Racial Implicit Bias and Communication Among Physicians in a Simulated Environment

JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(3), P. e242181 - e242181

Published: March 20, 2024

Importance Racial implicit bias can contribute to health disparities through its negative influence on physician communication with Black patients. Interventions for physicians address racial in their clinical encounters are limited by a lack of high-fidelity (realistic) simulations provide opportunities skill development and practice. Objective To describe the initial evaluation simulation conditions under which might be influenced bias. Design, Setting, Participants This cross-sectional study, performed an online platform from March 1 September 30, 2022, recruited convenience sample volunteers pilot educational simulation. Exposures In exercise, saw 52-year-old male standardized patient (SP) (presenting as or White) seeking urgent care epigastric pain, nausea, vomiting. The case included cognitive stressors common environments, including ambiguity, stress, time constraints, interruptions. Physicians explained diagnosis treatment plan SP, wrote assessment management plan, completed surveys, took Race Implicit Association Test (IAT) Medical Cooperativeness IAT. SPs, blinded purpose assessed each physician’s using skills checklists global rating scales. Main Outcomes Measures between physicians’ IAT scores SP race ratings skills. Results 60 (23 [38.3%] Asian, 4 [6.7%] Black, 23 White, 10 [16.7%] other, Latina/o/x, Middle Eastern, multiracial; 31 [51.7%] female, 27 [45.0%] male, 2 [3.3%] other), interaction score was significant overall (mean [SD] β = −1.29 [0.41]), all subdomains −1.17 [0.52] −1.43 [0.59]), −1.09 [0.39]). SPs rated lower given pro-White than White SPs; increased increased. Conclusions Relevance this calibrated environments elicited expected outlined process preliminary results inform interventions that seek improve

Language: Английский

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Designing Communication Feedback Systems To Reduce Healthcare Providers’ Implicit Biases In Patient Encounters

Published: May 11, 2024

Healthcare providers' implicit bias, based on patients' physical characteristics and perceived identities, negatively impacts healthcare access, care quality, outcomes. Feedback tools are needed to help providers identify learn from their biases. To incorporate perspectives the most effective ways present such feedback, we conducted semi-structured design critique sessions with 24 primary providers. We found that seek feedback designed transparent metrics indicating quality of communication a patient trends in patterns across visits. Based these trends, want this presented dashboard paired actionable, personalized tips about how improve behaviors. Our study provides new insights for interactive systems mitigate impact biases patient-provider communication. New build upon could support making more equitable, particularly patients marginalized communities.

Language: Английский

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Integrating Longitudinal Simulation-Based Education: Enhancing Trainee Competence in U.S. Emergency Medicine Residency Programs

Journal of Emergency Medicine, Journal Year: 2025, Volume and Issue: 68, P. 96 - 99

Published: Jan. 1, 2025

Language: Английский

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Defensive Responses to Implicit Association Tests and Bias Awareness in an Implicit Bias Mitigation Training

Advances in Medical Education and Practice, Journal Year: 2025, Volume and Issue: Volume 16, P. 419 - 430

Published: March 1, 2025

Implicit bias education that utilizes the Association Test (IAT) to raise self-awareness of can induce defensiveness. To describe clinical learners' awareness, self-perceptions relative colleagues (better-than-average), implicit and explicit biases defensive response IATs. Cross-sectional study. Internal medicine family residents, Doctor Nursing Practice students at a public medical nursing school affiliated with disproportionate share hospital who completed an recognition mitigation educational program (including didactics, IATs, communication skills training practice standardized patients) in 2018-2019. We measured attitudes stereotypes, reactions IAT results (defensive or not defensive), better-than-average perceptions, awareness participants' characteristics. examined associations between responses participant characteristics, self-reported biases, within self, society, healthcare, scores. Of N=61 respondents, 57% were female 59% White. found moderate favoring White people versus Black people, weak Hispanic/Latinx on both race ethnicity compliance stereotype Participants demonstrated society but self. Eighteen percent regarding their results. Perceptions own (self) always having less than colleagues, they better-than-average. There no statistically significant scores demographics interaction effect bias, defensiveness Clinical learners hold believe have others, almost 1-in-5 feedback. It is important design interventions include reflection personal provide safe environment minimize

Language: Английский

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Harnessing lived experience in health professions simulation-based education: a scoping review

Advances in Health Sciences Education, Journal Year: 2025, Volume and Issue: unknown

