Implicit Bias in Medicine

Implicit Bias in Medicine

What is implicit bias? Here’s a 2.5 min explanation from the New York Times, “Peanut Butter, Jelly and Racism.”

Implicit Association Test

Harvard’s Implicit Association Test (IAT) allows you to investigate what unconscious biases you may have. Consider taking the IAT on Race or the IAT on Skin Tone to evaluate what biases you may have unconsciously.

Unconscious bias in medicine cme activity

This free CME activity from Stanford provides education on unconscious bias in the academic medicine workplace. Existing research on unconscious bias will provide a science-based view of this seemingly non-science topic. Case studies with examples of unconscious bias, self-assessment opportunities, and exploring bias busting strategies will enable learners to understand how to bring the content into their own unique environments.


Burnout and Racial Bias

Burnout is widely acknowledged to be a problem within medicine, particularly during residency. This cohort study of 3392 non-black resident physicians published in JAMA found that symptoms of burnout appeared to be associated with greater explicit and implicit racial biases. This suggests that physician burnout may increase health disparities, or at least that addressing physician burnout may reduce biases in clinical settings.

Adapted from a webinar recorded July 31, 2018, this Pennsylvania Patient Safety Authority educational video discusses implicit bias and how it can affect clinician-patient interactions, including interviewing questions, diagnostic decisions, symptom management, treatment recommendations, and reported levels of trust. Following this presentation, participants will: • Define implicit bias as it relates to the delivery of healthcare • Describe the effect implicit bias has on health outcomes • Illustrate potential strategies to reduce implicit bias

 

Anurag Gupta, MPhil, JD, founder and CEO of Be More America, explains implicit or unconscious bias and how health care providers and others can stop it from negatively affecting people. Learn more about health equity here: http://www.ihi.org/Topics/Health-Equity

This brief 2.5 minute video reviews how implicit bias can manifest in healthcare.

 

Introductory module on implicit bias in healthcare.

 

Whistling Vivaldi (How Implicit Bias Shapes Our Work and World) is a presentation from Medicine Grand Rounds at Emory University from January 2018.

 

"Implicit Bias in Medicine" Pediatric Grand Rounds presentation by Nicole Jones, MD at Louisiana State University Health Shreveport.

 

Naomi Shike, MD, MSc presents Part 1 - Implicit Bias and Social Categorization in Medicine

Naomi Shike, MD, MSc. presents Part 2 - Implicit Bias and Social Categorization in Medicine.


Resources

Backhus LM, Lui NS, Cooke DT, Bush EL, Enumah Z, Higgins R. Unconscious Bias: Addressing the Hidden Impact on Surgical Education. Thorac Surg Clin. 2019 Aug; 29 (3): 259-267.

Chapman EN, Kaatz A, Carnes M. Physicians and implicit bias: how doctors may unwittingly perpetuate health care disparities. J Gen Intern Med. 2013 Nov; 28 (11): 1504-10.

Dossa F, Baxter NN. Implicit Bias in Surgery-Hiding in Plain Sight. JAMA Netw Open. 2019 Jul 3; 2 (7): e196535.

Dyrbye L, Herrin J, West CP, et al. Association of Racial Bias With Burnout Among Resident Physicians. JAMA Netw Open. 2019; 2 (7): e197457.

FitzGerald C, Hurst S. Implicit bias in healthcare professionals: a systematic review. BMC Med Ethics. 2017 Mar 1; 18 (1): 19.

Green AR, Carney DR, Pallin DJ, et al. Implicit bias among physicians and its prediction of thrombolysis decisions for black and white patients. J Gen Intern Med. 2007; 22 (9): 1231–1238.

Hall WJ, Chapman MV, Lee KM, et al. Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review. Am J Public Health 2015; 105 (12): e60-e76.

Maina IW, Belton TD, Ginzberg S, Singh A, Johnson TJ. A decade of studying implicit racial/ethnic bias in healthcare providers using the implicit association test. Soc Sci Med. 2018 Feb; 199: 219-229.

Payne NR, Puumala SE. Racial disparities in ordering laboratory and radiology tests for pediatric patients in the emergency department. Pediatr Emerg Care. 2013; 29 (5): 598‐606.

Penner LA, Dovidio JF, West TV, er al. Aversive racism and medical interactions with black patients: a field study. J of Experimental Social Psychology.2010;46(2):436–440.

Sabin JA, Greenwald AG. The influence of implicit bias on treatment recommendations for 4 common pediatric conditions: pain, urinary tract infection, attention deficit hyperactivity disorder, and asthma. Am J Public Health. 2012 May; 102 (5): 988-95.

Schnierle J, Christian-Brathwaite N, Louisias M. Implicit Bias: What Every Pediatrician Should Know About the Effect of Bias on Health and Future Directions. Curr Probl Pediatr Adolesc Health Care. 2019 Feb; 49 (2): 34-44.

van Ryn M, Hardeman R, Phelan SM, Burgess DJ, Dovidio JF, Herrin J, Burke SE, Nelson DB, Perry S, Yeazel M, Przedworski JM. Medical School Experiences Associated with Change in Implicit Racial Bias Among 3547 Students: A Medical Student CHANGES Study Report. J Gen Intern Med. 2015 Dec; 30 (12): 1748-56.