Implicit Bias and Its Relation to Health Disparities

A Teaching Program and Survey of Medical Students

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: The varying treatment of different patients by the same physician are referred to as within provider disparities. These differences can contribute to health disparities and are thought to be the result of implicit bias due to unintentional, unconscious assumptions. Purposes: The purpose is to describe an educational intervention addressing both health disparities and physician implicit bias and the results of a subsequent survey exploring medical students' attitudes and beliefs toward subconscious bias and health disparities. Methods: A single session within a larger required course was devoted to health disparities and the physician's potential to contribute to health disparities through implicit bias. Following the session the students were anonymously surveyed on their Implicit Association Test (IAT) results, their attitudes and experiences regarding the fairness of the health care system, and the potential impact of their own implicit bias. The students were categorized based on whether they disagreed ("deniers") or agreed ("accepters") with the statement "Unconscious bias might affect some of my clinical decisions or behaviors." Data analysis focused specifically on factors associated with this perspective. Results: The survey response rate was at least 69%. Of the responders, 22% were "deniers" and 77% were "accepters." Demographics between the two groups were not significantly different. Deniers were significantly more likely than accepters to report IAT results with implicit preferences toward self, to believe the IAT is invalid, and to believe that doctors and the health system provide equal care to all and were less likely to report having directly observed inequitable care. Conclusions: The recognition of bias cannot be taught in a single session. Our experience supports the value of teaching medical students to recognize their own implicit biases and develop skills to overcome them in each patient encounter, and in making this instruction part of the compulsory, longitudinal undergraduate medical curriculum.

Original languageEnglish (US)
Pages (from-to)64-71
Number of pages8
JournalTeaching and Learning in Medicine
Volume26
Issue number1
DOIs
StatePublished - Jan 2014

Fingerprint

teaching program
Medical Students
medical student
Teaching
Health
trend
health
Physicians
physician
Students
Curriculum
Surveys and Questionnaires
Demography
fairness
Delivery of Health Care
experience
data analysis
student
health care
instruction

Keywords

  • attitude assessment
  • health disparities
  • implicit bias
  • student survey

ASJC Scopus subject areas

  • Medicine(all)
  • Education

Cite this

@article{f6db180f8c794cc98de5743c6ee15f65,
title = "Implicit Bias and Its Relation to Health Disparities: A Teaching Program and Survey of Medical Students",
abstract = "Background: The varying treatment of different patients by the same physician are referred to as within provider disparities. These differences can contribute to health disparities and are thought to be the result of implicit bias due to unintentional, unconscious assumptions. Purposes: The purpose is to describe an educational intervention addressing both health disparities and physician implicit bias and the results of a subsequent survey exploring medical students' attitudes and beliefs toward subconscious bias and health disparities. Methods: A single session within a larger required course was devoted to health disparities and the physician's potential to contribute to health disparities through implicit bias. Following the session the students were anonymously surveyed on their Implicit Association Test (IAT) results, their attitudes and experiences regarding the fairness of the health care system, and the potential impact of their own implicit bias. The students were categorized based on whether they disagreed ({"}deniers{"}) or agreed ({"}accepters{"}) with the statement {"}Unconscious bias might affect some of my clinical decisions or behaviors.{"} Data analysis focused specifically on factors associated with this perspective. Results: The survey response rate was at least 69{\%}. Of the responders, 22{\%} were {"}deniers{"} and 77{\%} were {"}accepters.{"} Demographics between the two groups were not significantly different. Deniers were significantly more likely than accepters to report IAT results with implicit preferences toward self, to believe the IAT is invalid, and to believe that doctors and the health system provide equal care to all and were less likely to report having directly observed inequitable care. Conclusions: The recognition of bias cannot be taught in a single session. Our experience supports the value of teaching medical students to recognize their own implicit biases and develop skills to overcome them in each patient encounter, and in making this instruction part of the compulsory, longitudinal undergraduate medical curriculum.",
keywords = "attitude assessment, health disparities, implicit bias, student survey",
author = "Gonzalez, {Cristina M.} and Mimi Kim and Marantz, {Paul R.}",
year = "2014",
month = "1",
doi = "10.1080/10401334.2013.857341",
language = "English (US)",
volume = "26",
pages = "64--71",
journal = "Teaching and Learning in Medicine",
issn = "1040-1334",
publisher = "Routledge",
number = "1",

}

TY - JOUR

T1 - Implicit Bias and Its Relation to Health Disparities

T2 - A Teaching Program and Survey of Medical Students

AU - Gonzalez, Cristina M.