Published: April 24, 2025

Abstract Simulation is an established pedagogical approach in health professions education, typically led by educators and informed their clinical expertise. Partnerships between people with lived experience ensures simulation authentically represents the needs of accessing healthcare. To map available literature on how experiences are incorporated into simulation-based education a scoping review was conducted. In April 2024 CINAHL Complete, Scopus, ERIC, Medline, PsycINFO, ProQuest Dissertations Theses Global Database were searched. Studies screened against inclusion criteria, data extracted from 45 studies using purposively developed piloted extraction tool, organised according to four research questions. Medicine nursing most commonly include cultural linguistic diversity often harnessed. Lived involvement across entire six phases design delivery not common, however active meaningful represented at each stage. enhances provides additional opportunity for be involved education. There urgent need guidelines describing can harness Further research, partnership experience, required determine more represent

Language: Английский

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Impact of telehealth on patient-provider communication in prenatal care for pregnant women from underserved settings

Journal of Communications In Healthcare, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 9

Published: June 3, 2024

Introduction: Telehealth has emerged as a promising supplementary modality in prenatal care. However, its impact on patient-provider communication (PPC), especially among pregnant women from underserved settings, requires comprehensive evaluation. This study examined the factors associated with quality of during COVID-19 pandemic telehealth users and non-users.

Language: Английский

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Design and pilot test of an implicit bias mitigation curriculum for clinicians

Frontiers in Medicine, Journal Year: 2024, Volume and Issue: 11

Published: June 6, 2024

Clinician implicit racial bias (IB) may lead to lower quality care and adverse health outcomes for Black patients. Educational efforts train clinicians mitigate IB vary widely have insufficient evidence of impact. We developed pilot-tested an evidence-based clinician curriculum, "REACHing Equity." To assess acceptability feasibility, we conducted uncontrolled one-arm pilot trial with post-intervention assessments. REACHing Equity is designed to: (1) acquire knowledge about its impact on healthcare, (2) increase awareness one's own capacity IB, (3) develop skills in the clinical encounter. delivered virtually three facilitated, interactive sessions over 7-9 weeks. Participants were providers who completed baseline end-of-study evaluation surveys. Of approximately 1,592 invited, 37 participated, whom 29 self-identified as women 24 non-Hispanic White. Attendance averaged 90% per session; 78% attended all 3 sessions. Response rate surveys was 67%. Most respondents agreed or strongly that curriculum objectives met, equipped them care. consistently reported higher self-efficacy mitigating after compared before completing curriculum. Despite apparent barriers participation, demonstrated feasibility intervention. Further research needed objective measures uptake skill, test clinically relevant outcomes, refine dissemination.ClinicalTrials.gov ID: NCT03415308.

Language: Английский

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Reimagining Equitable Care: Simulation-Based Education and the Dismantling of Implicit Bias and Stigma of Vulnerable Populations in Hospitals

Published: Jan. 1, 2024

Background: Simulation-based education consists of using high-fidelity mannequins and equipment to provide a safe space for healthcare professionals practice crucial skills within healthcare. Used hospitals schools, simulation most commonly surrounds practicing hands-on such as central line insertion, IV Ultrasound-guided procedures, code blue response, etc. However, large portion that is overlooked tackling issues patient-provider relationships. Simulation can help dismantle the negative behaviors feelings providers push onto patients through use standardized role-playing. By these methods, reduce providers' personal implicit biases stigma associated with identity certain patients. Emotional intelligence in vital quality care community members receive.

Language: Английский

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Moving towards deep equity, diversity, inclusivity and accessibility in simulation: a call to explore the promises and perils

Advances in Simulation, Journal Year: 2024, Volume and Issue: 9(1)

Published: Feb. 8, 2024

Abstract Principles and issues of equity, diversity, inclusivity, accessibility (EDIA) are being explored currently in simulation designs trainings but with limited depth, often raising more questions than answers. This editorial invites the broader healthcare community to move beyond superficial explore expansively deeply these EDIA within simulation. Simulation is very environment context from which we may confront how existing (power) structures can be dismantled re-envisioned for optimal redistribution participation, power, benefits. We use experiment variations realities, start exploring consequences such alternatives benefit our health systems societies. uniquely combines opportunities experience, reflection, application active experimentation, enabling a ripe ground this study. In fact, it responsibility educators take up challenge, engage meaningful scholarship understand about impact topics. contributions empirical theoretical works that advance collective understanding EDIA, while also cautioning against complacency. The urged look inwards examine its own practices critically, spite uncertainty, vulnerability risks presents.

Language: Английский

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Diversity, Equity, and Inclusion

Obstetrics and Gynecology Clinics of North America, Journal Year: 2024, Volume and Issue: 51(3), P. 539 - 558

Published: Aug. 2, 2024

Language: Английский

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