Addressing racism and implicit biases in healthcare is a patient safety priority. This article describes the evaluation of a simulation training designed to help emergency medicine and pediatric learners identify implicit bias and develop bias mitigation skills. Using standardized participants, trainees were presented with a case involving an 18-month-old African American child with a spiral fracture of the left lower leg (a common ‘toddler fracture’). As part of the simulation, an orthopedic resident on the care team was pushing for involving child welfare and displaying non-specific and biased concerns about the child’s family and welfare. The simulation objectives were for the learners to (1) identify that the case was not concerning for non-accidental trauma, (2) identify that the resident was displaying bias, and (3) communicate with both the resident and family to diffuse the situation and prevent any potential harm. After the simulation, the simulation instructions led a debrief to discuss and reflect on the case.

Between August 2021 and January 2022, seventy-five learners (medical students, residents, fellows, and attending physicians) participated in the simulation training. Participants largely agreed that the simulation was an effective tool for teaching bias communication skills and increasing confidence in identifying and addressing implicit biases and racism.