and we need to respect those characteristics and value them. It is when we are as a group When different cultures races are joined together, that we excel and we produce better. So similarly to say to invalidate color or to invalidate someone's custom is not good and not being included. So you have group ISMs. You know someone is sitting separately. You know that is not good. It can't be. It should be a mixed you know, we are homogeneous one. We are just human beings. Not not anything else. Then what are the different forms of microaggression? It could be worse Herbal. It could be behavioral or it could be environmental. So a verbal would be, you know, a comment or a question that is hurtful of stigmatizing. You're so smart for a woman you know, as if women are equally smartest. Man, there is no difference. But that would be a verbal microaggression or behavioral. You know, you go to the bar. Some people are being served before you are being served because of your color or because of your characteristics. So that is again a behave microaggression or you can have an environmental. You go to the university. All the, uh, all the you know, posters or the photographs that you see are people who belong to a particular race or a particular you know, agenda you don't see maybe females you don't see black, uh, photographs being hung up. So that is again an environmental, you know, Microaggression. Yes. As I said, it is a wide sphere. And also there is sexual assault. It can be Some are potentially You can raise a complaint, but some maybe people ignore it and that is bad. And that shouldn't happen. And there is a high level of racism within the NHS, and it is a debilitating problem. This was published in the BMJ beginning of this year. And there is an inherent when you know, when I say of Microaggression, there is mild like, for instance, sexism in lectures. They put male faculty will show women in inappropriate dress, and it makes it feel as if only women dress inappropriately and men don't break the dress code. It doesn't happen. Everyone breaks this dress code. If there is and it should be normal, it should not be just one gender is, uh, you know, shown more or in other words, you can see junior doctors or, you know, being called Prince's sweetheart, nurse or you know how they look. They sing, you know, someone senior may say, Oh, you you Your dress looks good. I mean, you shouldn't come to the workplace and realize that you are a woman. You should just be a human being. You're there as a human being. You're working as a human being, everyone as a human being. There's no difference between gender and you just work Normally, you don't need to be reminded that you're a woman that is very important. And unfortunately, this is article and it from the US, which this is in the medical classes, a school. And there is a my When there is a microaggression, it is like a toxic rain. And when you read this article and it is easily understood by orthopedic surgeons and it's good that all of your orthopedic surgeons So if you take like a normal stress fracture, normal fracture and a stress fracture, a microaggression would be a high stress normal fracture where you break the whole bone. But a microaggression is like a stress fracture. There are micro insults, multiple micro insults, which causes the damage. And yes, it may not break. It may break, but What happens is there is injury to the bone or injury to the self or to the human, the person and that is what microaggression is. It's like a stress fracture and the toxic rain that occurs. And but what we know even from this country, is that communities or health establishments which respect Behm staff there is definite link that there is an improved care for patient's. If you don't respect game, there is actual harm being done. Show that by a classic example Uh, you know that happened in the last 10 years. Then we all live, say the top. There are three bars here or three zones here, so the top zone is a hyper arousal, or the bottom zone is a hyper arousal. But all of us want to be in the optimal arousal zone. We don't want to be hyper aroused. We don't want even around us to push us down into the hyperarousal. So in life we want to enter life and go through the optimal field without going into the hyperarousal like if you see that the silhouette, the female is luckily going through the optimal field. But the mail is going to hyperarousal because of things that is happening around. But that's what we want. Is the journey of life journey of our work going through the optimal without going into either extremes. And as I very clearly said, this evidence shows that there is when we respect the bomb staff, there's improved care for our own patient's. There is a pecking order. Even in all our hospitals and the consultant or the chief executed, the senior manager is the top. Then you have, and the lower down the rung it is. You know, uh, the student is the lower rung or the nursing oxyl ary or the nurse. And they have They have experienced more microaggression than people at the top, but it can happen to consultants also. I'm not saying it doesn't happen, and in this in this rung, disabled students may come even below that. And, you know, we need to understand that and rectify that issue. Even when we question people, this is very common. You can have