scholarly journals Implicit Bias Training in Residency Program: Aiming for Enduring Effects

2019 ◽  
Vol 51 (8) ◽  
pp. 677-681 ◽  
Author(s):  
Michelle D. Sherman ◽  
Jason Ricco ◽  
Stephen C. Nelson ◽  
Sheila J. Nezhad ◽  
Shailendra Prasad
Keyword(s):  
Focus Groups ◽  
Health Care Professionals ◽  
Racial Bias ◽  
Implicit Bias ◽  
Residency Training Program ◽  
Educational Interventions ◽  
Institutional Capacity ◽  
Structural Racism ◽  
Implicit Biases ◽  
National Expert

Background and Objectives: Implicit bias often affects patient care in insidious ways, and has the potential for significant damage. Several educational interventions regarding implicit bias have been developed for health care professionals, many of which foster reflection on individual biases and encourage personal awareness. In an attempt to address racism and other implicit biases at a more systemic level in our family medicine residency training program, our objectives were to offer and evaluate parallel trainings for residents and faculty by a national expert. Methods: The trainings addressed how both personal biases and institutional inequities contribute to structural racism, and taught skills for managing instances of implicit biases in one’s professional interactions. The training was deliberately designed to increase institutional capacity to engage in crucial conversations regarding implicit bias. Six months after the trainings, an external evaluator conducted two separate 1-hour focus groups, one with residents (n=18) and one with program faculty and leadership (n=13). Results: Four themes emerged in the focus groups: increased awareness of and commitment to addressing racial bias; appreciation of a safe forum for sharing concerns; new ways of addressing and managing bias; and institutional capacity building for continued vigilance and training regarding implicit bias. Conclusions: Both residents and faculty found this training to be important and empowering. All participants desired an ongoing programmatic commitment to the topic.

scholarly journals Stability and Change in Implicit Bias

2019 ◽  
Vol 30 (6) ◽  
pp. 854-862 ◽  
Author(s):  
Heidi A. Vuletich ◽  
B. Keith Payne
Keyword(s):  
Racial Bias ◽  
Implicit Bias ◽  
Social Environments ◽  
Structural Inequality ◽  
Stability And Change ◽  
University Campuses ◽  
Implicit Biases ◽  
The Stability ◽  
Original Interpretation ◽  
Individual Scores

Can implicit bias be changed? In a recent longitudinal study, Lai and colleagues (2016, Study 2) compared nine interventions intended to reduce racial bias across 18 university campuses. Although all interventions changed participants’ bias on an immediate test, none were effective after a delay. This study has been interpreted as strong evidence that implicit biases are difficult to change. We revisited Lai et al.’s study to test whether the stability observed reflected persistent individual attitudes or stable environments. Our reanalysis ( N = 4,842) indicates that individual biases did not return to preexisting levels. Instead, campus means returned to preexisting campus means, whereas individual scores fluctuated mostly randomly. Campus means were predicted by markers of structural inequality. Our results are consistent with the theory that implicit bias reflects biases in the environment rather than individual dispositions. This conclusion is nearly the opposite of the original interpretation: Although social environments are stable, individual implicit biases are ephemeral.

scholarly journals To Blame? The Effects of Moralized Feedback on Implicit Racial Bias

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Robin Scaife ◽  
Tom Stafford ◽  
Andreas Bunge ◽  
Jules Holroyd
Keyword(s):  
Racial Bias ◽  
Implicit Bias ◽  
Feedback Condition ◽  
Future Research ◽  
Behavioural Intentions ◽  
Implicit Racial Bias ◽  
Implicit Biases ◽  
Neutral Tone ◽  
The Impact ◽  
Intentions To Change

