Playbuilding as Reflexive Practice: Exploring Implicit Bias through Participatory Theatre


MICHAEL M. METZ, NADIA GANESH Brock University

KEVIN HOBBS Western University


In 2020, a group of faculty members from the fields of dramatic arts, applied health sciences, nursing, and experiential education, along with three graduate students, began discussing how they could explore concepts of implicit bias (IB) with undergraduate health science students. IB refers to assumptions and attitudes that shape how we perceive and behave in the world, often subconsciously (Greenwald & Krieger, 2006). Regardless of intention (FitzGerald & Hurst, 2017), unconscious and unexamined biases can have damaging social impacts, particularly towards people from marginalized groups in settings where biases may contribute to inequitable healthcare and medical decision-making (Edgoose et al., 2019). Despite a growing field of theatre-based health research and education (Rossiter et al., 2008), our team recognized a gap in the literature on how Research-based Theatre (RbT) can be utilized to explore IB. In 2021, we developed an RbT project that endeavoured to expand conversations on IB with health sciences students and promote critical reflexivity before they enter the health field. This project was called Haunting our Biases: Using Participatory Theatre to Interrupt Implicit Bias.

We use “reflexive,” as opposed to “reflective,” intentionally. Reflective practice refers to when we think back on our actions at suitable times, determining what was successful or not about an action or event, and then adjusting for the future (Thompson & Pascal, 2012). Reflexive practice goes much deeper. Sometimes referred to as critically reflective practice, Carol Thompson (2022) describes reflexivity as “the relationship between cause and effect, especially when linked to our belief structures, so it involves an examination of our beliefs, judgements and subsequent actions” (p. 32). This distinction is important, as we challenge our audiences to become reflexive practitioners — to examine their own biases such that they can disrupt them to intentionally provide ethical and equitable care.

The research team collaborated with Mirror Theatre (MT), a participatory research and arts-based theatre group that uses Playbuilding and Forum Theatre to create dialogic educational performance workshops to discuss social issues. Playbuilding (Leavy, 2020; Norris, 2009) is a research methodology wherein the MT cast, referred to as “actors / researchers / teachers” (A/R/Tors), collaborate to create a series of evocative theatrical vignettes centered around a social issue. MT’s process has three phases: research / data generation, vignette creation, and participatory dissemination (Norris, Ganesh, et al., 2022). The third phase involves MT utilizing a Forum Theatre (Boal, 1974/1979) approach, wherein audiences are shown the scenes and invited to deconstruct them through dialogue or by acting in the scenes to reshape the outcome. This process is led by a facilitator, referred to as the “Joker,” who guides the audience through the vignettes, allows for dialogue, and encourages (but does not demand) participation.

Playbuilding, a methodology that dramatizes data, falls under the umbrella of RbT. Beck et al. (2011) describe RbT as a spectrum, encompassing a variety of methods in which theatre is used “as a way to conduct and represent scholarly research” (p. 687). Using their two continua (performance and research) as categories for this spectrum, MT’s use of Playbuilding falls near the “closed/conference performances based on more informal, first-hand research” (Beck et al., 2011, p. 694). Haunting our Biases has been performed for mainly health sciences students but also at conferences. Our data generation emerged from both our own stories (first-hand) and existing research (second-hand).

MT rehearsals for Haunting our Biases began during the summer of 2021 and took place online. The final module consists of nine scenes and are open access: https://mirrortheatre.ca/performance/haunting-our-biases/. As of this writing, Haunting our Biases has been performed live for 16 audiences (six online, 10 in person). We also administered a mixed-methods questionnaire, which was research ethics approved, to determine audience responses to the performance workshop. Questions related to experiences in the workshop and how the scenes informed their understandings of the topic and themselves. Furthermore, a free facilitator’s guide was created to enable others to use the scenes and theatre-based facilitation techniques in their own context, assisting instructors with potentially limited knowledge on Playbuilding and/or Forum Theatre: https://ecampusontario.pressbooks.pub/implicitbias‌training/. Our project was funded by the Government of Ontario through eCampus Ontario’s support of the Virtual Learning Strategy.

In this article, three of the research team members reflect on their experiences and roles in the creation of Haunting our Biases, exploring how Playbuilding has expanded the much-needed discussion on IB in the health science field. First, Kevin Hobbs will discuss his role as “director / actor / researcher / teacher” (D/A/R/Tor) of Haunting our Biases, reflecting on online rehearsals and the process of unlearning for the MT cast. Michael M. Metz will focus on his role as curriculum developer, discussing construction of the facilitator’s guide as well as the pedagogical underpinnings that have come out of this project. Finally, Nadia Ganesh will reflect on her role as impact research lead, discussing how engaging with multiple research forms through this project aided in her growth as a researcher. In using this polyvocal approach, we hope to offer practical insights that contribute to the use of RbT in the health field.