some, uh, you know, in some hospitals you have the trauma meeting in the morning. And, yes, we need a Socratic method of teaching. The Socratic method of teaching is gently ask them questions the person whom you're teaching and by asking the questions, you're slowly milking out the answer from them, helping them to think outside the box that what they are comfortable with and then they come to an answer. But unfortunately, sometimes it becomes like pimping. And that is the word that is used when you add actually demean them when you demean them, they don't feel there is no there is no safety net. And they actually are not learning because that it has gone beyond the psychological safety. And actually, you are hurting them. There is no more interest to learn, so someone should have that psychological safety to ask. I don't understand this, you know. Question. Please. Can you explain it? Do not know the answer. Please. Can you let me know? But if you create an atmosphere that the person whom you're teaching cannot ask the genuine question, you are not creating an atmosphere to allow them to learn, so that should be it should allow them to learn. And you can only do that by creating uh, an environment where they are willing, and they are free to ask those questions and There is also elite versus poor. If you look at in the UK only 7% of the population sent to private schools. The Children go to private schools, but actually in medical schools 31st, 34% of the intake in, uh medical schools are from private schools, so there is a disproportionate. So people who go to states schools do not land up in medical schools. That cannot happen in a democratic country. We talk. We tease all of the countries around us or even in the East, that they're not doing well. But what are we doing? If only seven person of an elite population are occupying more than one third of the seats in medical schools, that is not really a democratic situation. And this is an article from The Guardian where, uh, someone who says that I'm doctor from a disadvantaged background, even it is still celebrated. We shouldn't be celebrating that it should be a norm. It should not be a question of celebration. It's not be a rare even it should be a completely normal even, but it doesn't happen so and there are things like bullying in the NHS and you know it cost us a lot of money. It's costing billions in the NHS. According to this article, you know, about two billion each year. Uh, and there are different methods to tackle Microaggression. So there is one called the triangle model. There is another one, the in the academic health. But what we have developed in Liverpool is the ICE model. So the Liverpool model is called the ICE model. And what is the ice model involved? So there are three, uh, parts of any microaggression, so there'll be a source of microaggression. There is a recipient of Microaggression and then there is the bystander. So there are three people or three different, uh, in a person's involved in a microaggression all event. Now what is the ice model? Ice stands for impact and not intent. So if you say something, you may say, Well, I didn't intend to say that, but that is not what is the criteria? The criteria is the impact. So no more Is it valued according to the intent? You know, But it's valued of the impact, So I can't say something. And if I have heard someone, it is not whether my intention was good or bad. It is the impact that is more valuable and what should be taken into consideration. So it is important the impact, and we look through the workshop later. Second, if someone does a microaggression, we don't want to create a nasty seen. We want to educate them, and two best way to educate them is not to go for any confrontation. But if you have to question them, ask them with curiosity. Why did you do such a thing? And when you ask them with curiosity, they are likely to be educated rather than it becoming antagonistic. So if you have to raise a concern, ask it in a curiosity fascia and not in a confrontation. The most important thing is the person who has been affected, the person who has received the microaggression, that should be empathy towards that person and the person who has, you know, the source of the microaggression. That should be education so that this is not repeated, and it should be made known to them that it has hurt. So it is the I don't tell them you are a racist. No one likes being told that they are a racist. But if you say well, you What you said made me hurt me because I felt I was being singled out because I thought it was because of my race that you made that. So it is. How it affects you is more important. Rather than blaming the other person should not be the you conversation should be I my It hurt me And that is what? And that is the impact on you. So just to revise it is the impact that happens and not the intentions. It is, if you have to, you know, ask a question. Do it Curiously not with confrontation and the person who has the recipient of the aggression. You need sympathy and the source of the aggressive. The source requires education, and that is what is the eyes model. Now let me give you a simple example. I'm a nation consultant and imagine my clinical director says, Oh, when are you retiring, George? Now you may think that this is not a microaggression, but