Implicit Bias in Health Care ___________________________________________________________________
One of the core features of ICP is sharing—professionals from different disciplines share their philosophies, values, perspec- tives, data, and strategies for planning of interventions [97]. ICP also involves the sharing of roles, responsibilities, deci- sion making, and power [98]. Everyone on the team employs their expertise, knowledge, and skills, working collectively on a shared, patient-centered goal or outcome [98; 99]. Another feature of ICP is interdependency. Instead of working in an autonomous manner, each team member’s contributions are valued and maximized, which ultimately leads to synergy [97]. At the heart of this are two other key features: mutual trust/respect and communication [99]. In order to share responsibilities, the differing roles and expertise are respected. ICP is a powerful tool to mitigate implicit biases. The inherent characteristics of ICP—enhanced communications, trust, and shared decision making—should help reduce implicit biases in the team. At the heart of ICP is also the promotion of equity, which builds in accountability and can facilitate learning about and increased awareness of members’ implicit biases [122]. Experts have recommended that a structural or critical theoretical perspective be integrated into core competencies in healthcare education to teach students about implicit bias, racism, and health disparities [100]. This includes [100]: • Values/ethics: The ethical duty for health professionals to partner and collaborate to advocate for the elimina- tion of policies that promote the perpetuation of implicit bias, racism, and health disparities among marginalized populations. • Roles/responsibilities: One of the primary roles and responsibilities of health professionals is to analyze how institutional and organizational factors promote racism and implicit bias and how these factors contrib- ute to health disparities. This analysis should extend to include one’s own position in this structure. • Interprofessional communication: Ongoing discussions of implicit bias, perspective taking, and counter- stereotypical dialogues should be woven into day-to-day practice with colleagues from diverse disciplines. • Teams/teamwork: Health professionals should develop meaningful contacts with marginalized communities in order to better understand whom they are serving. Adopting approaches from the fields of education, gender studies, sociology, psychology, and race/ethnic studies can help build curricula that represent a variety of disciplines [78]. Students can learn about and discuss implicit bias and its impact, not simply from a health outcomes perspective but holistically. Skills in problem-solving, communication, leader- ship, and teamwork should be included, so students can effect positive social change [78].
CONCLUSION In the more than three decades since the introduction of the IAT, the implicit bias knowledge base has grown significantly. It is clear that most people in the general population hold implicit biases, and health professionals are no different. While there continue to be controversies regarding the nature, dynamics, and etiology of implicit biases, it should not be ignored as a contributor to health disparities, patient dissatisfaction, and suboptimal care. Given the complex and multifaceted nature of this phenomenon, the solutions to raise individuals’ awareness and reduce implicit bias are diverse and evolving.
RESOURCES
American Bar Association Diversity and Inclusion Center Toolkits and Projects https://www.americanbar.org/groups/diversity/resources/ toolkits National Implicit Bias Network https://implicitbias.net/resources/resources-by-category The Ohio State University The Women’s Place: Implicit Bias Resources https://womensplace.osu.edu/resources/implicit-bias- resources The Ohio State University Kirwan Institute for the Study of Race and Ethnicity http://kirwaninstitute.osu.edu University of California, Los Angeles Equity, Diversity, and Inclusion: Implicit Bias https://equity.ucla.edu/know/implicit-bias University of California, San Francisco, Office of Diversity and Outreach Unconscious Bias Resources https://diversity.ucsf.edu/resources/unconscious-bias- resources Unconscious Bias Project https://unconsciousbiasproject.org Health Care Access Now https://healthcareaccessnow.org/implicit-bias-resources
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