Helping medical learners recognise and manage unconscious bias toward certain patient groups

Teal, Cayla R.; Gill, Anne; Green, Alexander R.; Crandall, Sonia

doi:10.1111/j.1365-2923.2011.04101.x

Cited by 157 publications

(143 citation statements)

References 53 publications

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“…Stone and Moskowitz (2011) have observed that implicit biases, although unconscious, may negatively influence how medical professionals interact with minority group patients. This, in turn, compromises health provider-patient rapport, fosters patient mistrust and dissatisfaction, and may ultimately lead to poorer healthcare (Teal, Gill, Green, & Crandall, 2012).…”

Section: Introductionmentioning

confidence: 99%

What you can't see can hurt you: How do stereotyping, implicit bias and stereotype threat affect Māori health?

Houkamau¹

2016

MAI Journal

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A number of studies demonstrate Mäori receive a poorer standard of healthcare than Päkehä and other non-Mäori in New Zealand. Implicit bias on the part of healthcare providers has been cited as a key contributor to health inequities internationally; however, the concept has not yet been explored in relation to Mäori health. This paper addresses that research gap and describes a theoretical basis for further research on the role of bias for Mäori health outcomes. Drawing from empirical research and theories formulated in social psychology, the paper considers the relevance of implicit bias, stereotyping and stereotype threat for Mäori health outcomes. These have not been integrated and applied to the problem of Mäori health inequities per se; however, it is proposed that they provide a useful conceptual lens for understanding how interpersonal dynamics between Mäori and Päkehä help perpetuate health disparities. Suggestions for further research are also made.

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Section: Introductionmentioning

confidence: 99%

What you can't see can hurt you: How do stereotyping, implicit bias and stereotype threat affect Māori health?

Houkamau¹

2016

MAI Journal

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“…Examples include promoting awareness of one's own implicit biases and enhancing conscious efforts to overcome these biases (Burgess, Fu et al 2004, Burgess, van Ryn et al 2007, Teal, Gill et al 2012. In order for educational interventions that incorporate conscious awareness of implicit bias as an effective strategy, they must be designed to address a potential "kick-back" effect where individuals over-compensate and develop counter-biases in response to bias-eradication efforts (Ross 2014).…”

Section: Introductionmentioning

confidence: 99%

Reducing Mental Illness Stigma through Unconscious Bias-Informed Education

Sukhera¹,

Chahine²

2016

MedEdPublish

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Mental illness stigma can have disastrous consequences for patients, families and healthcare organizations. Unconscious bias informed education seeks a systematic approach to addressing implicit biases in healthcare providers by promoting awareness and understanding in order to promote compassion and empathy. After a 1 hour intervention, third year medical students who were enrolled in the third year psychiatry clerkship rotation completed a demographic form, (pre/post) a shortened mental illness implicit association test (IAT) and the Brief Mental Illness Attitudes Scale (BMIAS). For the IAT, the majority (51.4%) of participants demonstrated a bias that mental illness was associated with dangerousness. A paired samples t test of BMIAS scores found no significant change in pre and post scores on Responsibility subscale. There was a statistically significant improvement in the in the Traits subscale from pre (n=87, m=5.15, sd=0.87) and post (n=87, m=5.62, sd=0.71), t(86)=5.16 p<0.001. Our brief seminar had a statistically significant impact on student attitudes towards patients with traits of individuals with psychiatric illness. These findings indicate that mental illness stigma is an important issue in medical education and that unconscious bias-informed education may provide an effective method to reduce stigma.

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“…Another potential cause of the racial gaps in proton therapy use is provider physician implicit bias; it has been demonstrated in pinnacle work on racial disparities that patient race influences provider decisions on treatment recommendations-a phenomenon that occurs with high predictive validity and that largely occurs at the unconscious level, and so is termed implicit bias. [21][22][23] It could be the case that providers might implicitly assume that minority patients are less able to afford the costs associated with proton therapy and/or that minority patients may be less likely to adhere to the treatment regimen of a form of therapy that still lacks level 1 evidence in terms of efficacy and so providers are less likely to recommend or push minority patients to receive proton therapy for prostate cancer. Unfortunately, implicit bias is difficult to study and would require physician surveys in order to determine the extent to which this phenomenon accounts for the gaps observed in this study.…”

mentioning

confidence: 99%

National trends and determinants of proton therapy use for prostate cancer: A National Cancer Data Base study

Mahal

Chen

Efstathiou

et al. 2016

Cancer

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Précis: Use of proton therapy to treat prostate cancer more than doubled from 2004-2012, with striking racial disparities in proton therapy use despite robust multivariable adjustments. Longterm follow-up is needed to determine whether the costly increased use of proton therapy for prostate cancer is justified and ongoing efforts should be made to ensure equal access to resource limited oncologic therapies. Page 2 of 25 CancerThis article is protected by copyright. All rights reserved. Page 3 of 25 CancerThis article is protected by copyright. All rights reserved. Accepted Article 4 AbstractBackground: We sought to both characterize the national trends in proton therapy use for

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Helping medical learners recognise and manage unconscious bias toward certain patient groups

Abstract: We propose a developmental model to illustrate how individuals might move from absolute denial of unconscious bias to the integration of strategies to mitigate its influence on their interactions with patients and offer recommendations to educators and education researchers.

Cited by 157 publications

References 53 publications

What you can't see can hurt you: How do stereotyping, implicit bias and stereotype threat affect Māori health?

What you can't see can hurt you: How do stereotyping, implicit bias and stereotype threat affect Māori health?

Reducing Mental Illness Stigma through Unconscious Bias-Informed Education

National trends and determinants of proton therapy use for prostate cancer: A National Cancer Data Base study

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