J. Sukhera is assistant professor of psychiatry and pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada, and PhD candidate in health professions education, Maastricht University, Maastricht, the Netherlands; ORCID: http://orcid.org/0000-0001-8146-4947. C. Watling is associate dean for postgraduate medical education and scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Acad Med. 2018 Jan;93(1):35-40. doi: 10.1097/ACM.0000000000001819.
Existing literature on implicit bias is fragmented and comes from a variety of fields like cognitive psychology, business ethics, and higher education, but implicit-bias-informed educational approaches have been underexplored in health professions education and are difficult to evaluate using existing tools. Despite increasing attention to implicit bias recognition and management in health professions education, many programs struggle to meaningfully integrate these topics into curricula. The authors propose a six-point actionable framework for integrating implicit bias recognition and management into health professions education that draws on the work of previous researchers and includes practical tools to guide curriculum developers. The six key features of this framework are creating a safe and nonthreatening learning context, increasing knowledge about the science of implicit bias, emphasizing how implicit bias influences behaviors and patient outcomes, increasing self-awareness of existing implicit biases, improving conscious efforts to overcome implicit bias, and enhancing awareness of how implicit bias influences others. Important considerations for designing implicit-bias-informed curricula-such as individual and contextual variables, as well as formal and informal cultural influences-are discussed. The authors also outline assessment and evaluation approaches that consider outcomes at individual, organizational, community, and societal levels. The proposed framework may facilitate future research and exploration regarding the use of implicit bias in health professions education.
现有关于内隐偏见的文献分散在认知心理学、商业伦理和高等教育等多个领域，但内隐偏见知情的教育方法在健康职业教育中尚未得到充分探索，并且难以使用现有工具进行评估。尽管健康职业教育领域越来越关注对内隐偏见的认识和管理，但许多项目仍难以将这些主题有意义地纳入课程。作者提出了一个六点可操作的框架，将内隐偏见的识别和管理纳入健康职业教育，该框架借鉴了先前研究人员的工作，并包括实用工具来指导课程开发者。该框架的六个关键特征是：创建一个安全且无威胁的学习环境，增加对内隐偏见科学的了解，强调内隐偏见如何影响行为和患者结果，提高对现有内隐偏见的自我意识，改善有意识地克服内隐偏见的努力，以及增强对内隐偏见如何影响他人的认识。讨论了设计内隐偏见知情课程的重要考虑因素，例如个体和环境变量，以及正式和非正式的文化影响。作者还概述了考虑个人、组织、社区和社会各级结果的评估和评价方法。该框架可能有助于未来关于健康职业教育中使用内隐偏见的研究和探索。
