Empowering Inclusion through Animation: Pioneering Digital Resources for Cultural Competency at King’s College London

The story began with discussions with colleagues about cultural competence content to train staff and students. I appreciated the unique insights I had on these perspectives, both as an outsider (experiences I had as a non-native) and as an insider (working as an academic in the UK for the past 17 years). Driven by a desire to address this issue, I began exploring the less overt forms of bias, i.e., microaggressions. While explicit biases are widely acknowledged for their impact, implicit biases are subtler and vary significantly based on individual backgrounds, education, and conditioning.

At the onset of the pandemic, I delved into the literature and recognised a need to communicate these concepts to a broader audience. Although scholarly articles exist to some level, their complexity often limits their reach. I found a video on the subject so straightforward that even my six-year-old son could understand it, inspiring me to pursue this area further. I sought funding to involve students in creating resources, though I was aware these might only reach a limited audience.

During this period, I also embraced facilitating yoga through the Isha Foundation, which had established a tiered support system during the pandemic. Yoga has become an integral part of my life since 2016. During the pandemic, the tiered support system did more than just introduce beginners to basic yoga practices; it also cultivated a community spirit through shared experiences and support, encouraging participants to advance through the tiers based on their involvement and efforts. However, the concept of "moving up the tiers" carries a different significance in everyday life compared to its meaning on a spiritual path. Motivated by this model, I proposed a research project to create engaging animated videos about microaggressions which was its short-term aim. The long-term goal was to train students who could then teach others, fostering a self-sustaining environment where knowledge and support cascaded through different levels. This marked the beginning of my journey to weave storytelling about implicit bias into the fabric of animated media, aiming to educate and empower viewers through visual narratives.

In November 2022, my project, "Empowering Inclusion: Developing Innovative Digital Resources and Sustainable Student-Led Tier Support System," received King’s College Race Equity and Inclusive Education Fund. This initiative was set out to train staff and students about cultural competency (CC) across academic and clinical settings, creating a space where diversity is understood and embraced through innovative educational methods.

The Genesis of the Project

Facing challenges of discrimination and stigmatisation based on identity markers such as gender, race, and more, the project aimed to foster an educational atmosphere that values and respects diversity. This initiative is crucial for meeting the professional and personal demands of today’s globalised society, as outlined in King’s College London’s strategic frameworks like the Internationalisation Strategy and King’s Vision 2029.

Role-Playing for Real Understanding or use of cartoon animated characters

A key feature of the approach included animated scenarios related to microaggressions, recorded in short videos to address these challenging situations through evidence-based strategies. However, after consulting with the students selected for the project, we realised that using cartoons would be more effective in preventing the portrayal of any specific physical appearances that could influence the scenarios' reception. Consequently, we decided against using role-playing and instead created cartoons through drawing and AI to produce the animated content.

Interdisciplinary Collaboration and Learning

Students and staff from three faculties—Life Sciences and Medicine, Social Science & Public Policy, and Dentistry—collaborated to explore microaggressions in academic and clinical settings. This diverse team ensured a comprehensive approach to creating digital resources that are both informative and reflective.

A Step-by-Step Process

The project was structured into five stages, from team formation and content development to final dissemination. Each stage was designed to build upon the previous, ensuring a thorough and effective delivery of content:

  1. Recruitment and Team Forming - Assembling a diverse group of students to lead and develop the project.

  2. Content Formation and Literature Search - Gathering and synthesising research to inform the educational content.

  3. Vignette Design and Consultation - Creating and refining the digital resources and videos.

  4. Creating, Testing, and Consultation - Producing the videos and refining them based on community feedback.

  5. Consolidation and Dissemination - Sharing the resources widely through seminars, conferences, and integration into existing college modules.

My Personal Journey and Collaborative Efforts

This journey has also been a personal one. Starting with five students, the team was streamlined to three who created outstanding resources (however I am most likely biased here so will let you decide) showcased at a college-wide event. We presented these thought-provoking animated videos created using AI and technology to illustrate instances of microaggression in academic and clinical settings. While the majority of the audience grasped the purpose of these videos—to raise awareness about implicit biases—a colleague criticised them as exaggerative and potentially sensitising people too much. We recognise the risk of over-labelling, but it's undeniable that many people feel discomfort in these situations, which can have a profound impact. Individuals might choose to confront these issues or remain silent, yet the effect remains. Education is crucial; it enables those willing to learn, though it might not reach those who are resistant to changing their perspectives.

This project has not only been a platform for local innovation but has also been featured in international collaborations with 33 medical schools worldwide, where I shared our work as a guest speaker.

While producing the videos (see below), some videos focused on introducing microaggressions and demonstrating how implicit biases can emerge in simple conversations. We included multiple perspectives in these videos for reflective analysis.

