Ruben Megan, Saks Norma S
Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane, Piscataway, NJ 08854 USA.
Med Sci Educ. 2020 Aug 14;30(4):1419-1426. doi: 10.1007/s40670-020-01047-3. eCollection 2020 Dec.
Studies show that implicit bias among healthcare providers contributes to health disparities. Despite this knowledge, most medical school curricula lack formal methods for assessing and reducing implicit bias among medical students.
The purpose of this study was to create a longitudinal, multidisciplinary training program for first-year medical students to reduce implicit bias toward skin tone, to increase awareness of personal bias, and to measure changes in bias after a targeted intervention.
First-year medical students participated in a three-part implicit bias training program that included visits to an art museum, a lecture on medical anthropology, and an interactive sociological discussion about bias in medical research. A control group did not participate in the training. All participants took the Harvard Implicit Association Test for Skin Tone and completed a questionnaire assessing awareness of implicit bias before and after the study activities were administered.
All participants indicated a bias toward light skin tone. In addition, a stronger bias score in the pre-test correlated with a stronger belief that the scores were inaccurate. Neither the experimental group nor the control group demonstrated a significant change in implicit bias, but the experimental group trended toward a decrease in bias. Power analysis suggested that significant results may have been obtained with a larger sample size. All participants indicated an awareness that implicit biases affect the provision of healthcare. When prompted to reflect on these biases, the experimental group provided richer, more detailed personal accounts of implicit bias in the healthcare environment after participating in the study.
First-year medical students who participated in this study were aware that implicit bias affects the provision of healthcare and therefore plays a role in perpetuating health disparities. However, they were less able to recognize bias in themselves. Providing opportunities for medical students to recognize and confront their own implicit biases is an important goal. This study suggests that a longitudinal, multidisciplinary curricular approach to building awareness and reducing implicit bias can produce promising results in medical students. We anticipate that further development and refinement of curricular activities may lead to significant results.
研究表明，医疗服务提供者的隐性偏见会导致健康差异。尽管有此认识，但大多数医学院课程缺乏评估和减少医学生隐性偏见的正规方法。
本研究的目的是为一年级医学生创建一个纵向、多学科培训项目，以减少对肤色的隐性偏见，提高对个人偏见的认识，并测量针对性干预后偏见的变化。
一年级医学生参加了一个由三部分组成的隐性偏见培训项目，包括参观艺术博物馆、一场关于医学人类学的讲座，以及一场关于医学研究中偏见的互动式社会学讨论。一个对照组未参加培训。所有参与者都进行了肤色的哈佛隐性联想测试，并在研究活动前后完成了一份评估隐性偏见意识的问卷。
所有参与者都表现出对浅肤色的偏见倾向。此外，测试前较强的偏见分数与更坚信分数不准确相关联｡实验组和对照组在隐性偏见方面均未显示出显著变化，但实验组的偏见有下降趋势。功效分析表明，如果样本量更大，可能会得到显著结果。所有参与者都表示意识到隐性偏见会影响医疗服务的提供。当被要求反思这些偏见时，实验组在参与研究后，对医疗保健环境中隐性偏见提供了更丰富、更详细的个人描述。
参与本研究的一年级医学生意识到隐性偏见会影响医疗服务的提供，因此在延续健康差异方面起到作用。然而，他们较难识别自身的偏见。为医学生提供机会来识别并直面自己的隐性偏见是一个重要目标。本研究表明，采用纵向、多学科的课程方法来增强意识和减少隐性偏见，可能会在医学生中产生有前景的结果。我们预计课程活动的进一步发展和完善可能会带来显著成果。
