23
Evidence-Based Implicit Bias Implications for Physicians and Healthcare Professionals: Summary 23
Race of the woman appears to be A strong factor of implicit bias in maternal care. Research related to race and childbirth indicates that Black women are twice as likely to deliver a premature baby than White women. Studies of women dying during childbirth or during the postpartum period indicates Black women are 3-4 times more likely to die during childbirth than White women. Implicit bias has also been shown to impact the quality of the clinical encounter, particularly communication. Provider race bias on the IAT was associated with lower quality communication with Black patients, such as more provider verbal dominance, lower patient positive affect, poorer patient ratings of interpersonal care, lower perceptions of respect from clinicians, and lower likelihood of recommending the clinician. Additionally, an example of bias via non-verbal communication is medical professional standing further away from a black patient. 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.
Case Study - Exercise 2 (continued) 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 vig- ilant 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. Selfreflection 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.
Powered by FlippingBook