Natalia Rodriguez1, Emily Kintzer2, Julie List3, Monica Lypson4, Joseph H Grochowalski5, Paul R Marantz6, Cristina M Gonzalez7. 1. Perelman School of Medicine, University of Pennsylvania, United States. 2. Department of Obstetrics and Gynecology, Montefiore Medical Center, United States. 3. Department of Family and Social Medicine, Albert Einstein College of Medicine, United States. 4. F. Edward Hébert School of Medicine, George Washington University School of Medicine and Health Sciences, University of Michigan Medical School, Uniformed Services University of the Health Sciences, United States. 5. Fordham University, United States. 6. Department of Epidemiology & Population Health, Department of Medicine, Albert Einstein College of Medicine, United States. 7. Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, United States. Electronic address: crgonzal@montefiore.org.
Abstract
BACKGROUND: Implicit bias instruction is becoming more prevalent across the continuum of medical education. Little guidance exists for faculty on recognizing and debriefing about implicit bias during routine clinical encounters. OBJECTIVE: To assess the impact and feasibility of single seminars on implicit bias and the approach to its management in clinical settings. METHODS: Between September 2016 and November 2017, the authors delivered five departmental/divisional grand rounds across three different academic medical centers in New York, USA. Instruction provided background information on implicit bias, highlighted its relevance to clinical care, and discussed proposed interventions. To evaluate the impact of instruction participants completed a twelve-item retrospective pre-intervention/post-intervention survey. Questions related to comfort and confidence in recognizing and managing implicit bias, debriefing with learners, and role-modeling behaviors. Participants identified strategies for recognizing and managing potentially biased events through free text prompts. Authors qualitatively analyzed participants' identified strategies. RESULTS: We received 116 completed surveys from 203 participants (57% response rate). Participants self-reported confidence and comfort increased for all questions. Qualitative analysis resulted in three themes: looking inward, looking outward, and taking action at individual and institutional levels. CONCLUSION: After a single session, respondents reported increased confidence and comfort with the topic. They identified strategies relevant to their professional contexts which can inform future skills-based interventions. For healthcare organizations responding to calls for implicit bias training, this approach has great promise. It is feasible and can reach a wide audience through usual grand rounds programming, serving as an effective early step in such training.
BACKGROUND: Implicit bias instruction is becoming more prevalent across the continuum of medical education. Little guidance exists for faculty on recognizing and debriefing about implicit bias during routine clinical encounters. OBJECTIVE: To assess the impact and feasibility of single seminars on implicit bias and the approach to its management in clinical settings. METHODS: Between September 2016 and November 2017, the authors delivered five departmental/divisional grand rounds across three different academic medical centers in New York, USA. Instruction provided background information on implicit bias, highlighted its relevance to clinical care, and discussed proposed interventions. To evaluate the impact of instruction participants completed a twelve-item retrospective pre-intervention/post-intervention survey. Questions related to comfort and confidence in recognizing and managing implicit bias, debriefing with learners, and role-modeling behaviors. Participants identified strategies for recognizing and managing potentially biased events through free text prompts. Authors qualitatively analyzed participants' identified strategies. RESULTS: We received 116 completed surveys from 203 participants (57% response rate). Participants self-reported confidence and comfort increased for all questions. Qualitative analysis resulted in three themes: looking inward, looking outward, and taking action at individual and institutional levels. CONCLUSION: After a single session, respondents reported increased confidence and comfort with the topic. They identified strategies relevant to their professional contexts which can inform future skills-based interventions. For healthcare organizations responding to calls for implicit bias training, this approach has great promise. It is feasible and can reach a wide audience through usual grand rounds programming, serving as an effective early step in such training.
Authors: Renee Butkus; Joshua Serchen; Darilyn V Moyer; Sue S Bornstein; Susan Thompson Hingle; Gregory C Kane; Jan K Carney; Heather E Gantzer; Tracey L Henry; Joshua D Lenchus; Joseph M Li; Bridget M McCandless; Beth R Nalitt; Lavanya Viswanathan; Caleb J Murphy; Ayteetin Azah; Lianne Marks Journal: Ann Intern Med Date: 2018-04-17 Impact factor: 25.391
Authors: Monica E Peek; Angela Odoms-Young; Michael T Quinn; Rita Gorawara-Bhat; Shannon C Wilson; Marshall H Chin Journal: Soc Sci Med Date: 2010-03-24 Impact factor: 4.634
Authors: Cristina M Gonzalez; Maria L Deno; Emily Kintzer; Paul R Marantz; Monica L Lypson; Melissa D McKee Journal: J Gen Intern Med Date: 2019-05 Impact factor: 5.128
Authors: Michelle van Ryn; Rachel Hardeman; Sean M Phelan; Diana J Burgess; John F Dovidio; Jeph Herrin; Sara E Burke; David B Nelson; Sylvia Perry; Mark Yeazel; Julia M Przedworski Journal: J Gen Intern Med Date: 2015-07-01 Impact factor: 5.128
Authors: Jennita G Meinema; Nienke Buwalda; Faridi S van Etten-Jamaludin; Mechteld R M Visser; Nynke van Dijk Journal: Acad Med Date: 2019-02 Impact factor: 6.893