Mitigating Implicit Bias in Patient-Clinician Communication in Clinical Encounters: Early Insights from the COmmuNity-engaged SimULation Training (CONSULT) Trial

Abstract

<jats:title>Abstract</jats:title> <jats:p>BackgroundTo address the gap in knowledge about how to design feasible and acceptable trainings for clinicians that aim to mitigate implicit bias in clinical encounters, we report the early insights from the COmmuNity-engaged SimULation Training for Blood Pressure Control (CONSULT) Trial.MethodsWe engaged academic and community stakeholders to design, pilot test and implement a training program addressing healthcare disparities knowledge, bias awareness, and communication skills focused on bias mitigation. A stepped wedge cluster randomized trial was developed to determine intervention dose effects. We assessed the CONSULT training program through structured feedback using online surveys, real-time comments, and individualized feedback from trainees, faculty and standardized patients.ResultsThe first training cohort completed the intervention (N = 64). Feedback prompted training program revisions as follows: reducing overall time burden and the number of implicit bias assessments; supplementing on-line learning with augmented in-person interactive sessions. Feedback also reinforced the critical importance of having highly skilled facilitators versed in implicit bias.ConclusionsIterative stakeholder engagement is essential for developing and revising educational interventions aimed at raising bias awareness and mitigating the effects of implicit bias.Trial RegistrationClinicalTrials.gov, NCT 03375918. Registered December 18, 2017, https://clinicaltrials.gov/ct2/show/NCT03375918?id=NCT+03375918&amp;draw=2&amp;rank=1</jats:p>

Battling Bias in Primary Care Encounters: Informatics Designs to Support Clinicians

“…Simulation occurs outside of real-world patient care and is thus advantageous for clinicians to confront discomfort often associated with implicit bias communication feedback. For example, simulated encounters with standardized patients can eliminate fears of actual harm to patients[ 29 , 30 ]. Role-play and vignettes are also strategies to address implicit bias[ 31 ], such as videotaped social history vignettes[ 32 ].…”