A D/A/R/Tor’s Practice: The Power of Disagreement

I entered this project as grant co-writer, project manager, and D/A/R/Tor. I had as much understanding as anyone as to the purpose of the module, and yet I soon found I had little understanding about what might emerge from this research with IB, and that my state of ignorance was for the best. It may be a strange thing to acknowledge, but not knowing in research can be the strongest path to reach a destination. It was this admission to myself that allowed / encouraged / inspired me to design a humility-based approach to this work, sidestepping to some degree the reaffirming preconceptions of confirmation bias (Allahverdyan & Galstyan, 2014), a psychological tendency that no “research method is immune from” (McSweeney, 2021, p. 850). I shall use this section to provide a specific example of my methodological process as a D/A/R/Tor to support the celebration of dissonance in research inquiry.

When beginning a project as D/A/R/Tor, I seek ways to “find myself in the middle of a whirlpool” (Norris, Hobbs, et al., 2022, p. 167), intentionally putting myself off-centre to challenge my notions on the research topic. Take for example my definition of IB. I align with De Houwer’s (2019) definition of IB as a behavioural phenomenon, “something that people do rather than something that people possess” (p. 836). It is a notion with which I entered the research. Yet, if my role as director is to set a tone that encourages the A/R/Tors to “question everything, even our current positions” (Norris, 2009, p. 23), then I must try to do so through example. In other words, I must publicly admit my uncertainty. Anyone familiar with staging a mainstream theatre production might expect a director who demands that “the creativity of the designers and actors lies in fulfilling the desires and vision of the director” (Schraft, 2018, p. 6). I have directed these kinds of shows, with cast members who need to know and emulate my overarching concept. Such is not the case in a Playbuilding context. I am a co-discoverer and co-learner. I construct alongside the A/R/Tors. In saying that, I do not take a laissez-faire attitude in which anything goes. There is planning, research, and structure to my rehearsals, something critical to my process. In Figure 1, you will find a partial record of my rehearsal logbook; I have shared the pre-planning of the first four of our seventeen 2-hour online rehearsals.

June 9, 2021, MT rehearsal

  • Exercise to bring us together: “I assume…”

    • Take 8 minutes to choose three personal items you are okay sharing with each other online

    • One item represents a music style, another a reading form, the third a film or TV genre.

    • Be imaginative. Find a metaphoric or symbolic object to represent your interest rather than something literal.

    • We go around and try to guess based on an item the preference of one art form.

  • Discuss the meaning of IB

    • Val and Nadia discuss their work (note: Dr. Val Michaelson was the Principal Investigator on this project)

    • Implicit vs. unconscious bias

June 16, 2021, MT rehearsal

  • Check-in

  • Warm-up:

    • Create a story with given words

  • Share context of MT

  • Share context of grant

  • Discussion on IB – put notes in Zoom Chat

June 23, 2021, MT rehearsal

  • Warm-up:

    • Create a story with given words from group

  • Share recipe cards. [a process to record ideas and insights from the sharing of stories and cast dialogue]

  • Share stories of bias. I start out with my Pride Flag story.

June 30, 2021, MT rehearsal

  • Check-in

  • Exercise: Fortunately/Unfortunately

  • What we talked about last week- recap

  • Chat burst – whom do you trust the most? Whom do you trust the least? (picture of young mom and family)

  • Chat Blast- 3 things that stand out the most in picture of graffiti – rank them

  • Story-sharing- where does your unconscious bias come from?

  • Bracketing out and bracketing in

  • Underlying assumptions-

  • Exercises on looking at own privilege?????

  • History of the word “bias”

  • Thinking Fast and Slow” – the book – see the summarizing document I wrote up about it

FIGURE 1. Rehearsal logbook excerpt

Each rehearsal was planned to scaffold our cast members into the devising work on IB. For example, in the first session (June 9, 2021) I constructed a three-task opening for the first few rehearsals to move the A/R/Tors into a place of sharing (i.e., choose three personal items), creativity (i.e., find a metaphoric or symbolic object to represent your interest rather than something literal), and conceptualization (i.e., discuss the meaning of IB). As it turned out, this online rehearsal pattern suited the company. It was not long before the tasks involving sharing, creativity, and conceptualization interlocked and harmonized as we moved into creating the theatrical vignettes, and I found that I did not have to “prime the pump,” so to speak, for the later rehearsals. Eventually, cast members arrived already thinking about the work, yearning to get into the devising.