Implicit bias training (IBT) is now frequently provided by employers, in order to raise awareness of the problems related to implicit biases, and of how to safeguard against discrimination that may result. However, as Atewologun et al. (2018) have noted, there is very little systematicity in IBT, and there are many unknowns about what constitutes good IBT. One important issue concerns the tone of information provided regarding implicit bias. This paper engages this question, focusing in particular on the observation that much bias training is delivered in exculpatory tone, emphasising that individuals are not to blame for possessing implicit biases. Normative guidance around IBT exhorts practitioners to adopt this strategy (Moss-Racusin et al. 2014). However, existing evidence about the effects of moralized feedback about implicit bias is equivocal (Legault et al. 2011; Czopp et al. 2006). Through a series of studies, culminating in an experiment with a pre-registered analysis plan, we develop a paradigm for evaluating the impact of moralized feedback on participants’ implicit racial bias scores. We also conducted exploratory analyses of the impact on their moods, and behavioural intentions. Our results indicated that an exculpatory tone, rather than a blaming or neutral tone, did not make participants less resistant to changing their attitudes and behaviours. In fact, participants in the blame condition had significantly stronger explicit intentions to change future behaviour than those in the ‘no feedback’ condition (see experiment 3). These results indicate that considerations of efficacy do not support the need for implicit bias feedback to be exculpatory. We tease out the implications of these findings, and directions for future research.

The Mixed Outcomes of Taking Ownership for Implicit Racial Biases

2018 ◽  
Vol 44 (10) ◽  
pp. 1424-1434 ◽  
Author(s):  
Erin Cooley ◽  
Ryan F. Lei ◽  
Taylor Ellerkamp
Keyword(s):  
Black People ◽  
Racial Bias ◽  
Implicit Bias ◽  
Prejudice Reduction ◽  
Implicit Measure ◽  
Implicit Racial Bias ◽  
Implicit Biases ◽  
Explicit Prejudice ◽  
Mixed Outcomes ◽  
Potential Strategy

One potential strategy for prejudice reduction is encouraging people to acknowledge, and take ownership for, their implicit biases. Across two studies, we explore how taking ownership for implicit racial bias affects the subsequent expression of overt bias. Participants first completed an implicit measure of their attitudes toward Black people. Then we either led participants to think of their implicit bias as their own or as stemming from external factors. Results revealed that taking ownership for high implicit racial bias had diverging effects on subsequent warmth toward Black people (Study 1) and donations to a Black nonprofit (Study 2) based on people’s internal motivations to respond without prejudice (Internal Motivation Scale [IMS]). Critically, among those low in IMS, owning high implicit bias backfired, leading to greater overt prejudice and smaller donations. We conclude that taking ownership of implicit bias has mixed outcomes—at times amplifying the expression of explicit prejudice.

Reply to Connor and Evers (2020): Critique of the Bias of Crowds Model Simply Restates the Model

2020 ◽  
Author(s):  
Keith Payne ◽  
Heidi A. Vuletich ◽  
Kristjen B. Lundberg
Keyword(s):  
Implicit Bias ◽  
Group Level ◽  
Systemic Racism ◽  
Individual Level ◽  
The Core ◽  
Psychological Science ◽  
Implicit Biases ◽  
The Individual

The Bias of Crowds model (Payne, Vuletich, & Lundberg, 2017) argues that implicit bias varies across individuals and across contexts. It is unreliable and weakly associated with behavior at the individual level. But when aggregated to measure context-level effects, the scores become stable and predictive of group-level outcomes. We concluded that the statistical benefits of aggregation are so powerful that researchers should reconceptualize implicit bias as a feature of contexts, and ask new questions about how implicit biases relate to systemic racism. Connor and Evers (2020) critiqued the model, but their critique simply restates the core claims of the model. They agreed that implicit bias varies across individuals and across contexts; that it is unreliable and weakly associated with behavior at the individual level; and that aggregating scores to measure context-level effects makes them more stable and predictive of group-level outcomes. Connor and Evers concluded that implicit bias should be considered to really be noisily measured individual construct because the effects of aggregation are merely statistical. We respond to their specific arguments and then discuss what it means to really be a feature of persons versus situations, and multilevel measurement and theory in psychological science more broadly.