it's as I said, it is the intent, not the intent. The impact. Now the clinical director may not think that that has hurt me at all, but As soon as the clinical director asked me the question, I'm slightly, you know, at 60 years of age, our my immediate thought is goodness. Does he want to restructure the department? Am I going to you know, uh, be told that there may not be a job for me again? That is my immediate thought. What do I do with my mortgage? What do I do with my two Children who may be in, uh, you know, uh, in university? Those are my thoughts. Now. He might not have intended to do be a micro aggressor, that so it is not the intention. It is the imp. So we need to be. And especially leaders need to be absolutely careful. And one of the, uh, terms that Tony uses is very good. Tony Clayton uses very good, you know, compassionate leadership. So the leader should be compassionate, understand? Every word of his or her makes a big difference. So even if it is a question like, you know, Are you retired? When are you retiring? Has a potential impact on the other person Now, Now, that cognitive load. Suddenly I'm worried. What? Why did my clinical director asked me that. But to tell you, I've got a lovely clinical director. So you know, this is just an example. You know, I've got the best clinical director in the whole of the country, so nothing against my clinical director, but it gives a cognitive lord suddenly, I think goodness is this happening. Is this not happening? So I'm sitting in the clinic seeing patient's but 25 person of my brain is now try troubled by this. Oh, what is going to happen? What is going to the future? So then I am not focusing on the patient in front of me. I'd li if I have a clear mind. There are no worries. If we come to work without worries, then obviously we can work without a problem. And there is good productivity beneficial to the patient. But if half a quarter of my mind is occupied by this cognitive load, then I'm not going to perform well. And that is what happens in a microaggression. So Harper Lee tells it very clearly. You never really understand a person until you consider things from their point of view until you climb into their skin and walk around it and that's in to kill a Mockingbird. So if I have to question, I need to Curiously, why did you ask me? This question was there, you know, Don't say you did this. You wanted to accuse me. You want to send me out of the department? That's why you asked me that. Know why Did you ask me this question? Is there any particular reason? Then it is possible and then explain to him I was you know, I was very worried when you asked me this question. I thought you wanted to restructure the department. I thought I may not have a job tomorrow, and that's why I was worried that he's quite likely say no. No, that was not intentions fine. And both understands. He also understands that it's an educational even for him that, you know, he or she understands that he shouldn't be asking this question, you know, without forethought. So that is the ice model so that it is the impact and not the intentions. And if need we need to question, we need to ask, in a curiosity way, not with a confrontation. And the person who's the recipient of the microaggression requires empty but the and the source Education. Now, many instances. All of you know these instances. The FAA chair Greg Clark. So these are all microaggressions gone into macro aggressions. He used racially offensive. He used the word colored. Now the word colored is associated with segregation. In the past, it was historically so. That is why this is using the word colored as a microaggression, same way. The other common microaggression is something like this. You know, you're teaching your focusing all the questions on a certain group either on the on the boys or you're just questioning. And in this particular case, the girl, the black girl that you see, she's not being questioned. She does not feel part of the group because the professor, he's an excellent teacher. But he's just, you know, asking questions and directing. I contact with only the others. That is, again a microaggression that shouldn't. If you're in that role, you should be making eye contact with everyone. You should be asking everyone the questions. Same way in our job interviews. You can see you know, you coming to the end of your registrar training you're applying. You got your C c c C S t. You're applying for jobs. Some people get jobs. Some people don't get jobs. Why does that happen? You know, and yes, many of these things? Yes. With you know, uh, potentially with artificial intelligence, we may be able to control it. Some of these biases, Maybe because we're all tribal in origin. You know, 10,000 years ago, we were living in a cave and we were guarding the cave with a spear. Someone who came into the cave. We had a split second to decide whether to throw the spear or not. So we like some phases. We think our friendly some faces we consider as non friendly. That is a tribal is, and we need to move out of it. And potentially artificial intelligence can help us. Because, say, for instance, in a job interview, you're selecting more of, uh, say white. Okay, White, uh, men. Then Obviously, it will tell you you're selecting only white. You're not selecting black females or you