Early in the devising process I thought it would be wise to build with the A/R/Tors a shared definition of IB. This became contentious. Some A/R/Tors believed that IB was a set of behaviours found in us all (De Houwer, 2019), while others argued it was an extremity of prejudice (Holroyd et al., 2017). A/R/Tors also disagreed on the moral responsibility a person must accept for the bias they hold. The following observation has been pulled from my post-session notes about one rehearsal’s discussion:

A very difficult rehearsal. [Name anonymized] took centre stage and made numerous statements about how we should approach this work. Much of it was repetition from another rehearsal. The comments are valid but repetitive. It took up all our time and we did not get to devising. Very little “Yes and …” and mostly “Yes but …”

It was a challenge to simultaneously hold competing views on the definition of IB, and yet it became clear that prescribing one definition meant negating a set of voices. We held discourse over several rehearsals and, ultimately, we did not agree on a single definition or the degree of moral responsibility in holding IB (Madva, 2018). We did not need to agree, however. Once we dove into the devising work, the creative impulse took hold, resulting in a set of vignettes with a variety of perspectives, sometimes paradoxical in nature, providing ample choices for directions of dialogue with audience members.

I would like to share two examples of vignettes that approach IB differently. In “What’s in a Title?” (https://youtu.be/QQ7WD8x-NI0) MT A/R/Tors created a series of short interactions demonstrating microaggressions committed by individuals of various backgrounds. This example demonstrates various ways in which people, both from non-marginalized and marginalized groups, can express bias. In “Missed Interpretation” (https://youtu.be/zZUPdV1qHH8) we addressed the more blatant racial divide in which a white-skinned person acts on an assumption about a darker-skinned person that cannot be dismissed as a momentary lapse of reason. This example demonstrates the embedded power of the White perspective and its social harm.

Conrad (2006) speaks of ethical entanglements in her popular theatre participatory research project Life in the Sticks, finding guidance through the words of predecessors such as Denzin (2003), Conquergood (1985), and Boal (1974/1979). I have my own signpost predecessors, pointing me in directions I can choose to take. Norris (2009, 2020), Kandil (2016), and Carter (2010) are a few colleagues I can look to for reassurance that chaos leads to creativity. As Sajnani (2012) says, the “practice of improvisation embraces uncertainty” (p. 81). I suggest that in the whirlpool of uncertainty, we can collectively find a creative path to understanding.

Self-reflection is part of the understanding process. Conrad (2006) emphasizes the critical need for self-reflection “in hopes of accounting for the circumstances under which knowledge was produced, exploring the potential effects of my work and acknowledging the ethical tangles that it provoked” (p. 438). As I wrap up my section of the article, I wish to emphasize the need for both reflectivity (Simmons et al., 2021) and reflexivity (Fox & Allan, 2014) in this work. As a reflective practitioner I engaged in “a deliberate way of thinking about experiences” (DunnGalvin et al., 2019, p. 536), setting aside time immediately after rehearsal to make notes, applying my insights to create a follow-up agenda for the next rehearsal. As a reflexive practitioner I considered my own situated position (straight White male) and its effect on the research (Cunliffe, 2009), forcing me to challenge myself in the moment (rehearsal) and later (post rehearsal, during a reflective period). Was I listening clearly to other perspectives? Did my own privilege prevent me from exploring sexist, genderist, ableist, and racist scenes for my own protection? What elements of my common speech contributed to forms of othering, preventing cast members from fully expressing themselves? As D/A/R/Tor, I constantly questioned my methods to generate conversation, my decisions to direct the dialogue or to shut it down and move on to something else, and how I may have emphasized certain avenues of creativity over another. For example, when do I embrace the power of disagreement and when do I redirect the cast to other pastures? It is an obligation I embrace.

Reflections from a Curriculum Developer: A Pedagogical Perspective

Over the years, I have gained interest in exploring the pedagogical aspects of Playbuilding (Shabtay et al., 2019) and the educative qualities of RbT (Bulk, 2022; Jarus, 2022). As curriculum developer for this project, I led the creation of a facilitator’s guide that would allow for the expanded use of MT scenes in classrooms / learning settings. This was no small task! As the guide is open access, meaning anyone could use these scenes, we felt a responsibility to ensure the guide was rigorous. If a health sciences teacher with no theatre experience were to use this resource, could they adequately facilitate the scenes with their students? Furthermore, given that IB can be a contentious topic, what can we include to help teachers navigate difficult conversations? These were just two questions of many we discussed when creating this resource. In this section, I reflect on our process of constructing the guide and the pedagogical intersections that have emerged.

