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Evidence-Based Implicit Bias Implications for Physicians and Healthcare Professionals Summary
CASE STUDY - EXERCISE 2 John is a White nurse caring for a Black pregnant woman in an obstetrics unit in a hospital. The patient is a lesbian and had an in vitro fertilization. Her partner is White and asks to speak to you in private and not in the patient’s room. The partner mentions that she recently saw a news story about how Black women are treated unfairly in comparison to White women. You’re sure that her partner will be given the same level of care as other patients, and you give this reassurance consciously in a deliberate manner. However, you know that, in addition to this conscious process, there are potential areas of implicit bias that might occur, both in decision making and in communication. Question 1: How might the racial difference between the nurse, John, and the patient influence provider-patient communication? Commentary on question 1 : Given the history of racism in America, racial discordance between provider and patient may negatively impact trust in the clinical encounter. Black patients may have experienced racial insensitivities, bias, or discrimination in the past and may be vigilant for signs of caring and trust from the provider. In addition to racial implicit bias, there can be implicit bias based on other characteristics, such as sexual orientation. Question 2: How might implicit bias show up in this case? Commentary on question 2 : Given that there might be a difference between conscious attempts to be fair and equitable and implicit bias, care needs to be taken to ensure that word choice and nonverbal communication (eye contact, smiling, etc.) do not reflect unintentional bias. Self reflection and awareness can be useful tools. Reflecting on the question, Would I react differently if the patient was White or heterosexual? can be a useful strategy. Mitigating Implicit Bias
3. Organization Systems and Processes: Mitigating unconscious bias in rewards and recognition, as well as in selection decisions, is of critical importance in the work to increase the diversity of medical students, clinical providers, researchers, managers, and senior healthcare providers 4. Cues and Reminders: Information about implicit bias as well as motivation to reflect on personal biases can begin to fade months and even weeks after the initial intervention. Strategies to stimulate recall or remind providers about the work to mitigate implicit bias can be useful 5. Disparities in access to and delivery of health care services
There are several strategies that have shown promise in mitigating or reducing the occurrence of implicit bias: 1. Increasing Knowledge: useful for workshops and presentations to describe how implicit bias develops and its relationship to societal stereotypes (race, gender, sexual orientation, disability, etc.) 2. Self-Awareness: personal tendencies or becoming aware of an area of personal bias can help in modifying communication, where necessary
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