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How to Reduce Implicit Bias in Emergency Medical Care


Jefferson researchers devise training to combat bias in emergency healthcare providers

med students talking to each other

Emergency departments treat a myriad of patients from diverse ethnic, cultural and racial backgrounds. But as human beings, healthcare providers are susceptible to unconscious biases that may affect the care they give to patients.

To address the possibility of bias, Bernard Lopez, MD, MS, Associate Provost for Diversity and Inclusion and Associate Dean of Diversity and Community Engagement at the Sidney Kimmel Medical College at Jefferson (Philadelphia University + Thomas Jefferson University) collaborated with researchers at the University of Pennsylvania on a training program for emergency medicine residents and then tested how well it worked.

The results, published in the journal Academic Emergency Medicine Education and Training, demonstrate how education can effectively change awareness and self-identification of bias, which could lead to reducing health disparities.

“We all have biases,” says Dr. Lopez. “It’s okay that we have them, but we need to work with them so we can improve our interpersonal interactions.” Many biases are unconscious or implicit, leaving individuals unaware that they have them. But these biases may nonetheless impact behaviors especially in situations where split-second decisions are made.  

The training program included an introductory talk on unconscious bias followed by the participants taking the Implicit Association Test. A facilitated discussion that highlighted the relationship between implicit bias and care, helped doctors identify biases within their medical practice and possible ways to mitigate those behaviors.

After the intervention, emergency department caregivers raised awareness of their implicit biases by 33 percent, Dr. Lopez and team showed.

“What we found is that the first and probably most important step in unconscious bias or implicit bias education is simply awareness that it exists, and what it might look like in each of us,” says Dr. Lopez. “It's recognizing that we have implicit biases and providing the space to change them.”

Residents who participated in the training were eager to learn about the topic and acknowledged biases exist on personal and systemic levels that could affect the care they give.

But, “implicit bias education doesn't even have to be healthcare related at all,” adds Dr. Lopez. “This is really for anybody.”

Article reference: Amy J. Zeidan, MD, Utsha G. Khatri, MD, Jaya Aysola, MD, MPH, Frances S. Shofer, PhD, Mira Mamtani, MD, Kevin R. Scott, MD, MSEd, Lauren W. Conlon, MD, and Bernard L. Lopez, MD, MS, “Implicit Bias Education and Emergency Medicine Training: Step One? Awareness,” AEM Education and Training, doi: 10.1002/aet2.10124, 2018.

Media Contact: 
Edyta Zielinska