scholarly journals Health care network for chronic conditions: an intervention and evaluation in the health system

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C S Cardoso ◽  
N R Baldoni ◽  
C F Melo ◽  
L O Rezende ◽  
K Noronha ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Professionals ◽  
Chronic Conditions ◽  
Panel Study ◽  
Health Indicators ◽  
Institutional Capacity ◽  
Local Health ◽  
Care Network ◽  
Health Care Network

Abstract Background Health assessments are necessary for the (re) formulation of effective public policies and to guarantee the quality of care offered. This study aim to evaluate the perception of health professionals concerning the institutional capacity of the health system to care for Chronic Conditions (CC) after intervention in a medium-sized municipality in Minas Gerais, Brazil. Methods It is a panel study with evaluation before, during and after an intervention in the health system with a focus on three CC, i.e., i) diabetes; ii) hypertension; and iii) pregnant women. Health care professionals from primary and specialized care units were interviewed using the Assessment of Chronic Illness Care (ACIC) scale, which was applied in nine focal groups organized by health care unit. Results A total of 240 professionals participated of this evaluation, being 94, 63 and 82 participants in 2013, 2015 and 2018 respectively. The ACIC scores showed an positive evolution in the capacity of the health system to care for CC over the years. In the first wave the global score was 5.40 (basic capacity), while in the third wave the score was 9.38 (optimal capacity), with a significant increase in the scores (p < 0.01). Conclusions An important gain in the institutional capacity of the municipality was evidenced for the care of chronic conditions after intervention in the health system. Such an enhancement of the health system to operate in the CC might be sustainable over the time. Furthermore, its impact may directly reflect on the health indicators of the population. Key messages The results showed a strengthening of the local health system. These findings can subsidize other municipalities with a similar reality in the organization of the health care network and, consequently improve the care provided to chronic conditions.

scholarly journals Knowledge, attitudes and behaviours towards vaccination: a survey of university students in Europe

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Callegaro ◽  
L Chinenye Ilogu ◽  
O Lugovska ◽  
S Mazzilli ◽  
A Prugnola ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Health Care Professionals ◽  
Online Survey ◽  
Educational Interventions ◽  
Cross Sectional ◽  
High Level ◽  
Coverage Rates ◽  
The University ◽  
Vaccination Knowledge

Abstract Background Immunisation programs are still facing substantial challenges in achieving target coverage rates. This has been attributed to the growing negative individual vaccination attitudes and behaviours. Most of the current studies assessing vaccination knowledge, attitude and beliefs targets adults. However, young people represent future parents and health care professionals. The objective of this study was to investigate vaccination knowledge attitudes and behaviours among university medical and non-medical students in Europe. Methods We performed a cross-sectional online survey between April and July 2018. The study participants were students attending different faculties at the University of Antwerp, Belgium and the University of Pisa, Italy. We described sample characteristics. The effect of risk factors was tested with univariate and multivariate logistic regressions. Results A total of 2079 participants completed the survey including 873 medical students and 1206 from other faculties. The average of vaccination knowledge, attitudes, and confidence was respectively 5.51 (SD: 1.41), 4.66 (SD: 0.14) and 5.28 (SD: 0.57) on the 6-points scale. Our respondents demonstrated a high level of awareness with respect to their vaccination history. In total, 67.7% (n = 1407) reported to have received at least one vaccine in the previous five years; only 6.0% (n = 35) did not receive any vaccine in the previous 10 years. According to logistic regression analysis Italian students had significantly higher knowledge, attitude and confidence scores than Belgium respondents. Students of medicine scored significantly higher compared to non-medical students. Conclusions In order to reduce the gaps in vaccinations knowledge between non-medical and medical students we should plan educational interventions. In this way the number of future sceptical parents could be decreased. Further studies are required to explain the differences between countries. Key messages Young adults are the parents and the health care professionals of the future, for this reason their vaccination knowledge attitudes and behaviours should be carefully monitored. European non-medical students have lower vaccinations knowledge, attitudes and confidence compared with medical student. In order to fill these gaps, we should plan educational interventions.