Constructing the guide

One major question we grappled with when constructing the guide was in relation to focus. Given this was a transdisciplinary research project, with stakeholders in different fields, we often conversed on how to balance the Playbuilding and applied health science sections. This led to many different iterations of the guide, each containing its own unique layout. Ultimately, we decided on three major foci: Playbuilding and Forum Theatre; facilitator preparation, rooted in our own experience giving performance workshops to applied health science classes; and promoting reflexive practice.

Our Playbuilding / Forum Theatre sections were a complex undertaking. They needed to be extensive enough so that they were accessible to all, regardless of the reader’s prior knowledge. We also knew that we should not overcomplicate things and unintentionally make potential readers apprehensive of using the scenes. Not only would we have to define Playbuilding, Forum Theatre, and “jokering” (a technique I describe below), but we would also need to demonstrate the relevance of and need for such methods. To accomplish this, we contextualized the scenes as “activating,” which Rohd (1998) describes as garnering attention and care while inviting the audience to get involved and explore how the scene might be changed. One could teach the definition of IB through a traditional lecture, but we argue that a Playbuilding methodology, in which we actively engage audiences in dialogue, enables students to implicate themselves in the discussion in an experiential learning environment.

To assist educators in facilitating scenes, we explained the role of the Joker, taken from Boal’s (1974/1979) Forum Theatre, as the intermediary between the scene and the audience. To be the Joker is to be the facilitator, to listen, to avoid giving prescriptive answers, and to know when to stop conversations. In the guide, we provide a list of facilitation / jokering techniques (https://ecampusontario.pressbooks.pub/implicitbiastraining/part/facilitating-applied-theatre/) that MT often uses during performance workshops. We go into further detail in each scene, making specific suggestions as to how one might “joker” or workshop the scene. For example, in the scene “Labels” (https://ecampusontario.pressbooks.pub/‌implicitbiastraining/chapter/labeling/), we suggest that Jokers could use hot seating, wherein an A/R/Tor or participant takes on the role of a character from a scene that was just presented and is then interviewed by the audience. Norris (2009) notes how hot seating can add new depth and perspective to the character. If the scene were to be replayed, new insights might be gained as to the character’s behaviours or actions. After jokering, we suggest questions that might be used to generate discussion, dialogue, and reflection.

While we felt confident in our explanation of RbT methodologies and how to use the techniques, we knew that potential users might still feel out of their comfort zone. Our principal investigator, Dr. Valerie Michaelson, wrote a section called “What We Learned in a Large Undergraduate Health Sciences Class” which outlined many suggestions for preparing the workshop and post-workshop debriefs. For example, we suggest that facilitators consider the emotional safety of the individuals in the group. As we cannot predict the outcomes of each workshop, co-constructing learning agreements with the class might prove beneficial (Hobbs et al., 2022). Safety has always been an important part of our performance workshops. We advise facilitators to encourage participation, but to never demand it. Furthermore, we strongly advise against grading participation in the performance workshops, as doing so may create pressure and a lack of authentic participation. Instead, we encourage the use of reflexive practices after the performance workshop has concluded.

The final major section of the guide, “Becoming Reflexive Practitioners,” addressed our learning objective, which we outlined in the guide’s introduction:

Our main learning objective is that co-learners who engage with this resource will develop a deepened sense of self-reflexivity about the implicit biases that they themselves hold and what the impacts of addressing (or not addressing) these implicit biases may be. (Hobbs et al., 2022, Introduction and Goals section, para. 4)

Our aim was to make clear to facilitators that by using an RbT approach rooted in a Playbuilding methodology, learners can engage and develop their own skills in reflexive practice. Emily Style (1988) writes that curriculum can be viewed as a window and a mirror. As a window, learners see perspectives outside of their own, while as a mirror, learners can see themselves reflected within the curriculum. Our experiences have demonstrated that by using drama, learners could achieve similar aims — that they might begin to see how IB affects others (the window) but is also something that is rooted in the self (the mirror).

