Addressing implicit bias in pediatric hematology‐oncology

Tsai, Jessica W.; Kesselheim, Jennifer C.

doi:10.1002/pbc.28204

Cited by 7 publications

(5 citation statements)

References 29 publications

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“…This finding emphasizes the need for increased diversity and inclusion training for pediatric hematology‐oncology providers in all practice settings. Awareness and education regarding implicit bias and its role in clinical settings is one of the first steps toward mitigating its potential effects 22 …”

Section: Discussionmentioning

confidence: 99%

“…The protocolized nature of pediatric oncology practice may be similarly protective. Additional interventions to address and mitigate implicit bias in medical settings and other industries include recruiting a diverse health care workforce, care checklists and algorithms, and patient navigators 22 . Continued investigation and adaptation of these tools and training methods for pediatric oncology is warranted to further understand implicit bias and its potential effect on patient care, including clinical trial enrollment.…”

Section: Discussionmentioning

confidence: 99%

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Role of implicit bias in pediatric cancer clinical trials and enrollment recommendations among pediatric oncology providers

Graetz

Madni

Gossett

et al. 2020

Cancer

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BackgroundProvider implicit bias can negatively affect clinician‐patient communication. In the current study, the authors measured implicit bias training among pediatric oncology providers and exposure to implicit association tests (IATs). They then assessed associations between IATs for race and socioeconomic status (SES) and recommendations for clinical trial enrollment.MethodsA prospective multisite study was performed to measure implicit bias among oncology providers at St. Jude Children's Research Hospital and affiliate clinics. An IAT was used to assess bias in the domains of race and SES. Case vignettes were used to determine an association between bias and provider recommendation for trial enrollment. Data were analyzed using Studentttests or Wilcoxon tests for comparisons and Jonckheere‐Terpstra tests were used for association.ResultsOf the 105 total participants, 95 (90%) had not taken an IAT and 97 (92%) had no prior implicit bias training. A large effect was found for (bias toward) high SES (Cohend, 1.93) and European American race (Cohend, 0.96). The majority of participants (90%) had a vignette score of 3 or 4, indicating recommendation for trial enrollment for most or all vignettes. IAT and vignette scores did not significantly differ between providers at St. Jude Children's Research Hospital or affiliate clinics. No association was found between IAT and vignette scores for race (P= .58) or SES (P= .82).ConclusionsThe authors noted a paucity of prior exposure to implicit bias self‐assessments and training. Although these providers demonstrated preferences for high SES and European American race, this did not appear to affect recommendations for clinical trial enrollment as assessed by vignettes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Role of implicit bias in pediatric cancer clinical trials and enrollment recommendations among pediatric oncology providers

Graetz

Madni

Gossett

et al. 2020

Cancer

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“…11 The program leaders could explain implicit bias with the message that it is present in everyone and is distinct from explicit racism. 12 The director could offer examples of how implicit bias might have influenced her practice to model its ubiquity. Programs could suggest resources to address implicit bias.…”

Section: Reflection Points For This Scenario Includementioning

confidence: 99%

“…A review of the research indicates that healthcare professionals exhibit the same levels of implicit bias as the wider population 11. The program leaders could explain implicit bias with the message that it is present in everyone and is distinct from explicit racism 12. The director could offer examples of how implicit bias might have influenced her practice to model its ubiquity.…”

Section: Implicit Biasmentioning

confidence: 99%

When the Supervisor Needs a Supervisor: A Case-based Guide for Developing Psychotherapy Supervisors

Murray

Frank

Sudak

et al. 2023

Journal of Psychiatric Practice

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Supervision of psychotherapy is recognized as fundamental for attaining competency in psychotherapy. However, there is a lack of training in “best practices” of supervisory skills, and some supervisors may lack contemporary knowledge to support supervisees adequately. Training program leadership challenged by limited time and resources to provide supervisors with the necessary education and support can benefit from additional resources for developing psychotherapy supervisors. The authors present 3 core elements of navigating supervisory challenges: training, open dialogue in supervision, and a formal program-level process. Common issues in psychotherapy supervision are then presented in a case-based format. Reflection questions are included to provide an opportunity to consider a personal approach to the case, while specific guidance based on the literature addresses critical aspects of the case examples. Complex supervisory conflicts can challenge programs, but they are normative to the learning process and promote growth in our supervisors.

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“…Healthcare providers, regardless of specialty area (e.g., internal medicine, primary care, cardiology, emergency medicine, pediatrics, surgery, and psychiatry), profession (e.g., physicians, nurses, genetic counselors, occupational clinicians, mental health professionals), and training level (e.g., students, residents, fellows, faculty, and licensed professionals), have been found to have more negative and less positive implicit attitudes toward people of color (with the vast majority of the literature focusing on Black people) compared to non-Hispanic White people (i.e., pro-White bias) [ 4 , 7 , 9 , 10 , 11 , 12 , 17 ]. Research shows that these pro-White/anti-Black biases even extend to children and pediatric care [ 3 , 14 , 18 , 19 , 20 ]. Moreover, these biases have been found to be associated with lower quality of care [ 6 , 7 , 10 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

A Brief Online Implicit Bias Intervention for School Mental Health Clinicians

Liu

Coifman

McRee

et al. 2022

IJERPH

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Clinician bias has been identified as a potential contributor to persistent healthcare disparities across many medical specialties and service settings. Few studies have examined strategies to reduce clinician bias, especially in mental healthcare, despite decades of research evidencing service and outcome disparities in adult and pediatric populations. This manuscript describes an intervention development study and a pilot feasibility trial of the Virtual Implicit Bias Reduction and Neutralization Training (VIBRANT) for mental health clinicians in schools—where most youth in the U.S. access mental healthcare. Clinicians (N = 12) in the feasibility study—a non-randomized open trial—rated VIBRANT as highly usable, appropriate, acceptable, and feasible for their school-based practice. Preliminarily, clinicians appeared to demonstrate improvements in implicit bias knowledge, use of bias-management strategies, and implicit biases (as measured by the Implicit Association Test [IAT]) post-training. Moreover, putative mediators (e.g., clinicians’ VIBRANT strategies use, IAT D scores) and outcome variables (e.g., clinician-rated quality of rapport) generally demonstrated correlations in the expected directions. These pilot results suggest that brief and highly scalable online interventions such as VIBRANT are feasible and promising for addressing implicit bias among healthcare providers (e.g., mental health clinicians) and can have potential downstream impacts on minoritized youth’s care experience.

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Addressing implicit bias in pediatric hematology‐oncology

Cited by 7 publications

References 29 publications

Role of implicit bias in pediatric cancer clinical trials and enrollment recommendations among pediatric oncology providers

Role of implicit bias in pediatric cancer clinical trials and enrollment recommendations among pediatric oncology providers

When the Supervisor Needs a Supervisor: A Case-based Guide for Developing Psychotherapy Supervisors

A Brief Online Implicit Bias Intervention for School Mental Health Clinicians

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