A call for grounding implicit bias training in clinical and translational frameworks

• Published in: The Lancet (British edition) 2020-05, Vol.395 (10234), p.1457-1460
• Main Authors: Hagiwara, Nao, Kron, Frederick W, Scerbo, Mark W, Watson, Ginger S
• Format: Article
• Language: English
• Subjects: Administrative Personnel - ethics; Affect - physiology; Attitude of Health Personnel - ethnology; Bias; Clinical outcomes; Cognition - physiology; Elections; Faculty, Medical - education; Faculty, Medical - psychology; Health care; Health disparities; Health Personnel - education; Health Personnel - ethics; Healthcare Disparities - ethnology; Healthcare Disparities - statistics & numerical data; Humans; Medical schools; Motivation; Patients; Prejudice; Prejudice - psychology; Schools; Social Discrimination - psychology; Social psychology; Stereotypes; Stereotyping; Training; United States - epidemiology
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(20)30846-1

Since the publication of Unequal Treatment in 2003,1 the number of studies investigating the implicit bias of health-care providers and its troubling consequences has increased exponentially. Literature on health disparities focuses primarily on implicit prejudice and few studies have systematically investigated the role of implicit stereotyping in patient care.5 Consequently, implicit bias in previous research generally refers to implicit prejudice. [...]we specify whether we mean implicit prejudice or implicit stereotyping, particularly when we review findings from previous studies. [...]several candidates for the 2020 US presidential election acknowledged the role of health-care providers' implicit bias in racial or ethnic health disparities and have demanded remediation.8 On Oct 2, 2019, California assembly bill no 241 was signed into law,9 mandating implicit bias training for health-care providers, and thereby making it probable that other US medical schools and health organisations will follow suit. A programme that taught college students about five evidence-based strategies for reducing implicit bias (ie, stereotype replacement, counter-stereotypical imaging, individuating, perspective taking, and contact) resulted in lower implicit racial prejudice, as measured by an implicit association test, 8 weeks after the intervention.20 These findings suggest that implicit bias training should also provide health-care providers with concrete strategies to reduce their implicit bias.