know it can. So artificial intelligence may help, But in the day to day work where microaggressions occur, the artificial intelligence is not going to help. And that is why we need to call it out. So you know these discrimination should not occur. And this is real. I mean, it's not that I have just, you know, created imaginary if you This is an article in the BMJ in 2021. Black and Asian doctor still face discrimination when applying for jobs, and it depends on the even if you have a good so TV they are not given at Barts. Health white applicants for 15 times more likely than black applicants to be offered a job. And at Saint George's white applicants were 13 times more likely than black applicants and 11 times more likely the nation applicants to be offered a job, you know. And unfortunately, what is happening is something called gaslighting. The gaslighting is from a previous 1940 film where, you know, the girl believes that the light the gas is, uh, the light is flickering because of, so it takes you away from reality. So sometimes we are all forced. Maybe some people, people from the game coming CFOs that they are not performing enough. That is why he didn't get the job. So there is a constant that reality is not correct. Maybe I need to perform more. I need to do more, Which may be other colleagues are not doing. And that that that corporate gaslighting is occurring in the NHS again for disabled. You look at this. On the left, you can see a lady is attending a class. She is disabled. She's actually there is No, there is no access. This is on the internet. Uh, and, uh, this lady cannot come to the main classroom because there there is the there are no ramp into the classroom, so she has to sit separately. But as look at the actually a better solution where there is a ramp and where there is a desk for the disabled, that would be far better. So we need to understand this. And, uh, you know, uh, address these issues, things like, Can I touch your hair? You know it, You know, it is only asked to, uh, surprisingly to brag females to, you know, Can I touch your hair? It is personal to them. You cannot ask them. Can I touch your hair? It it's like dehumanizing them, making them, you know, like animals. You know, you only you pet a dog. You don't pet human beings, so you cannot ask such a question. Same way to say that I'm color blind when I look at you, I don't see color. Know. We need to see the color. We need to respect the color. And that is how they bring value from their color. From there, different cultures, they bring value to the organization. And then there's other terms. All lives matter, you know? Yes, all lives do matter. But what we know from evidence is unfortunately, black lives are lost, so black lives matter too. So the important thing is not to you know, uh, say that black lives don't matter and all lives matter, but black lives matter is very important. And things like, I'm not racist. I have a black friend Just because you've got a yes, you may not have prejudice, and you may not. You may have black friends, but that doesn't mean if you support an organization. If you support a system where there is still these racial discrimination, then obviously it you know, you are participating in that racism. So we need to change from that. Just because you've got a black friend doesn't mean so the other Microaggressions. As I said earlier, your so articulate you don't sound like an Indian. Don't blame me. I never owned slaves. White privilege doesn't exist. Know it does exist. Now, let's talk to you about, uh, something that took place in the last 10 years. And, uh, I don't know whether anyone of you know, these two surgeons. One is both, uh, general surgeons. One is a breast surgeon. One is, uh, abdominal surgeon, Uh, one black, one white. I don't know whether anyone knows, but let me tell you their stories on the leftist Solu, Doctor Celia and the writers Ian Paterson and Ian Paterson. Let's tell you the story of Ian Paterson for 20 years he was doing the wrong operation. He actually creating needless breast surgeon. So he's a breast surgeon. Needless breast surgery. And he did a particular operation called clear weight saving operations. And by doing that, he was not actually clearing the cancer, and people were having a repeat cancer. And for 20 years, he escaped. Even organizations said that he was okay. And finally, when they had an inquiry, they said how in plain sight. So the right Reverend Graham James bishop of knowledge to the inquiry, if only was hiding in plain sight for years and allowed to harm hundreds of women because of a healthcare system that was dysfunctional because he had the white privilege. No one questioned what he was doing. And unfortunately, people the chief executive and all that and the medical director of his trust just, you know, whitewashed over him. And they were given cash, you know, incentives. The same medical director and the same chief executive got a big you know, Chief 2.7 million pensions pot. You know, they were not checked for 20 years. He remained unchecked. But what happened to David Solu is completely different. He's a black surgeon. He was in, uh, in Clementine Hospital in London, and, uh, he was operating. He so there was a patient who had a totally replacement following which he had some abdominal problem, and, uh, he