Intersecting pedagogies

As the guide was coming together, I began taking notice of the multiple pedagogies embedded within this project. As the intersecting lenses of our team informed the creation of Haunting our Biases, they also informed the educative outcomes. With my own personal background in drama education and curriculum development, the lens through which I saw this project was very different from those with health science backgrounds. This did not detract from our work; rather, it broadened our scope. By intersecting RbT with the applied health sciences, our result was what we believe to be a transformative learning experience. In this next section, I will outline some of the pedagogical undertones that I found present in our guide. While I am sure my colleagues could add more to this list, I have noticed three, which I separate by how I see they are brought out in our work. The first pedagogy is in the approach to RbT: Where/how does the teaching begin? The second pedagogy is rooted in how we witness, and the potentially discomforting yet necessary call to recognize IB from within. The final pedagogy moves beyond the workshops, focusing on how the learning may remain after.

Approach — Dialogic pedagogy

Dialogue is a core tenant of MT’s work. From the early phases of data generation, MT members engage in dialogic practice, building ideas off one another through conversation and storytelling. Norris (2020) notes how performative research that utilizes Forum Theatre is dialogic, as participants discuss and often rewrite scenes to expand understandings of a given topic. This form of pedagogy runs in opposition to didactic pedagogies, which Waks (2015) describes as those where the teacher talks while the student passively listens. Freire (1968/2000) refers to this as the “banking” method of education, wherein information is merely stored, often so that students can write an exam, and knowledge gained is forgotten shortly thereafter. By placing a dialogic pedagogy at the forefront, we intend to break down traditional hierarchical barriers of teacher / student and encourage participants and facilitators to view themselves as co-learners. We aim for learning outcomes that are much more profound.

Witness — Pedagogy of discomfort

It was not until after our facilitator’s guide was published that I came across the pedagogy of discomfort; however, I immediately recognized its relevance to Haunting our Biases. As Boler (1999) describes:

A pedagogy of discomfort begins by inviting educators and students to engage in critical inquiry regarding values and cherished beliefs, and to examine constructed self-images in relation to how one has learned to perceive others. Within this culture of inquiry and flexibility, a central focus is to recognize how emotions define how and what one chooses to see, and conversely, not to see. (p. 176)

Framed within the pedagogy of discomfort, Haunting our Biases not only asks participants and co-learners to recognize the negative impact that IB has within society, but it serves as a call to confront biases held within the self. This can be challenging in the classroom setting. Taylor (2015) points out that educators discussing difficult issues in the classroom (racism, sexism, ableism, etc.) may reproduce rather than interrupt the IBs and norms “that permeate our educational institutions and practices” (p. 113). We often discussed this concern, recognizing that discourse around IB can bring out heavy and emotional conversations that require openness, humility, and careful navigation. Could a facilitator intentionally / unintentionally reproduce biases we were trying to disrupt? In making this guide publicly accessible, what responsibilities do we have in ensuring these reproductions do not happen?

Rather than avoiding these difficult conversations, Taylor (2015) proposes that the pedagogy of discomfort presents an opportunity for students to engage in witnessing, wherein learners can be challenged to confront their own assumptions. Zaliwska and Boler (2018) describe witnessing as stepping out of one’s “inscribed habits of (inattention),” daring to move beyond the comfort zone, and to recognize the ways in which we view the world, however discomforting it may be (p. 79). Witnessing, in this way, could be viewed as the beginnings of reflexivity. Witnessing not only asks one to watch the scenes, but to question how one is implicated. This is by no means an easy task. Students may be uncomfortable, and rightly so, sharing in a room of peers. Furthermore, the scenes we present can themselves be discomforting or triggering. Each scene has its own sets of questions and assumptions that can be unpacked and discussed. However, I have seen how the pedagogy of discomfort blends with our Forum Theatre approach.

When we have shown the scene “Missed Interpretation” (https://www.youtube.com/watch?v=zZUPdV1qHH8) to health science classrooms, it is often met with reactions of discomfort and embarrassment. Non-racialized students have remarked their disbelief that such an encounter could really happen. Some are soon shocked to learn that these scenes are rooted in real life, as “Missed Interpretation” was borrowed with permission from a Woman of Colour’s direct encounter at a park (Wozolek, 2020). I remember one student who challenged the idea that the scene was even a racist encounter, that because the White character was not being intentionally racist it did not qualify as a microaggression. I have wondered what caused such a reaction. Perhaps the student had not taken to the challenge of witnessing in a way that we had anticipated and that “one’s fear of talking about race complicates one’s ability to see … experiences of racism as reasonable” (Taylor, 2015, p. 120). Salverson (2006) notes that “becoming a witness is a process” (p. 151). We never expect our participants will instantly reach epiphanies or solutions to complex social problems, nor should we. Rather, we position our performance workshops as invitations to start the conversation and sit in the pedagogy of discomfort. Perhaps for some, becoming a witness comes after.

