Investigating the Relationship between Resident Physician Implicit Bias and Language Use during a Clinical Encounter with Hispanic Patients.

Prior research suggests that the implicit biases of physicians are negatively associated with quality of medical care and patient satisfaction among minority patients. However, relatively little is known about how physicians express these subtle forms of bias in patient interactions. This study examined the implicit and explicit anti-Hispanic biases of 53 resident physicians and the relationship between anti-Hispanic bias and language use during outpatient medical appointments with 291 Hispanic patients. Physician implicit bias was positively associated with use of interrogatives and work-related words and negatively associated with the use of prepositions and relativity-related words (e.g., words related to time and the future). These findings contribute to the growing body of evidence suggesting that, in addition to nonverbal and paraverbal behaviors, providers may communicate implicit bias to patients through the words they use during a clinical visit.

Testing active learning workshops for reducing implicit stereotyping of Hispanics by majority and minority group medical students.

The present research tested if having first year medical students complete active learning workshops would reduce their implicit stereotyping of Hispanics as medically noncompliant. The workshops were tested with 78-majority (White) group, 16-target minority (Hispanic, African-American and American-Indian) group, and 42-non-target minority (Asian-American and foreign born students from East Asia and Southeast Asia) group students in the 2018 and 2021 classes in the American Southwest. Prior to the workshops, students completed an implicit association test (IAT), and then participated in two workshops that covered the psychology of intergroup bias, the role of implicit bias in patient care, and activities for learning six strategies for controlling the implicit stereotyping of patients. The results showed that before the workshops, the level of implicit stereotyping of Hispanics was significant for the majority and non-target minority group students, but it was not significant for the target minority group students. After the workshops, target minority students again showed no bias, and implicit stereotyping was significantly lower for the majority group students, but not for the non-target minority students. The results suggest that the workshops may have been effective for majority group and target minority group students, but that more cultural tailoring of the materials and activities may be necessary to address implicit bias among some minority group medical students.

Implicit bias toward cervical cancer: Provider and training differences.

OBJECTIVE: Implicit prejudice and stereotyping may exist in health care providers automatically without their awareness. These biases can correlate with outcomes that are consequential for the patient. This study examined gynecologic oncology care providers' implicit prejudice and stereotyping toward cervical cancer. METHODS: Members of professional gynecologic oncology organizations were asked to complete two Implicit Association Tests to determine if they implicitly associate cervical cancer with feelings of anger (prejudice) and beliefs about culpability for the disease (stereotypes), compared to ovarian cancer. Linear models and Student t-tests examined average levels of implicit bias and moderators of the implicit bias effects. RESULTS: One-hundred seventy-six (132 female, 43 male, 1 nonresponse; X¯age = 39.18 years, SDage = 10.58 years) providers were recruited and the final sample included 151 participants (93 physicians and 58 nurses, X¯age = 38.93, SDage = 10.59). Gynecologic oncology providers showed significant levels of implicit prejudice, X¯â€¯= 0.17, SD = 0.47, 95% CI: (0.10, 0.25), toward cervical cancer patients. They also showed significant levels of implicit stereotyping of cervical cancer patients, X¯â€¯= 0.15, SD = 0.42, 95% CI: (0.08, 0.21). Whereas physicians did not demonstrate significant levels of implicit bias, nurses demonstrated greater levels of implicit prejudice and implicit stereotyping. Providers without cultural competency/implicit bias training demonstrated greater bias than those who had completed such training (p < .05). CONCLUSIONS: This study provides the first evidence that gynecologic oncology providers hold implicit biases related to cervical cancer. Interventions may be designed to target specific groups in gynecologic oncology to improve interactions with patients.