wanted to take to surgery. But there was some delay in getting the patient to surgery, and unfortunately, the patient died, and the medical director of the hospital withheld the causation report and did not reveal it out. And the, uh, CPS put a case against of manslaughter against David Sello and it became that series. Errol Cause Patient's Death. He was then jailed for manslaughter, but subsequently the conviction was quashed and he was let out. And and But he has stopped being a surgeon. He's actually his son was a medical student in Manchester. He stopped, uh, pursuing medical studies because of the, uh, what his father had to undergo. He's written a very good book. You should I recommend all of you to read it. David Sello Did he save lives? And this question did he save lives? The question is, Barrister asked him during the trial, and the person who came out to squash his conviction is a lady called Jenny. One amazing lady. I met her. She's just amazing. She's what is a true a good Samaritan or a genuine bystander. She had no relationship with him, didn't know him from Adam, but saw that an injustice had been done and she took it upon herself and the conviction got squashed. No. Now, yes, in this case, what I showed you of two surgeons, one Ian Paterson. Other one, David Sello. Now yes, you may say Ian Paterson, uh, did some wrong operations. He got away but actually harmed. And we'll come to that in a minute. And that is from the white privilege. Whereas here, an entire career of a surgeon was armed because he was black just from one death, which was accidental, you know, not really. If you look at Ian Paterson, there is now a 37 million compensation fund. I know it's part of it is being contributed by spire hospitals, but part of it is coming from the NHS. So valuable money which should be used for treating our patients', is now being, you know, being used as compensation. And again, I'm not forget the compensation people have been harmed. 5500 victims have been harmed. Forget the money. No one should be harmed. And this was harmed because the white privilege people said he he couldn't be doing a mistake. And on the left is Nadine Doris apologizing in the House of Commons. Uh, for, uh, for the victims, uh, of this rogue surgeon. So if you discriminate, if you have a white privilege that is going to cause harm, it is not that it is harmless. It is causing harm and there's a direct evidence of that. And yes, there is a courtier. S David Silla was finally released, and also Ian Paterson is now in jail, serving about 20 years of, uh, you know, sentence. But what we need to understand is what Roger clients said. There is the snowy white peaks and in the snowy white peaks, if you look, there's a lot of discrimination and the top. If you look at the top part, there are discriminate numbers. So the the workforce Race Equality Standard says that number of people working the board should be same as a proportion. There'll be workers working within normal positions. But among the board members, only eight to, you know, eight person or now it might have gone up to nine person, but it's actually the Behm staff. Working in the NHS is nearly 19 person, so there is a big mismatch. It should represent the number of staff that are working in the NHS trust, and that is when you won't have snowy peaks. So that is the first part. We can have a short break now, but as I said before we leave, no one is perfect. We have all made mistakes. It's not to blame anyone. And, uh, at 10 minutes, if you come back, then we will have the workshops and in the workshops. As I said, we will break out into groups. There'll be four groups, and then, uh, you need to elect one person for each group. So if you can have a short break and you are, you know, can ask me questions or during this break holes if you want, uh, and then we will regroup. So now the time, according to me, is, uh, 3. 55. If we can regroup at four, let's have some 55 minutes of questions and then we can dismiss after that. So I'll stop sharing and we'll have some questions she's gonna on me. Uh, hello. Thank you. Thank you, Mr. And But that was a really, really good talk. I'm really engaging And some really good examples, I think, examples that I personally seen in my daily practice at work as well, um, so really relatable. And thank you for highlighting them. And the ice model, um is excellent. And I think it's really a good way of remembering how to approach these situations. when we do witness Microaggression. So thank you for sharing that Liverpool model, uh, for Congress held in Liverpool. So I hope that participants can make the use of it as well. And so we'll be, uh, breaking into our break rooms. Um, Sue has kindly posted on the chat in terms of which rooms that you'll be in any questions from anyone. Oh, there is some chat. Sorry. Uh, in the chat, we can see the room. Sorry. Yeah. You can see the rooms in the chat standby when you've personally experienced microaggression. Um, and you do bringing up using the the ice model? Um, have you? We found people tend to react, um, quite badly or in generally because of the way that you know, it's a very it's a very logical, uh, it seems to be very effective model to implement. Have you had any bad responses to Well, uh, as you very rightly said, no one likes to be, you know, uh, you