AU - Kim, Mimi

AU - Marantz, Paul R.

PY - 2014/1

Y1 - 2014/1

N2 - Background: The varying treatment of different patients by the same physician are referred to as within provider disparities. These differences can contribute to health disparities and are thought to be the result of implicit bias due to unintentional, unconscious assumptions. Purposes: The purpose is to describe an educational intervention addressing both health disparities and physician implicit bias and the results of a subsequent survey exploring medical students' attitudes and beliefs toward subconscious bias and health disparities. Methods: A single session within a larger required course was devoted to health disparities and the physician's potential to contribute to health disparities through implicit bias. Following the session the students were anonymously surveyed on their Implicit Association Test (IAT) results, their attitudes and experiences regarding the fairness of the health care system, and the potential impact of their own implicit bias. The students were categorized based on whether they disagreed ("deniers") or agreed ("accepters") with the statement "Unconscious bias might affect some of my clinical decisions or behaviors." Data analysis focused specifically on factors associated with this perspective. Results: The survey response rate was at least 69%. Of the responders, 22% were "deniers" and 77% were "accepters." Demographics between the two groups were not significantly different. Deniers were significantly more likely than accepters to report IAT results with implicit preferences toward self, to believe the IAT is invalid, and to believe that doctors and the health system provide equal care to all and were less likely to report having directly observed inequitable care. Conclusions: The recognition of bias cannot be taught in a single session. Our experience supports the value of teaching medical students to recognize their own implicit biases and develop skills to overcome them in each patient encounter, and in making this instruction part of the compulsory, longitudinal undergraduate medical curriculum.

AB - Background: The varying treatment of different patients by the same physician are referred to as within provider disparities. These differences can contribute to health disparities and are thought to be the result of implicit bias due to unintentional, unconscious assumptions. Purposes: The purpose is to describe an educational intervention addressing both health disparities and physician implicit bias and the results of a subsequent survey exploring medical students' attitudes and beliefs toward subconscious bias and health disparities. Methods: A single session within a larger required course was devoted to health disparities and the physician's potential to contribute to health disparities through implicit bias. Following the session the students were anonymously surveyed on their Implicit Association Test (IAT) results, their attitudes and experiences regarding the fairness of the health care system, and the potential impact of their own implicit bias. The students were categorized based on whether they disagreed ("deniers") or agreed ("accepters") with the statement "Unconscious bias might affect some of my clinical decisions or behaviors." Data analysis focused specifically on factors associated with this perspective. Results: The survey response rate was at least 69%. Of the responders, 22% were "deniers" and 77% were "accepters." Demographics between the two groups were not significantly different. Deniers were significantly more likely than accepters to report IAT results with implicit preferences toward self, to believe the IAT is invalid, and to believe that doctors and the health system provide equal care to all and were less likely to report having directly observed inequitable care. Conclusions: The recognition of bias cannot be taught in a single session. Our experience supports the value of teaching medical students to recognize their own implicit biases and develop skills to overcome them in each patient encounter, and in making this instruction part of the compulsory, longitudinal undergraduate medical curriculum.

KW - attitude assessment

KW - health disparities

KW - implicit bias

KW - student survey

UR - http://www.scopus.com/inward/record.url?scp=84893040436&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84893040436&partnerID=8YFLogxK

U2 - 10.1080/10401334.2013.857341

DO - 10.1080/10401334.2013.857341

M3 - Article

VL - 26

SP - 64

EP - 71

JO - Teaching and Learning in Medicine

JF - Teaching and Learning in Medicine

SN - 1040-1334

IS - 1

ER -