Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA.
Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
Med Educ. 2020 Jul;54(7):637-642. doi: 10.1111/medu.14146. Epub 2020 Apr 17.
Implicit bias is common and is thought to drive discriminatory behaviour. Having previously demonstrated discrimination against specific applicant demographics by academic radiology departments in a simulated resident selection process, the authors sought to better understand the relationship between implicit bias and discrimination, as well as the potential and mechanisms for their mitigation.
A total of 51 faculty reviewers at three academic radiology departments, who had participated in a 2017 audit study in which they were shown to treat applicants differently based on race or ethnicity and physical appearance, were invited to complete testing for implicit racial and weight bias using the Implicit Association Test in 2019. Respondents were also surveyed regarding awareness of their own personal racial and weight biases, as well as any prior participation in formal diversity training. Comparisons were made between implicit bias scores and applicant ratings, as well as between diversity training and self-awareness of bias.
A total of 31 out of 51 faculty reviewers (61%) completed and submitted results of race and weight Implicit Association Tests. A total of 74% (23/31) reported implicit anti-obese bias, concordant with discrimination demonstrated in the resident selection simulation, in which obese applicants were rated 0.40 standard deviations (SDs) lower than non-obese applicants (P < .001). A total of 71% (22/31) reported implicit anti-Black bias, discordant with application ratings, which were 0.47 SDs higher for Black than for White applicants (P < .001). A total of 84% (26/31) of participants reported feeling self-aware of potential racial bias at the time of application review, significantly higher than the 23% (7/31) reporting self-awareness of potential anti-obese bias (P < .001). Participation in formal diversity training was not associated with implicit anti-Black or anti-fat bias, nor with self-reported awareness of potential racial or weight-based bias (all P > .2).
These findings suggest that implicit bias, as measured by the Implicit Association Test, does not inevitably lead to discrimination, and that personal awareness of implicit biases may allow their mitigation.
内隐偏见很常见，被认为会导致歧视行为。作者先前在一项模拟住院医师选拔过程中发现，学术放射科部门对特定申请人群体存在歧视，因此本研究旨在进一步了解内隐偏见与歧视之间的关系，以及减轻内隐偏见和歧视的潜力和机制。
邀请了 3 个学术放射科部门的 51 名教员评审员参加 2019 年的研究，他们在该研究中完成了种族和体重内隐联想测验，以评估他们是否存在基于种族或族裔以及外貌的偏见。研究对象还接受了关于自身种族和体重偏见意识的调查，以及任何先前参加正式多样性培训的情况。比较了内隐偏见评分与申请人评分之间的差异，以及多样性培训与自我意识之间的差异。
在 51 名教员评审员中，共有 31 名（61%）完成并提交了种族和体重内隐联想测验的结果。共有 74%（23/31）的人报告存在内隐肥胖偏见，与住院医师选拔模拟中的歧视一致，肥胖申请人的评分比非肥胖申请人低 0.40 个标准差（P<0.001）。共有 71%（22/31）的人报告存在内隐反黑偏见，与申请评分不一致，黑人申请人的评分比白人申请人高 0.47 个标准差（P<0.001）。共有 84%（26/31）的参与者报告在申请审查时对潜在种族偏见有自我意识，明显高于 23%（7/31）报告对潜在肥胖偏见有自我意识（P<0.001）。参加正式多样性培训与内隐反黑或反胖偏见无关，也与自我报告的潜在种族或体重偏见意识无关（所有 P>0.2）。
这些发现表明，内隐偏见（通过内隐联想测验测量）并不一定会导致歧视，而个人对内隐偏见的认识可能会减轻这种偏见。