scholarly journals Improving support for breastfeeding mothers: a qualitative study on the experiences of breastfeeding among mothers who reside in a deprived and culturally diverse community

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Erica Jane Cook ◽  
Faye Powell ◽  
Nasreen Ali ◽  
Catrin Penn-Jones ◽  
Bertha Ochieng ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Groups ◽  
Health Care Professionals ◽  
Culturally Diverse ◽  
Local Community ◽  
Framework Analysis ◽  
Black African ◽  
Early Stages ◽  
Practical Support ◽  
Diverse Community

Abstract Background The United Kingdom has one of the lowest breastfeeding rates in Europe, with the initiation and continuation of breastfeeding shown to be closely related to the mothers’ age, ethnicity and social class. Whilst the barriers that influence a woman’s decision to breastfeed are well documented, less is known how these barriers vary by the UK’s diverse population. As such, this study aimed to explore mothers’ experiences of breastfeeding and accessing breastfeeding services offered locally amongst a deprived and culturally diverse community. Methods A qualitative interpretive study comprising of 63 mothers (white British n = 8, Pakistani n = 13, Bangladeshi n = 10, black African n = 15 and Polish n = 17) who took part in single-sex focus groups, conducted in local community centres across the most deprived and ethnically diverse wards in Luton, UK. The focus groups were audio-recorded, transcribed and analysed thematically using Framework Analysis. Results The most common barriers to breastfeeding irrespective of ethnicity were perceptions surrounding pain and lack of milk. Confidence and motivation were found to be crucial facilitators of breastfeeding; whereby mothers felt that interventions should seek to reassure and support mothers not only during the early stages but throughout the breastfeeding journey. Mothers particularly valued the practical support provided by health care professions particularly surrounding positioning and attachment techniques. However, many mothers felt that the support from health care professionals was not always followed through. Conclusions The findings presented inform important recommendations for the design and implementation of future programs and interventions targeted at reducing breastfeeding inequalities. Interventions should focus on providing mothers practical support and reassurance not only during the early stages but throughout their breastfeeding journey. The findings also highlight the need for tailoring services to support diverse communities which acknowledge different traditional and familial practices.

scholarly journals 136. In Their Own words: a Qualitative Analysis of Factors Contributing to Gender Bias in Academic Advancement in Infectious Disease

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S198-S198
Author(s):  
Wendy Stead ◽  
Jennifer Manne-Goehler ◽  
Jasmine R Marcelin ◽  
Carlos Del Rio ◽  
Douglas Krakower
Keyword(s):  
Focus Group ◽  
Focus Groups ◽  
Gender Bias ◽  
Implicit Bias ◽  
Faculty Members ◽  
Full Professor ◽  
Major Theme ◽  
Academic Advancement ◽  
Assistant Professors ◽  
Implicit And Explicit

Abstract Background Large and persistent inequities in academic advancement exist between men and women faculty in academic Infectious Diseases (ID). To identify and characterize beliefs about why these inequities persist in ID, we asked ID faculty members to share their thoughts and experiences with the advancement process. Characteristics of Focus Group Participants Summary of Main Emergent Themes from Focus Group Analysis Methods We conducted four 60-minute focus groups with ID faculty members during IDWeek 2019. We enrolled women that were diverse geographically and in academic rank (i.e., Instructor/Assistant, Associate, Full Professor). We assigned women to focus groups by rank to minimize social desirability bias across rank. Our fourth focus group included only men who were Full Professors, to capture additional perspectives about barriers to advancement and solutions. (Table 1) We analyzed focus group discussion transcripts using content analysis. Results We identified nine main themes regarding inequities in academic advancement of women in ID. (Table 2) In all 4 focus groups, gender bias as a barrier to academic advancement was a major theme. Women Full Professors emphasized explicit gender bias such as sexual harassment and “predatory mentoring,” whereas women Instructors/Assistant Professors more frequently cited barriers related to implicit bias, such as obscure maternity leave policies and divisional meetings scheduled during childcare hours. Women Associate Professors cited implicit and explicit gender bias, while men Full Professors focused primarily on implicit bias. Women Instructors/Assistant Professors experienced the greatest difficulty in balancing demands of family with career, though this was a prominent theme in all groups. The perception that women less often utilize negotiation to advance themselves was a dominant theme for women Associate Professors, though all groups raised examples of this theme. Conclusion Gender bias, both implicit and explicit, is an important and ongoing barrier to equitable academic advancement of women in ID. Difficulty balancing demands of family with career and gender differences in professional negotiation are also perceived barriers that can be targeted by innovative programs and interventions to address gender disparities in academic advancement. Disclosures All Authors: No reported disclosures

