Background: Unconscious attitudes, also known as implicit biases are ubiquitous and their effects are wide-ranging. From something as seemingly insignificant as the clutching of a purse in lieu of a passerby to something of potential great consequence such as the lack of a surgical referral, the fingerprints of implicit bias are on many of the decisions we make. However hard it is to conceive, physicians’ patient care decisions are not immune to the influence of unconscious beliefs and attitudes, and the data showing the effect of implicit bias on healthcare disparities is growing. Mirroring the societal disparities seen in the criminal justice system and employment, in healthcare, the divide is just as great. Given the strong data linking implicit bias to healthcare disparities, it is very important to promote awareness of implicit bias in not only healthcare, but also healthcare providers as individuals. Our study looked to increase resident awareness and confidence in managing unconscious attitudes and beliefs that may be affecting patient care.
Methods: Participants were 53 internal medicine, pediatric and family medicine residents at OU-TU School of Community Medicine. Between August 2018 and October 2018, during Academic Grand Rounds, participants attended a 90-minute implicit bias workshop. The interactive workshop looked to define implicit bias, demonstrate its origins and show its societal impact via lecture, hands-on activities and small group discussion. Via a 7-point Likert scale, a pre and post-workshop questionnaire measured participants’ awareness of implicit bias and confidence in discovering and managing implicit attitudes. Data was analyzed via paired T-test analysis.
Results: There was a mean increase of resident physicians’ awareness of general, personal implicit bias (mean increase of 0.938, P<.001) and awareness of implicit bias toward patients (mean increase 0.698, P<.001). The results also reflected an increase in confidence in discovering personal implicit bias (mean increase 0.358, P<.001) and in management of implicit attitudes discovered about patients (mean increase 0.321, P<.001).
Conclusions: Our implicit bias workshop proved successful in increasing resident awareness of their vulnerability to unconscious attitudes and in increasing their confidence in recognizing and managing these same attitudes. Although increasing awareness, alone is not an adequate strategy for eliminating implicit bias, it has been shown to be effective in beginning to limit unconscious bias. Paired with increased confidence in recognizing and managing these biases, this workshop appears to be a practical and effective first step towards combatting implicit bias.