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Implicit Bias Training in Health Care [60 Sec Psych]

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What practical role do we have as mental health professionals in creating a more fair and just society? Doctors Javeed Sukhera and Chris Watling published a framework for integrating implicit bias recognition in medical education that makes a lot of sense. Here’s their six point framework. Sukhera J, Watling C. A Framework for Integrating Implicit Bias Recognition Into Health Professions Education. Acad Med. 2018;93(1):35‐40. doi:10.1097/ACM.0000000000001819 [Link]

Published On: 7/18/20

Duration: 3 minutes, 38 seconds

Transcript:

Mara: Today on 60 Second Psych, Recognizing Implicit Bias in Health Care.

Dr. Feder: What practical role do we have as mental health professionals in creating a more fair and just society? Doctors Javeed Sukhera and Chris Watling published a framework for integrating implicit bias recognition in medical education that makes a lot of sense. Here’s their six point framework.

Point Number 1: Creating a safe and nonthreatening learning context.

The authors recommend setting the stage by acknowledging bias is everywhere. Any discomfort, guilt, or resentment participants may feel is a common human experience and those feelings can be openly addressed in a safe, nonjudgmental learning environment.

Point Number 2: Increasing knowledge about the science of implicit bias.

Bias is a result of neurobiological mechanisms and psychological processes outside of our conscious awareness. Understanding this research sets apart this kind of training from typical diversity training you might find in corporations.

Point Number 3: Emphasizing how implicit bias influences behaviors and patient outcomes.

A key component of this framework is citing statistics and research on implicit bias in medical education, as well as discussing the impact of internalized bias on stereotypes. 

This helps motivate learners to take the next step in…

Point Number 4: Increasing self-awareness of existing implicit biases.

Time to take an implicit association test or I-A-T. I’ve put link to Harvard’s Project Implicit version in the show notes. It’s a computer-based exercise that demonstrates an association between groups of people and stereotypes. There are valid criticisms of IAT, so nobody should look at their score as a definitive metric of their bias. It’s simply a demonstration of the facts already laid out and an opportunity to reflect and think “Bias is everywhere. To some degree I have bias. What can I do about it?” 

Which leads to…

Point Number 5: Improving conscious efforts to overcome implicit bias.

This is where we practice thinking about our thinking, or mindfulness training. As we make conclusions, we periodically take the time to interrogate the thinking behind each conclusion to determine if it’s fact-based, or bias-based. 

Point Number 6: Enhancing awareness of how implicit bias influences others.

Now we use the awareness we have of our own bias to focus on empathy. It’s time to put ourselves in our patients’ shoes, and in their family’s shoes for that matter. 

The authors demonstrate this by citing a research study of nurses who were shown pictures of either white or black patients with expressions of pain. The nurses who were asked to recommend doses of pain medication based on their best judgment gave more pain medication to white patients. 

The nurses who were instructed to imagine how the patient felt recommended equal treatment. 

The authors go into more detail on designing specific interventions, including social-contact-based strategies of inviting patients who have experienced bias to speak with the learners. and I recommend taking a look at the study for more details. The key takeaway is that implicit bias training can be part of everyone’s medical training, and there’s a lot of research behind it. 

Today on 60 Second Psych, Recognizing Implicit Bias in Health Care.

Josh: What practical role do we have as mental health professionals in creating a more fair and just society? Doctors Javeed Sukhera and Chris Watling published a framework for integrating implicit bias recognition in medical education that makes a lot of sense. Here’s their six point framework.

Point Number 1: Creating a safe and nonthreatening learning context.

The authors recommend setting the stage by acknowledging bias is everywhere. Any discomfort, guilt, or resentment participants may feel is a common human experience and those feelings can be openly addressed in a safe, nonjudgmental learning environment.

Point Number 2: Increasing knowledge about the science of implicit bias.

Bias is a result of neurobiological mechanisms and psychological processes outside of our conscious awareness. Understanding this research sets apart this kind of training from typical diversity training you might find in corporations.

Point Number 3: Emphasizing how implicit bias influences behaviors and patient outcomes.

A key component of this framework is citing statistics and research on implicit bias in medical education, as well as discussing the impact of internalized bias on stereotypes. 

This helps motivate learners to take the next step in…

Point Number 4: Increasing self-awareness of existing implicit biases.

Time to take an implicit association test or I-A-T. I’ve put link to Harvard’s Project Implicit version in the show notes. It’s a computer-based exercise that demonstrates an association between groups of people and stereotypes. There are valid criticisms of IAT, so nobody should look at their score as a definitive metric of their bias. It’s simply a demonstration of the facts already laid out and an opportunity to reflect and think “Bias is everywhere. To some degree I have bias. What can I do about it?” 

Which leads to…

Point Number 5: Improving conscious efforts to overcome implicit bias.

This is where we practice thinking about our thinking, or mindfulness training. As we make conclusions, we periodically take the time to interrogate the thinking behind each conclusion to determine if it’s fact-based, or bias-based. 

Point Number 6: Enhancing awareness of how implicit bias influences others.

Now we use the awareness we have of our own bias to focus on empathy. It’s time to put ourselves in our patients’ shoes, and in their family’s shoes for that matter. 

The authors demonstrate this by citing a research study of nurses who were shown pictures of either white or black patients with expressions of pain. The nurses who were asked to recommend doses of pain medication based on their best judgment gave more pain medication to white patients. 

The nurses who were instructed to imagine how the patient felt recommended equal treatment. 

The authors go into more detail on designing specific interventions, including social-contact-based strategies of inviting patients who have experienced bias to speak with the learners. and I recommend taking a look at the study for more details. The key takeaway is that implicit bias training can be part of everyone’s medical training, and there’s a lot of research behind it. 

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