Improving Intergroup Relations in Higher Education: A Critical Examination of the Influence of Educational Interventions on Racial Bias

2004 ◽  
Vol 74 (4) ◽  
pp. 473-524 ◽  
Author(s):  
Mark E. Engberg
Keyword(s):  
Higher Education ◽  
Intergroup Relations ◽  
Intervention Studies ◽  
Racial Bias ◽  
Educational Interventions ◽  
Critical Examination ◽  
Research Designs ◽  
Student Change ◽  
And Training

This study examines the influence of various educational interventions in higher education on students’ racial bias. The author reviews studies in four principle domains: multicultural courses, diversity workshops and training, peer-based interventions, and service-based interventions. He pays particular attention to the varied approaches, measures, and research designs used to assess the effectiveness of interventions. He concludes with specific recommendations for improving the quality of intervention studies, suggests a conceptual model for explaining student change, and points out gaps in the extant knowledge base. An appendix provides an overview of racial bias measures used in the reviewed studies.

Collective soul: The spirituality of an interdisciplinary palliative care team

2006 ◽  
Vol 4 (1) ◽  
pp. 13-24 ◽  
Author(s):  
SHANE SINCLAIR ◽  
SHELLEY RAFFIN ◽  
JOSE PEREIRA ◽  
NANCY GUEBERT
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Focus Groups ◽  
Health Care Professionals ◽  
Palliative Care Team ◽  
Care Team ◽  
Cancer Center ◽  
Team Members ◽  
Spiritual Journeys ◽  
Common Goals

Objective:Although spirituality as it relates to patients is gaining increasing attention, less is known about how health care professionals (HCP) experience spirituality personally or collectively in the workplace. This study explores the collective spirituality of an interdisciplinary palliative care team, by studying how individuals felt about their own spirituality, whether there was a shared sense of a team spirituality, how spirituality related to the care the team provided to patients and whether they felt that they provided spiritual care.Methods:A qualitative autoethnographic approach was used. The study was conducted in a 10-bed Tertiary Palliative Care Unit (TPCU) in a large acute-care referral hospital and cancer center. Interdisciplinary team members of the TPCU were invited to participate in one-to-one interviews and/or focus groups. Five interviews and three focus groups were conducted with a total of 20 participants.Results:Initially participants struggled to define spirituality. Concepts of spirituality relating to integrity, wholeness, meaning, and personal journeying emerged. For many, spirituality is inherently relational. Others acknowledged transcendence as an element of spirituality. Spirituality was described as being wrapped in caring and often manifests in small daily acts of kindness and of love, embedded within routine acts of caring. Palliative care served as a catalyst for team members' own spiritual journeys. For some participants, palliative care represented a spiritual calling. A collective spirituality stemming from common goals, values, and belonging surfaced.Significance of results:This was the first known study that focused specifically on the exploration of a collective spirituality. The culture of palliative care seems to foster spiritual reflection among health care professionals both as individuals and as a whole. While spirituality was difficult to describe, it was a shared experience often tangibly present in the provision of care on all levels.

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