Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
Montefiore Medical Center- Weiler Division, 1825 Eastchester Road, DOM 2-76, Bronx, NY, 10461, USA.
BMC Med Educ. 2021 Apr 12;21(1):205. doi: 10.1186/s12909-021-02640-9.
Implicit bias instruction is becoming more prevalent in health professions education, with calls for skills-based curricula moving from awareness and recognition to management of implicit bias. Evidence suggests that health professionals and students learning about implicit bias ("learners") have varying attitudes about instruction in implicit bias, including the concept of implicit bias itself. Assessing learner attitudes could inform curriculum development and enable instructional designs that optimize learner engagement. To date, there are no instruments with evidence for construct validity that assess learner attitudes about implicit bias instruction and its relevance to clinical care.
The authors developed a novel instrument, the Attitude Towards Implicit Bias Instrument (ATIBI) and gathered evidence for three types of construct validity- content, internal consistency, and relationship to other variables.
Authors utilized a modified Delphi technique with an interprofessional team of experts, as well as cognitive interviews with medical students leading to item refinement to improve content validity. Seven cohorts of medical students, N = 1072 completed the ATIBI. Psychometric analysis demonstrated high internal consistency (α = 0.90). Exploratory factor analysis resulted in five factors. Analysis of a subset of 100 medical students demonstrated a moderate correlation with similar instruments, the Integrative Medicine Attitude Questionnaire (r = 0.63, 95% CI: [0.59, 0.66]) and the Internal Motivation to Respond Without Prejudice Scale (r = 0.36, 95% CI: [0.32, 0.40]), providing evidence for convergent validity. Scores on our instrument had low correlation to the External Motivation to Respond Without Prejudice Scale (r = 0.15, 95% CI: [0.09, 0.19]) and the Groningen Reflection Ability Scale (r = 0.12, 95% CI: [0.06, 0.17]) providing evidence for discriminant validity. Analysis resulted in eighteen items in the final instrument; it is easy to administer, both on paper form and online.
The Attitudes Toward Implicit Bias Instrument is a novel instrument that produces reliable and valid scores and may be used to measure medical student attitudes related to implicit bias recognition and management, including attitudes toward acceptance of bias in oneself, implicit bias instruction, and its relevance to clinical care.
内隐偏见教学在医疗专业教育中越来越普遍，呼吁从意识和认识层面将基于技能的课程转变为内隐偏见管理。有证据表明，学习内隐偏见的卫生专业人员和学生（学习者）对内隐偏见教学的态度各不相同，包括对内隐偏见本身的概念。评估学习者的态度可以为课程开发提供信息，并能够设计出优化学习者参与度的教学方案。迄今为止，尚无具有构建效度证据的工具可评估学习者对内隐偏见教学及其与临床护理相关性的态度。
作者开发了一种新的工具，即内隐偏见态度量表（ATIBI），并收集了内容、内部一致性和与其他变量关系三种类型的构念效度的证据。
作者利用具有跨专业专家团队的改良 Delphi 技术以及对医学生进行的认知访谈来完善项目，从而提高内容效度。7 个批次的医学生共 1072 人完成了 ATIBI。心理测量学分析显示其具有较高的内部一致性（α=0.90）。探索性因素分析产生了 5 个因素。对 100 名医学生的子样本分析表明，该工具与类似工具（综合医学态度问卷，r=0.63，95%置信区间：[0.59，0.66]）和内部动机无偏见反应量表（r=0.36，95%置信区间：[0.32，0.40]）之间存在中等相关性，提供了聚合效度的证据。该工具的分数与外部动机无偏见反应量表（r=0.15，95%置信区间：[0.09，0.19]）和格罗宁根反思能力量表（r=0.12，95%置信区间：[0.06，0.17]）之间的相关性较低，提供了区分效度的证据。分析得到最终工具包括 18 个项目；它易于管理，无论是纸质形式还是在线形式。
内隐偏见态度量表是一种新的工具，可产生可靠有效的分数，可用于衡量医学生对内隐偏见识别和管理的态度，包括对自身偏见的接受、内隐偏见教学及其与临床护理相关性的态度。