know, told that he's a racist or, you know, and there is obviously So that is why we need to be as mild as possible. And even the curious question should be you know, it looks as you know, uh, there is resistance. I'm not denying. There is, uh, no resistance. There will be resistance, But even with that, I mean, I I I developed developed this model main mainly when we were I was part of the, uh, e d. I lead in the school of medicine in Liverpool. Uh, and that is where we develop this model. And how? Because students, unfortunately get, you know, they are the lowest rung in the, you know, uh uh, the health system. Say if you look from the consultant, you know, registrar f i to f one, uh, nurses, and then the student is the very bottom. And that is microaggression from patient's microaggression from, uh, you know, uh, staff, Um, uh, different forms of microaggression. And, uh, sometimes it is very difficult to. So when it comes from a patient, sometimes it becomes slightly difficult. You know, how do you, uh, ask them the question? You know, you can see the same patient telling one student I don't want you to examine me. So it could be a black female student saying I don't You don't want I don't want you to examine me. But when a white male comes, Yeah, you can examine me, You know, how do you, you know, address that that becomes very difficult, You know, in the health system, you know you can, And being ignored is quite common, you know. You know, I have to say that all of us getting even door Waggett I mean, but people in leadership position should not do that. I worked in places where the clinical director will come. Ignore me, but not in my My current job is amazing. And my clinical director is just gold star all gold stars, you know? But there are places where I worked where the clinical director will not talk to you. We go to a room, he's there, but he doesn't talk to you. That is not being compassionate. You need to be. If you've employed someone, you need to be have the same. You know, uh, and I'm sure you have faced you may go for a meeting, and, uh, someone talks to you. Someone doesn't. There are people in in leadership roles, you know, they should understand that. What? How they react can have a ripple effect on people around them. especially the leaders. So, you know, it is compassionate leadership that is, you know, required. Yeah. I think having it from patient's is a particularly challenging in a tricky situation they find Find yourself in, and I've I've definitely experienced it myself before. Do you have any advice about how to approach something like that? You know, when a patient comes in to the clinic room and I know you're not from here, I'm like, how's your hip? Um, and I just don't know how to. Sometimes I still find it very difficult, you know? Yeah. So I I get that, too. I get that, too. So, you know, where are you from? Is a very common question. So my stock answers. I'm from Southport. That's what That's what. You know, though I have originally for been the I don't tell them I'm from India because, you know, I don't need That's not part of the, uh, you know. And then if they ask No, no. Where are you really from? I said that, You know, you don't need to find out that for, you know, taking care of you. You know that knowledge is not necessary. So let's get on with treating you, you know, then they understand. But, you know, how do you stop that? And, uh, I mean, as a woman, I presume it may be more because, uh, our medical students used to be called Princess, and, you know, things like that they are slides, you know, they should not be reminded of how they look or what they are. You know, uh, you're just a doctor or a medical student. That's it. You know, you're nothing different but very difficult to get that. And slowly and even the management, the senior And we have some good workshops when we do. You know, Uh, so, you know, uh, a couple of things we can set by standard. I understand. This must have been hurtful for the nurse. What did you mean by that? You can ask the patient. We looked at that. And the important thing that even the source I now understand. I'm sorry this has happened because you need to apologize if harm has come. It's not the. And as I said, it's not the intentions, but the impact and how Cynthia could have address. What do you mean by the boy? Did he asked me. I felt very hurt and sad. I assume the request was based on my race or gender. These are different ways. We can address it. So, uh, let's go to the next scenario. And this could have happened. I just put a white consultant could have happened in our clinical scenario in day to day life. It could have happened with any consultant there. You know, the, uh, situation is to brush it under the carpet. The case to it is the physio departmental meeting. And, uh, this is Mr a Row Row, a new physio, and Mrs Jensen, the departmental head. And this is the interaction. I'll read it out slowly, if you don't mind. Mr. Arroyo has just been hired as a new physiotherapist and is meeting the other team members at a departmental meeting on his first day. During a conversation, he mentions to another team member, Ms Jones, that his Children have just joined a new school in the area. Mrs. Jensen wishes to make a new colleague feel welcomed and included and asked, Mr Arroyo, I'd like you and