Microaggressions are brief, commonplace, and daily verbal, behavioral, and environmental slights towards marginalized groups. Underrepresented in medicine (UiM) learners experience a barrage of microaggressions in the pediatric clinical learning environment. Literature demonstrates that microaggressions are detrimental to the mental and physical well-being of the recipient. There is an urgent need to bring greater awareness and understanding of how microaggressions operate in the clinical learning environment, the impact they have on UiM learners and the educational and institutional strategies needed to best support learners.

Several databases were searched using combinations of subject headings and keywords as described. While “microaggressions” is not yet an official medical subject heading (Mesh term) for the National Library of Medicine's databases, nonetheless there are numerous studies using the term microaggressions in the research literature about health care, medical education and learning environments. Items were limited to English language publications from the past 10 years.

Microaggressions are rooted in power differentials and indirect assertion of power. The clinical learning environment contains learners at all levels along with patients and families. The impact of microaggressions leads to (1) othering (2) stunted professional identity formation and (3) racial battle fatigue. Both educational initiatives targeted at recognizing and responding to microaggressions and institutional anonymous reporting systems and policies are best practices to combat the negative impact of microaggressions.

Institutions-at-large and graduate medical education need to create safe spaces for anonymous reporting, robust policies for addressing bias and educational initiatives for responding to microaggressions. Together these will begin to create safe spaces for our UiM learners in a system that so often perpetuates they do not belong.

微攻击是针对边缘化群体的简短、司空见惯的日常言语、行为和环境轻视。医学中代表性不足 (UiM) 学习者在儿科临床学习环境中经历了一连串的微攻击。文献表明，微攻击不利于接受者的身心健康。迫切需要提高对微攻击在临床学习环境中的运作方式、它们对 UiM 学习者的影响以及为学习者提供最佳支持所需的教育和机构策略的认识和理解。

如所述，使用主题词和关键字的组合搜索了几个数据库。虽然“微攻击”还不是国家医学图书馆数据库的官方医学主题词（网格术语），但在有关医疗保健、医学教育和学习环境的研究文献中，有许多研究使用了“微攻击”一词。项目仅限于过去 10 年的英语出版物。

微观侵略植根于权力差异和间接的权力主张。临床学习环境包含各级学习者以及患者和家属。微攻击的影响会导致 (1) 他人化 (2) 职业身份形成障碍和 (3) 种族战斗疲劳。旨在识别和应对微攻击的教育举措以及机构匿名报告系统和政策都是对抗微攻击负面影响的最佳实践。

大型机构和研究生医学教育需要为匿名报告、解决偏见的强有力政策和应对微攻击的教育举措创造安全空间。这些将一起开始为我们的 UiM 学习者在一个经常使他们不属于他们的系统中创造安全空间。