Made with Padlet

Additionally, we deliberately included certain stereotypes to highlight issues, such as featuring a woman as a receptionist and a man as a dentist in a scenario addressing fatphobia and the standard size of dental chairs.

One of the other scenarios explores the effects of misgendering a transgender student in a clinical environment by a patient who, without their glasses, mistakenly refer the student as a boy because they cannot see that the appropriate pronoun on student’s name tag is "she”. The situation escalates when the patient, upon finding his glasses and realising the mistake, overcompensates with comments like "you are more beautiful than normal girls," which unintentionally causes further distress and negatively impacts the student. These examples are designed to provoke thought and discussion about the subtleties and consequences of implicit biases.

By employing animation as a tool, we have managed to make the content thought-provoking yet accessible, enabling viewers of all ages to understand how we can unintentionally affect others negatively and the importance of raising awareness about these bias that could undermine our efforts to foster a more inclusive society.

Engaging the Community with Workshops and Discussions

To deepen the impact, we hosted an event where all 9 faculties staff and students from King’s College London were invited to reviews these videos, discusses them, and collaborates on developing potential solutions. This active participation was a cornerstone of their cultural competency development and also supporting our college-wide CC programs.

I also had the opportunity to present this topic to a group of international ICEP students from 33 medical schools and we had an interesting debate around it.

Understanding the intent behind inquiries like "Where are you really from” or “I will call you something normal” is crucial to discern whether it constitutes a microaggression or not. Without this clarity, people may shy away from genuine interactions for fear of inadvertently causing offense and make individuals overly sensitive. When intent is consciously negative, it transcends the realm of microaggression (no longer unconscious). Yet, negative feelings might arise even without malicious intent, stemming from confusion or lack of exposure to certain situations. These emotions extend beyond genuine intent but fall short of deliberate negativity or derogation.

So, should we implement legislation or a structured framework for raising awareness? Our discussion raised this intriguing question. Crafting a robust framework for addressing implicit and unconscious biases is essential, but it is equally vital to consider the potential effects of education. Could it inadvertently make individuals overly sensitive? While there is a risk of over-labelling, it is undeniable that many individuals recognise discomfort in such situations. They may option to address it directly or remain silent, but the impact persists. Education seems to be the key; it empowers those eager to learn, although it may not reach everyone!

Regarding punitive measures, penalising unconscious behaviour risks ensnaring the innocent. It raises the ethical dilemma of punishing individuals for actions they were not aware of.

The debate around - should we actively seek out microaggressions or focus on bolstering our resilience? Undoubtedly, I feel personal growth is essential; we must cultivate resilience to navigate challenging interactions (Yoga and being mindful has been my tools!). Yet, education remains invaluable for those open to learning. It equips them with tools to navigate such situations effectively, fostering understanding and empathy.

In any case, it's essential to continue spreading awareness and developing or enhancing frameworks for action, while always learning.

Animation serves as a powerful tool for broadening the reach of educational content, particularly on complex topics like microaggressions and implicit bias. This medium transcends the boundaries of academic, clinical, or professional environments, offering a versatile and accessible format for widespread information dissemination. The universal appeal of animated videos makes them an invaluable resource for engaging diverse audiences, including children. For instance, when my six-year-old son reviewed some of the animated content on these issues, it sparked his curiosity and prompted reflective questioning which helped me to understand that we can reach out to young viewers like him and work towards contributing to a more inclusive, kind, and compassionate society.

A Vision for the Future

As we develop this initiative further, our goal is to establish a self-sustaining platform led by learners of all ages. This 'Tier Support System' will develop a group of learners who are and will be leaders in educational innovation, working to create an inclusive society. By incorporating animation into our methods, we aim to make a substantial impact by presenting complex issues in a compelling and accessible way, thus broadening understanding and empathy across a diverse audience.

**Article published: May 3, 2024**

Biography

Mandeep Gill Sagoo is a Senior Lecturer in Anatomy in the Faculty of Life Sciences and Medicine, Faculty Lead for Inclusive Education for Bioscience and the Head of MBBS Year 1 Assessments at King's College London. She co-leads both the award-winning Synthetic Anatomy module, which received the Anatomical Society Education Innovation Award in 2023, and the Common Year 1 Anatomy module. She is a Senior Fellow of the Higher Education Academy UK and King's College lead for the International Collaboration and Exchange Programme initiated by Columbia University, NY, in 2014.

In addition to her academic roles, she contributes as an anatomist to postgraduate courses for the Royal College of Obstetrics and Gynaecology and the British Society of Gynaecological Endoscopists. She also works as a reviewer for the Anatomical Sciences Education Journal.

Her research interests include developing innovative assessment techniques involving AI, enhancing cultural competence in medical education, and creating MRI/CT-compatible brain phantoms embedded with tumours to improve neurosurgical training