Implicit Stigma Recognition and Management for Health Professionals

Sukhera, Javeed; Miller, Kristina; Scerbo, Christina; Milne, Alexandra; Lim, Rod; Watling, Christopher

doi:10.1007/s40596-019-01133-8

Cited by 27 publications

(22 citation statements)

References 16 publications

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“…However, the actual goal of most implicit bias training used in these settings stops short because training effectiveness is gauged merely by asking study participants to reflect on their own implicit bias (ie, assessment of changes in awareness) 23 or to retake the implicit association test (ie, assessment of changes in the levels of implicit bias). 24 To our knowledge, none of the current programmes evaluate their effectiveness on the basis of improved patient outcomes. Although research suggests that reduction in implicit bias should result in improved patient care, a previous study only compared care quality across health-care providers with different levels of implicit bias (ie, comparisons between people).…”

mentioning

confidence: 99%

A call for grounding implicit bias training in clinical and translational frameworks

et al. 2020

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confidence: 99%

A call for grounding implicit bias training in clinical and translational frameworks

et al. 2020

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“…A 4-hour workshop using educational strategies, such as a didactic lecture on the impact of stigma, group discussion, role play simulation, case discussions and self-reflection exercises, were included. While this implicit stigma reduction approach had mixed results, it proved to be a potential alternative to traditional stigma reduction educational approaches (Sukhera et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

“…An interesting aspect identified in a study (Sukhera et al, 2020) was related to the need to develop strategies that address implicit stigma, since stigmatizing attitudes and behaviors often manifest outside of consciousness (Sukhera et al, 2017). Despite the best intentions of educational strategies to combat stigma, implicit stigma may persist due to the limited reach of educational programs (Ashburn-Nardo, 2010; Gershan, 2013).…”

Section: Discussionmentioning

confidence: 99%

Health care providers and people with mental illness: An integrative review on anti-stigma interventions

Carrara

Fernandes

Bobbili

et al. 2020

Int J Soc Psychiatry

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Background: Health care providers are an important target group for anti-stigma interventions because they have the potential to convey stigmatizing attitudes towards people with mental illness. This can have a detrimental impact on the quality and effectiveness of care provided to those affected by mental illness. Aims and methods: Whittemore & Knafl’s integrative review method (2005) was used to analyze 16 studies investigating anti-stigma interventions targeting health care providers. Results: The interventions predominantly involved contact-based educational approaches which ranged from training on mental health (typically short-term), showing videos or films (indirect social contact) to involving people with lived experiences of mental illness (direct social contact). A few studies focused on interventions involving educational strategies without social contact, such as mental health training (courses/modules), distance learning via the Internet, lectures, discussion groups, and simulations. One study investigated an online anti-stigma awareness-raising campaign that aimed to reduce stigmatizing attitudes among health care providers. Conclusion: Anti-stigma interventions that involve social contact between health care providers and people with mental illness, target specific mental illnesses and include long-term follow-up strategies seem to be the most promising at reducing stigma towards mental illness among health care providers.

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“…Debriefing on implicit bias in a team or small group setting may counter the erosion of students’ professional ideals and ease the frustration of being aware of bias and feeling isolated in their efforts 23,32 . Research studies to date have not specifically studied team interventions, but implicit bias instruction delivered to an entire group of individuals with the same task yielded positive outcomes 27,48,49 . Both students and faculty in our previous work have expressed a desire to debrief about implicit bias 23,32 .…”

Section: Discussionmentioning

confidence: 99%

Qualitative analysis of medical student reflections on the implicit association test

et al. 2021

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Introduction Health professions educators use the Implicit Association Test (IAT) to raise awareness of implicit bias in learners, often engendering strong emotional reactions. Once an emotional reaction ensues, the gap between learner reaction and strategy identification remains relatively underexplored. To better understand how learners may identify bias mitigation strategies, the authors explored perspectives of medical students during the clinical portion of their training to the experience of taking the IAT, and the resulting feedback. Methods Medical students in Bronx, NY, USA, participated in one 90‐minute session on implicit bias. The focus of analysis for this study is the post‐session narrative assignment inviting them to take the race‐based IAT and describe both their reaction to and the implications of their IAT results on their future work as physicians. The authors analysed 180 randomly selected de‐identified essays completed from 2013 to 2019 using an approach informed by constructivist grounded theory methodology. Results Medical students with clinical experience respond to the IAT through a continuum that includes their reactions to the IAT, acceptance of bias along with a struggle for strategy identification, and identification of a range of strategies to mitigate the impact of bias on clinical care. Results from the IAT invoked deep emotional reactions in students, and facilitated a questioning of previous assumptions, leading to paradigm shifts. An unexpected contrast to these deep and meaningful reflections was that students rarely chose to identify a strategy, and those that did provided strategies that were less nuanced. Conclusion Despite accepting implicit bias in themselves and desiring to provide unbiased care, students struggled to identify bias mitigation strategies, a crucial prerequisite to skill development. Educators should endeavour to expand instruction to bridge the chasm between students’ acceptance of bias and skill development in management of bias to improve the outcomes of their clinical encounters.

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Implicit Stigma Recognition and Management for Health Professionals

Cited by 27 publications

References 16 publications

A call for grounding implicit bias training in clinical and translational frameworks

A call for grounding implicit bias training in clinical and translational frameworks

Health care providers and people with mental illness: An integrative review on anti-stigma interventions

Qualitative analysis of medical student reflections on the implicit association test

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