your wife to come over for dinner next weekend. You can bring your kids and your family can meet my family. I'm sure your wife will get along very well with my family. Mr. Arroyo is not sure what to say. Because he has a husband, not a wife. He decides to take a chance and let Mrs Jensen know that he is married to a man. Mrs. Jensen, response to this by saying reply. Oh, sorry. I guess there was has to be a woman involved for you to have Children. No need to be defensive. I'm not homophobic. I've had friends who choose that lifestyle. So if we can now I'll stop the shouting again. So let's we'll miss three. So, yes, we have come to the end. Uh, we'll just do a quick survey, but as before we leave, no one is perfect. We have all made mistakes. The purpose of this workshop is not to place blame, but rather to educate. We're all working towards the common goals of educating ourselves and moving forwards. And but that is light at the end of the tunnel that even Liverpool is actually quite, uh, you know, uh, important with this, uh I don't know whether you are aware of the Anthony Walker killing. It was a racist killing. But there is an Antony Walker Foundation that has grown out of that and that is providing support to a lot of people in Liverpool. So there is light at the end of the tunnel, and there is under the Michael cause He was killed. Uh, it was a homophobic attack. And, uh, again for his sexuality. And now there is a Michael cause a foundation again, supporting people. Uh, it is important. I mean, there is light when you know bad things happen. Good things also come out of it. And once again, if I've discussed anything sensitive or if you these are some of the sign posting that I can give you or a few, uh, you know, if this you're not clear, I can further give further sign posting either to Karen, not to my, uh, And what we learned is that it is not the intentions that matters. It is the impact that matters. So we need to value the impact and not the intentions. And then we need to address it with curiosity and not with any confrontation. Because there is no education. If you con front empathy to the person who has been the recipient and education to the source is important. And if you can once again do the post workshop survey. And as I said, if you use the same code, the first two characters will be the first two characters of your surname. And the last two characters will be the, uh, the date from your date of birth. Thank you, Mr. And Pat. Thank you for leading that discussion and and for handling this topic very sensitively and with nuance. I think we can argue that we've witnessed some of these scenarios in real life and appreciate that it's a very difficult situation when it does occur, and we will want to help. But sometimes we just don't really know how we don't feel. We're empowered to speak up. Um, and I think you know the tools that you recognize in terms of that You, um you know, you recommend in terms of the ice model be good to have just like at the back as a little as a tool kit. Uh, as John mentioned about having a first aid to kit and something that we can just bring out, uh, where medics we love having algorithms to work through for a t l s. And maybe this is something that we can consider putting it into our toolbox as well. So thank you for for needing that. And I we really appreciate the interactive workshop as well. I think we have some really great discussion. Um, today. Thank you. Thank you, Karen. And thank you for, uh, you know, giving me the opportunity to present this workshop. And, uh, if I hope everyone has got the link, hope the link is working. Um, and I'll stop sharing. Yeah. Thank you. I think we'll also be collecting postcode feedback as part of the metal platform. So you also receive some of that feedback as well. In addition to this, uh, post workshop, uh, survey. Yeah, but if they can up Yeah, but if they can, uh, do that I just wanted to find the pre and post so that we know how valuable this workshop was. So if, uh, I know that only Oh, yeah, some people have entered. Yeah, yeah, yeah. Anyway, thank you, Karen. Thank you for inviting me. And thank you for allowing me to present this workshop. Yeah. Thank you very much. Thank you for taking the time out of your busy day. I know you've got, you know, clinical commitment, academic commitments. And so we really appreciate you taking time to present to us. I think it's a really important topic. Thank you. Thank you for your time. Thanks a lot. Thank you, Karen. Thank you for everyone who participated Lucy Oddity, Marietta and all the others. Thank you. I have a lovely evening. Thank you. Thank you. Bye. Bye. Bye. Um, so that concludes our full day of training. I hope you've all found it useful. Educational, Um, and insightful. I certainly had a lot to think about. I think we had some interesting discussion, especially in the last talk by Mr George AM Pat. I just wanted to, uh, briefly again just highlight our culture diversity champions program. Uh, these are the Champions program, which is also available on our on the boat, a website. So if you do have any ideas or you have any issues, please feel free to approach these people. Um, who are all extremely passionate individuals who really care about improving, uh, cultural diversity in orthopedics. Um, So you feel free to reach out to