Foundation and Decision-Making Framework for Understanding and Combating Implicit Bias in Pediatrics

Author Type(s)

Faculty

Document Type

Abstract

Publication Date

2022

DOI

10.1136/jim-2022-ERM.242

Journal Title

Journal of Investigative Medicine

Department

Pediatrics

Abstract

Purpose of Study Implicit bias (IB) is understood to be unconscious, but with notable effects on patient care. Physician views will affect their management, notably as seen with pain assessment and management. Studies have shown medical students (MS) and residents have false beliefs regarding biological differences between races which have been associated with their decision-making. It is also clear that racial and ethnic disparities in health care are modifiable. Thus, there is room for growth in the medical community which will ultimately result in improved outcomes for patients. In recent years, medical education has been working on curricula to address explicit and implicit bias. However, MSs have expressed the need to further their training in IB through skill development. There is an ongoing need for foundational medical education in IB. We have created a workshop to introduce a decisionmaking framework for MSs when witnessing implicit bias, 'STOP.' It also allows the MS to reflect on their own implicit biases and have a tool to address them. Methods Used The Kern model was applied to design, implement, and evaluate this workshop. The objectives of this workshop included understanding IB, exploring IB in pediatrics, and providing a practical way to combat and reduce IB in pediatric training and practice. The educational strategies used included pedagogical strategies for student engagement, such as lecturing, reflection, small group discussion, and case scenarios. We evaluated the workshop's impact through pre/ post surveys by having students rate their confidence with implicit bias on a 5-point Likert scale. Mean change in scores was evaluated by paired t-test. Summary of Results A total of 75 MSs completed the workshop with 51 completed surveys to date. MS's confidence was assessed after the workshop in 4 areas, with statistically significant increased confidence in each (table 1). Using a paired student t-test, we found MS's confidence in now having a tool to combat implicit bias increased (p< 0.01). In total 98% of participants reported this session will affect their future practice. Conclusions Our work demonstrates the effectiveness of our workshop in increasing the confidence of the MS when it comes to IB understanding. Throughout implementation, the workshop was revised to meet the needs of the students both length and content. The workshop serves as our starting point in the continued journey in delivering equitable healthcare and dismantling structural racism in medicine. (Table Presented).

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