Confirmation Bias: The tendency to look for information that supports our existing beliefs and reject data that challenges what we believe. Group Think: When a group concludes without opposing views, particularly when under pressure (consciously or Microaggressions Microaggressions are defined as the everyday, subtle, intentional—and oftentimes unintentional—interactions or behaviors that communicate some sort of bias toward historically marginalized groups. 48 A microaggression is a subtle verbal or nonverbal behavior, committed consciously or not, that is directed at a member of a marginalized group and has a harmful, derogatory effect . 49 Self-Assessment Question Which of the following are examples of microaggressions? a. A patient is waiting to see a medical professional in the hospital. A woman enters the room, and the patient assumes that she is a nurse instead of a doctor. b. A person meets someone who is a visible minority and asks where they are “really from.” CHAPTER 417 An act to amend Sections 2190.1 and 3524.5 of, and to add Section 2736.5 to, the Business and Professions Code, relating to healing arts. [Approved by Governor October 02, 2019. Filed with Secretary of State October 02, 2019.] LEGISLATIVE COUNSEL'S DIGEST This bill would require the Board of Registered Nursing, by January 1, 2022, to adopt regulations requiring all continuing education courses for its licensees to contain curriculum that includes specific instruction in the understanding of implicit bias in treatment. Beginning January 1, 2023, the bill would require continuing education providers to comply with these provisions and would require the board to audit education providers for compliance with these provisions, as specified. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. The Legislature finds and declares all of the following: i. Implicit bias, meaning the attitudes or internalized stereotypes that affect our perceptions, actions, and decisions in an unconscious manner, exists, and often contributes to unequal treatment of people based on race, ethnicity, gender identity, sexual orientation, age, disability, and other characteristics. j. Implicit bias contributes to health disparities by affecting the behavior of physicians and surgeons, nurses, physician assistants, and other healing arts licensees. k. Evidence of racial and ethnic disparities in healthcare is remarkably consistent across a range of illnesses and healthcare services. Racial and ethnic disparities remain even after adjusting for socioeconomic differences, insurance status, and other factors influencing access to healthcare.
subconsciously) to form a consensus, or when facing external threats, such as time pressures. Halo or Horns Bias: Allowing our judgment to be influenced by one particular trait (either positive or negative).
c. A person is walking down the street and crosses to the other side of the road to avoid someone (out of fear) because of their outward appearance (i.e., a visible minority). d. Someone tells a person who is LGBTQ that they don’t “seem gay.” e. A woman speaks up during a business meeting and afterward is told that she was being too assertive. f. A person who is a visible minority is told that they are very articulate. g. A person who is a visible minority (e.g., Asian) is told that they must be good in math because of their ethnicity. h. The pronouns used in a document or other communication exclude women or other groups of individuals (e.g., LGBTQ). l. African American women are three to four times more likely than White women to die from pregnancy-related causes nationwide. African American patients often are prescribed less pain medication than White patients who present the same complaints, and African American patients with signs of heart problems are not referred for advanced cardiovascular procedures as often as White patients with the same symptoms. m. Implicit gender bias also impacts treatment decisions and outcomes. Women are less likely to survive a heart attack when they are treated by a male physician and surgeon. LGBTQ and gender-nonconforming patients are less likely to seek timely medical care because they experience disrespect and discrimination from healthcare staff, with one out of five transgender patients nationwide reporting that they were outright denied medical care due to bias. n. The Legislature intends to provide specified healing arts licensees with strategies for understanding and reducing the impact of their biases in order to reduce disparate outcomes and ensure that all patients receive fair treatment and quality healthcare. The process of implicit bias in no way diminishes the importance of conscious, deliberate behavior. Physicians’ conscious endorsements of the values of equity and fairness can be an important element of their service to patients. In addition to deeply held values, creating equitable healthcare environments requires physicians’ conscious actions to build systems and processes that move them towards the elimination of disparities. It is not only the responsibility of those with particular titles, like a chief diversity officer, 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.
ASSEMBLY BILL NO. 241
Book Code: PCIL1525
Page 94
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