What is a microaggression and how can it affect PT outcomes?

• A. A direct, overt harm that always improves adherence.
• B. A subtle, often unintentional remark or action belittling a marginalized group; it can erode trust, reduce adherence, and worsen outcomes.
• C. Only occurs in written notes.
• D. Not relevant to PT practice.

Answer: (B)

Microaggressions are subtle, often unintentional remarks or actions that belittle or devalue someone because of their identity. In physical therapy, where a trusting, collaborative relationship with the patient is crucial for adherence and progress, these microaggressions can erode trust, make patients feel dismissed or disrespected, and reduce their engagement in the treatment plan. When trust and rapport are compromised, patients are less likely to follow home exercise programs, attend sessions, or fully participate in recommended activities, which can lead to poorer functional outcomes. Microaggressions can be verbal, nonverbal, or even conveyed through tone or assumptions, and they can occur in everyday interactions, not just in written notes. Cultivating respectful, person-first language and culturally sensitive communication helps protect the therapeutic relationship and supports better adherence and outcomes.

The other options don’t fit because microaggressions are not only direct, overt harm that always improves adherence; they can harm adherence and outcomes. They are not confined to written notes; they occur in speech and behavior as well. And they are relevant to PT practice, where the patient–therapist relationship significantly influences outcomes.