129 Evidence Based Implicit Bias Implications for Physicians and Healthcare Professionals
scious endorsements of the values of equity and fairness can be an important element of their service to patients. In ad- dition to deeply held values, creating eq- uitable healthcare environments requires physicians’ conscious actions to build sys- tems and processes that move them to- wards the elimination of disparities. It is not only the responsibility of those with particular titles, like a chief diversity offi - cer, but all healthcare providers must be “activists” in their own areas of work: in the treatment room, in the laboratory, or in the administrative suite. The focus on implicit bias does not absolve providers of conscious, focused, deliberate action, it simply highlights an important parallel process. EARLY CHILDHOOD RESEARCH Did you know? Much of the research on implicit bias has only occurred in the last 40 years. It has provided increasing support for theories related to the development of implicit biases and ways in which unconscious biases impact decision making. One of the important areas of implic- it bias research focuses on the question, how early in one’s development does im- plicit bias begin to show up? Recent re- search suggests that the foundation for what later shows up as implicit bias oc- curs in infancy. For example, if we track the eyes of infants, at about 4 weeks of age, they will stare longer and more fre- quently at female faces if a woman has been the primary caregiver. This is clearly not implicit bias, but it appears to reflect a differential association or a preference. This process of differential response in terms of what types of faces infants tend
to stare at continues to evolve (Balas et al., 2011; Lee at al., 2017). Although care has to be taken to not infer bias from in- fant behavior, it appears that responsive- ness to faces that are similar to the infant or the individual who provides nurturing/ food may be a precursor to preferences later in development. As toddlers and older children begin to spend time online, watch television, and read books, they sense the race or gender of the people who tend to be in leadership roles, those who appear dan- gerous, those who are police and fire people, those who are doctors, etc. In- equities and biases in the broader society get incorporated into media, which get consumed by children, whether intention- ally or not. These portrayals then influ - ence and shape unconscious associations in children of all ages (Williams & Steele, 2017). Children are also influenced by the behavior of parents, caregivers, and other significant adults in their life, notic - ing the complexion and gender of their close friends, as well as comments and jokes. It’s not only the things that parents and caregivers say to convey fairness and kindness for all people, but it’s also what children observe day-to-day in the behav- ior of those adult models (Pirchio et al., 2018). The process of unconscious associa- tions can also be seen in the way adults begin to view and interact with children. In a study at the Yale Child Study Center in 2016, preschool teachers viewed videos of African American and White children walking around a classroom, talking and interacting with each other (Gilliam et al., 2016). The viewing device also recorded who and what the teachers were looking at during the study. When teachers were told that there might be challenging be-
Powered by FlippingBook