Beyond — Pedagogy of haunting

As the research team spent time thinking about what to title our project, we became enamored with the phrase “haunting our biases.” We describe haunting as “the sense that the thoughts, reflections, and conversations that remain after the educational encounter are etched into the heart and mind of the learner, leaving a lasting impression that evokes further questions and more self-reflexive actions and behaviours” (Hobbs et al., 2022, para. 4). Our intention was not to scare audiences with haunting; rather, we see haunting as an invitation for the participants to think deeply about what they may have learned in the workshop.

I argue for a pedagogy of haunting that is most aligned with our aims for reflexive practice. Kelly (2019) notes the transformational qualities of reflexive practice, stating that the reflexive practitioner “will automatically self-assess and react to circumstances as they are happening” (para. 3). Reflexivity requires self-awareness — to be able to ask how one’s actions impact or contribute to a particular outcome. Whereas witnessing in the pedagogy of discomfort might be seen as the beginning of reflexive practice, the pedagogy of haunting can be seen as the maintenance of reflexive practice. To be reflexive is to engage with that which has and continues to haunt us. These moments, engrained into our memories, are lessons that shape our future outcomes and how we view the world. Reflexivity and haunting, in this way, are constantly intertwined. It would require a much larger longitudinal study to know the long-term impacts of this kind of work. While such a study has not been undertaken, after having spent almost a decade doing these workshops in various settings, I have had encounters where someone says to me, “I remember when you came to my class, and we did that drama workshop.” Therein, for me, lies the pedagogy of haunting.

Through curricular and pedagogical approaches, I am consistently reminded of the educational merit that stems from RbT methodologies. We invite our participants to engage in material that does not provide answers but provokes complex questions that inspire discussion, scene-making, and reflection, all of which are deeply pedagogical. The pedagogies discussed above represent a selection among many that one could examine, with each one intersecting with another in our aim to create a rich, dialogic learning experience.

Reflections from a Mixed-Methods Researcher: The Power of Reflexivity

In this section, I discuss how my perspective shifted on implementing quantitative research practices in addition to utilizing an RbT approach in my role as the lead impact researcher and a Woman of Colour. I will also discuss the process and challenges encountered when I attempted to lead a mixed-methods study designed to empirically assess the extent to which our workshop reduces IB in participants. Finally, I reflect on the complexities of my journey when navigating the liminal space of both positivistic quantitative research and Playbuilding, as well as how this experience has impacted me as a researcher.

The process – Utilizing research to create the workshop

Based on a literature review that I conducted, it became apparent that, as far as we were aware, research had yet to explore how Playbuilding methodology could reduce IB in healthcare settings. Historically, antiquated tropes depicting Black people’s aptness for slavery were used to justify their enslavement (e.g., the fictitious belief that Black [vs. White] people are less sensitive to pain; Plous & Williams, 1995). Unfortunately, these stereotypes may still be endorsed in contemporary times, as 50% of healthcare students were found to believe at least one negative stereotype depicting fictitious biological differences between Black and White people (Hoffman et al., 2016). Such stereotypes may contribute to discrimination against Black healthcare recipients. For example, stereotypes regarding perceived differences in pain tolerances between Black (vs. White) people may contribute to Black people being prescribed lower pain medication than needed (Hoffman et al., 2016; Yearby, 2021). Stereotype endorsement can be conscious or unconscious, and healthcare professionals may be unaware that negative stereotypes may be influencing their treatment of marginalized patients (see FitzGerald & Hurst, 2017, for a meta-analysis on IB in healthcare).

The vignette “But I’m a Good Person” (https://www.youtube.com/‌watch?v=UWBEx-pXbtw&feature=emb_logo) was created to depict findings that unconscious stereotyping contributes to racial discrimination in healthcare. We list research that showcases how systemic racism contributes to racial disparities in healthcare (e.g., Yearby, 2021) in our facilitator’s guide for students who prefer scientific research (in addition to a dramatic scene) to illustrate this point. Thus, engaging in a literature review inspired scene development but also provided additional evidence of racial bias in healthcare for audiences who may be skeptical of data derived from RbT.

While there are many conventional approaches to collecting data rooted in positivism (i.e., all truths can be scientifically verified), Playbuilding encourages insights made in the dramatic process to be employed in the final output (e.g., scenes). Through this practice, we utilized the lived experiences of our cast members to showcase negative consequences of IB as relatable to university students. For example, the team wanted one scene that depicted the harm of experiencing a microaggression (i.e., often unintentional / unconscious subtle actions rooted in prejudiced attitudes towards people from oppressed groups). Cast members who worked on this scene realized that many of our Members of Colour were often asked where they were from, which made us feel othered and implied that People of Colour do not inherently belong in North America (Vega, 2017). Here, the cast was surveyed, and we found that the majority of Members of Colour had a similar discriminatory experience, which was utilized in the scene entitled “Role Call” (https://www.youtube.com/watch?v=‌B_j8pDTmXoo).

