Javeed Sukhera1, Michael Wodzinski, Pim W Teunissen, Lorelei Lingard, Chris Watling. 1. J. Sukhera is assistant professor in psychiatry and paediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada, and a PhD candidate in health professions education, Maastricht University, Maastricht, the Netherlands. M. Wodzinski is an MD candidate, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. P.W. Teunissen is professor of workplace learning in healthcare, Faculty of Health Medicine and Life Sciences, Maastricht University, and gynecologist, Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands. L. Lingard is professor, Department of Medicine, and director, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. C. Watling is professor and associate dean for postgraduate medical education, Schulich School of Medicine and Dentistry, Western University, and scientist, Centre for Education Research and Innovation, London, Ontario, Canada.
Abstract
PURPOSE: Implicit biases worsen outcomes for underserved and marginalized populations. Once health professionals are made aware of their implicit biases, a process ensues where they must reconcile this information with their personal and professional identities. The authors sought to explore how identity influences the process of implicit bias recognition and management. METHOD: Using constructivist grounded theory, the authors recruited 11 faculty and 10 resident participants working at an academic health science center in Canada. Interviews took place from June to October 2017. Participants took an online version of the mental illness implicit association test (IAT) which provides users with their degree of implicit dangerousness bias toward individuals with either physical or mental illness. Once they completed the IAT, participants were invited to draw a rich picture and interviewed about their picture and experience of taking their IAT. Data were analyzed using constant comparative procedures to develop focused codes and work toward the development of a deeper understanding of relationships among themes. RESULTS: Once implicit biases were brought into conscious awareness, participants acknowledged vulnerabilities which provoked tension between their personal and professional identities. Participants suggested that they reconcile these tensions through a process described as striving for the ideal while accepting the actual. Relationships were central to the process; however, residents and faculty viewed the role of relationships differently. CONCLUSIONS: Striving for self-improvement while accepting individual shortcomings may provide a model for addressing implicit bias among health professionals, and relational dynamics appear to influence the process of recognizing and managing biases.
PURPOSE: Implicit biases worsen outcomes for underserved and marginalized populations. Once health professionals are made aware of their implicit biases, a process ensues where they must reconcile this information with their personal and professional identities. The authors sought to explore how identity influences the process of implicit bias recognition and management. METHOD: Using constructivist grounded theory, the authors recruited 11 faculty and 10 resident participants working at an academic health science center in Canada. Interviews took place from June to October 2017. Participants took an online version of the mental illness implicit association test (IAT) which provides users with their degree of implicit dangerousness bias toward individuals with either physical or mental illness. Once they completed the IAT, participants were invited to draw a rich picture and interviewed about their picture and experience of taking their IAT. Data were analyzed using constant comparative procedures to develop focused codes and work toward the development of a deeper understanding of relationships among themes. RESULTS: Once implicit biases were brought into conscious awareness, participants acknowledged vulnerabilities which provoked tension between their personal and professional identities. Participants suggested that they reconcile these tensions through a process described as striving for the ideal while accepting the actual. Relationships were central to the process; however, residents and faculty viewed the role of relationships differently. CONCLUSIONS: Striving for self-improvement while accepting individual shortcomings may provide a model for addressing implicit bias among health professionals, and relational dynamics appear to influence the process of recognizing and managing biases.
Authors: Wil L Santivasi; Hannah C Nordhues; Frederic W Hafferty; Brianna E Vaa Stelling; John T Ratelle; Thomas J Beckman; Adam P Sawatsky Journal: Perspect Med Educ Date: 2022-03-17