them. They are advocates in your region. Uh, and if you are considering, if you're training, you're considering joining us. Uh, the post holds for two years, so, uh, we're going to go for another year, and then we'll reopen nominations and elections the year after. So please consider joining this big, friendly and welcoming, inclusive family of orthopedics. And I read an orthopedics is the first surgical and medical specialty to host and to run such a program. So we really are leading the field in healthcare in the UK for this. So please do join us and be part of the change. I also wanted to bring back which something Mr Tony Clayton brought up earlier in his talk. It's the trainees survey, which is run by the Northwest Coast University champions. Um, by Hannah Seven Oaks. Theophilus, assume you Mr Tony Claesson and Camila Ciga Mony. This is, uh, the QR code. So I'll just leave this here for a few seconds. If you can please do take time to, uh, complete this survey, it's gonna give us really important information about, uh, some of the demographics of the trainees and orthopedic surgeons across the UK. Uh, and we want to understand what experiences have been, um, working in orthopedics. What does an orthopedics? Actually, this is a pan surgical pan medical survey. Just trying to understand your experiences, uh, in the UK And how? Because without the data, uh, we can't really, uh, present defining to the people who make big decisions up top in the kind of, you know, in the RCs in the b o A. If you want to enact change, we need to show them that this is happening. People are being negatively impacted by it, and then we need to do something about it. Um, so please do take time to complete the survey. Uh, and then I would like to give another big thank you again to our faculty. Who's taking time to present to you today? Kate Atkinson. Uh, Nickel Lowry. Mr. Tonique Laysan, Vicky Cherry Morita. Franklin, Uh, John Padded and Mr George Abbott, who present a variety of talks today. And we really thank them for taking the time to put together such brilliant presentation that I really I personally learned a lot today, and I think this is a great thing about um, d I is that it's constantly, uh, evolving and growing. And we bring more and more people on board to understand how this we're creating a better, more inclusive future and promoting equality in our community, but also across the world. So I really want to give a big shout out to these people. Um, I've put their twitter handles on there. So if you want to contact them, uh, if you have any ideas or you want to ask for any advice, um, please feel free to contact them, um, and or just get in touch with them if you have any. Any suggestions? Uh, so that wraps up from my part. Uh, I want to say thank you for for the participants for staying online the whole throughout the whole day. Really appreciate giving you giving your time and to to sign up for this course. I know there's lots, of course, is running for us for the boat to Congress Pre course. So I appreciate you signing up for this, and I hope you find it useful and we will be releasing the feedback form on the group chat and it'll be sent to you as well, so if, uh, to get your certificate, you will need to complete the feedback from let us know what you enjoyed What could have been better whether this format worked well for you, um, and see, and let us know whether or not you wanted to have any further d I training in the future And also any events that you'd like to see, um, both to hold. I also wanted to highlight these other groups on Twitter. So we heard from John today, who represented a pride in surgery form for prison. Uh, we also have Marie to speak on behalf behalf of, uh, women in surgery for Botha and for the Royal College of Surgeons. So they all have Twitter page is that if you want to get more information about the events that they're holding or, uh, want to join the network, I want something to speak to about. Please do check out their Twitter pages and And if you and contact them. Last but not least, we are holding our botha a GM, and it's open to all trainees. Uh, that hold a national training number. Who is a member of both A and B o A. We are boating for our next, uh, committee for Botha. And it's a really important, uh, event for us because it will, uh, determine the committee that we have for next year to continue the amazing work that you know, uh, go to committee led by Presidente Oliver Adebayo has done for this year. Um, please do check out this, uh, link, Um, all the videos up on the AM website and this QR code will lead you straight to the surveymonkey to vote. And that's my last slide. Thank you, everyone for attending. I hope you had a had a great day. And for those who are joining us, uh, go to Congress, uh, tomorrow I'll be seeing you in person and feel free to come up to speak to myself For Marita, Uh, about what you thought about this course, uh, about any ideas you have that boat issued. Uh, endeavor one, uh, am always welcome to hear your ideas. I'll be staying on for a little bit if anybody wants to chat, but feel free to enjoy the rest of your evening. And thank you so much for attending. Please complete the feedback form. So we can know how to improve this course better for you and also to get your certificate. Thank you very much, everyone.