This scene depicts a teacher unassumingly but insidiously asking a Student of Colour where they are from, whilst asking other (White) students benign questions related to their personality. The Playbuilding methodology promoted the use of lived experience and permitted us to depict real-life examples of microaggressions as experienced by members of our cast. Indeed, the use of lived experience, as customary for Playbuilding, transforms the norms of research by creating non-traditional spoken data that shape the final theatrical output.

The assessment – Utilizing research to evaluate the efficacy of the workshop

In addition to utilizing traditional / non-traditional research approaches in the development of scenes, we also employed various research approaches when assessing the efficacy of our workshop. Due to my training in quantitative methodologies, I became somewhat fixated on measurement and believed that developing an additional survey, alongside our original one, that could measure the extent to which our workshop reduces IB in students would be beneficial to the project. One common strategy of assessing IB in healthcare workers is the assumption method, which involves administering a healthcare scenario and having participants provide recommendations toward an assigned patient whose marginalized identity is adjusted (e.g., Black/White, male/female) to test whether participants are more likely to discriminate against certain groups (FitzGerald & Hurst, 2017). For example, in my (quantitative) MA thesis (Ganesh, 2023), I assessed the extent to which participants were less willing to prioritize Black or East-Asian (vs. White) female patients for healthcare treatment and services using the assumption method. Because the assumption method was an appropriate tool for assessing bias in my thesis, I also assumed that this strategy could work well for this project.

However, there were issues and challenges involved with incorporating the assumption method for this project. For example, the method often utilizes a deficit-based approach, which identifies inequities based on social categories (e.g., race, gender). A deficit-based approach can place blame for inequities on equity-seeking groups and derives from scientific racism wherein researchers set out to prove that People of Colour were inferior to White people (Silverman et al., 2023). Thus, utilizing such an approach was not conducive to the social justice goals of this project. Furthermore, we still have yet to receive enough data to analyze results and form conclusions because participants had to complete the survey before and after completing the workshop for this project (unlike my MA thesis), leading to a low response rate. In hindsight, after administering this survey, I began to question whether the assumption method and quantitative methodology were most appropriate for the purposes of this research. After reviewing the data from our other survey, I realized that the qualitative data was incredibly rich and, although unable to measure the reduction of attendees’ IB, qualitative methodologies encouraged participants to express in their own words whether they benefited from the workshop, without the usually more prescriptive format of quantitative questionnaires.

One participant noted that, based on this workshop, “One thing I may start doing is evaluating body language more on a deeper aspect in the same way that was done in the workshop because of how much more it can say and state in specific contexts.” Overall, many participants expressed how the workshop resulted in greater awareness and reflexivity on how their body language and tone could accidentally convey IB, an insight not captured using the assumption method. I began to consider how qualitative (vs. quantitative) methodologies may be particularly beneficial during the early stages of assessing our workshop by encouraging participants to arrive at broader conclusions. Then, we could later use this qualitative data to create a quantitative survey measuring the effectiveness of our workshop if we desired.

I also began to reflect more deeply on the purposes of our research. In hindsight, it was prescriptive and dogmatic of me to assume that the methodology I had previously used was appropriate for an entirely different project with different goals. I have learned through my journey that IB cannot be reversed through one workshop alone. Consequently, it was not appropriate to mainly assess the efficacy of this workshop using quantitative methodologies. I now realize that significantly reducing IB was not necessarily the main purpose of our workshop, as our workshop is still useful even if we simply increased reflection on IB and encouraged greater reflexive practices. I originally prioritized numerical measurement when determining the efficacy of this workshop because of my primarily quantitative training which biased me from initially considering other forms of evaluation criteria beyond those rooted in positivistic quantitative methods. Through collaboration outside of my initial disciplinary home, I gained greater insight into other forms of research and can now better appreciate the value of both quantitative and qualitative methodologies.

Furthermore, I gained a greater appreciation for qualitative approaches through this research project. In the Playbuilding workshops, participants often derived conclusions on how IB applies to their lives. These conclusions offer as much, if not deeper, insight into the workshop's effectiveness. For example, one workshop attendee did not understand how a microaggression could occur without malice. In my opinion, this student was genuinely and respectfully attempting to gain further insight into a phenomenon that they did not understand. Although facilitators explained that microaggressions can cause harm even when unintended, some racialized students also volunteered to share personal recollections of experiencing microaggressions and the related unintended harm. I noticed that the attendee was nodding a lot and positioned themselves to directly face the Students of Colour who were speaking. This contrasted with their previous engagement wherein this student appeared to be less visibly engaged in the workshop prior to asking their question (e.g., was checking their phone). From my perspective, I witnessed the attendee respectfully listen to and engage with the discriminatory experiences of Students of Colour. Thus, the attendee who asked the question had the opportunity to gain greater insight into the harmful effects of microaggressions through peer-to-peer learning and will hopefully use this insight to further reflect on their IBs.

Moreover, as a Woman of Colour, I sometimes am particularly concerned about whether we are creating a conducive environment for marginalized students to explore bias without feeling harmed in addition to an environment that fosters reflexivity and growth for students with a rudimentary knowledge of bias. Thus, I decided to check in with some of those who volunteered to share their lived experiences with the class to ensure that they felt comfortable doing so. These students shared that they felt empowered through choosing to share their experience, but that it was essential that this participation happened organically and was not forced. Their emphasis on voluntary participation resonated with me; as an undergraduate student, I was uncomfortable in classes where I was pressured to educate White students on my experiences of marginalization and only volunteered to share my experiences when the atmosphere and environment felt comfortable to do so.

Students of Colour voluntarily sharing their experiences of marginalization, in combination with their comments following the workshop, indicated to me that we had indeed created an environment where marginalized students felt comfortable sharing their experiences of prejudice and discrimination (as well as a space where students with rudimentary knowledge on bias can also ask questions to gain further insight). Although I did not directly speak to students who witnessed the aforementioned exchange regarding microaggressions without engaging about their experience, the majority of attendees indicated that the workshop provided them with “lots to think about” (89% agreed or strongly agreed) and that “they did not feel pressure to participate more than [they] wanted to” (95% neutral, agreed, or strongly agreed) in our mixed-methods assessment. Through the Playbuilding process, subtle cues (e.g., body language, conclusions made by attendees), in addition to written / numerical data, were used to better understand the efficacy of our workshop. Quantitative research methodologies and RbT as a methodology provided unique but equally valuable insights into the efficacy of our workshop.

Overall, I am grateful to have been part of this transformative experience using interdisciplinary methods to reduce IB, and I appreciate gaining greater insight into qualitative research and the unique value of RbT. In hindsight, I incorporated quantitative research methodologies because this approach was familiar and because my previous limited knowledge of qualitative research aided in my false notion that the positivistic quantitative methodology (e.g., assumption method) would translate well to an entirely different project with different goals. However, I now attempt to reflect on which approaches will be more appropriate to answer my research questions and derive conclusions rather than allowing the methodology to guide my research. My journey of becoming a multi-methods arts-based researcher is ongoing, similar to the journey of confronting and eliminating our own IBs. I constantly struggle to navigate the liminal space between quantitative, qualitative, and RbT approaches. I always encourage workshop participants to engage in reflexivity to assist in diminishing the negative effects of IB. Applying this approach to myself, reflecting on the challenges of integrating traditional and RbT practices, and how to better integrate qualitative, quantitative, and RbT methods to maximize the benefits of each approach, allows me to best navigate this liminal space and continue to grow as a researcher.

The Reflexive Possibilities of Playbuilding

At the end of one of our in-person workshops, one participant (an undergraduate student in the health sciences) said that a scene primed her to recall an experience from many years ago, and that the workshop allowed her to realize that this experience was a microaggression. Although it will take many years of conducting workshops, interviews, and questionnaires to truly understand the efficacy of this type of work, our anecdotal experience showcases that our use of Playbuilding does have a positive impact. Not only are we continually witnessing how Haunting our Biases contributes to our audiences understanding of IB, but we also see how this process has contributed to our own growth — that months of rehearsals and discussions have allowed us to unlearn and become more attentive and reflexive of our own IBs and those that we see in our daily lives. Although Haunting our Biases is an RbT project primarily aimed at the health sciences, we recognize that IB is not limited to one field and see the potential for projects such as this to be used across disciplines. Overall, Playbuilding as a sub-genre of RbT transforms the learning process by encouraging participants to engage in greater reflexivity when examining their bias, both within and beyond the workshop, but has also transformed us, the researchers, by fostering greater reflexivity on how we can reduce our own IB throughout our lives and within our research.

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