Institute of Health and Society, UCLouvain, Brussels, Belgium.
Faculty of Psychology and Educational Sciences, UCLouvain, Louvain-la-Neuve, Belgium.
BMC Prim Care. 2022 Apr 21;23(1):91. doi: 10.1186/s12875-022-01698-8.
General Practitioners (GPs) are the first point of contact for people from ethnic and migrant groups who have health problems. Discrimination can occur in this health care sector. Few studies, however, have investigated implicit and explicit biases in general practice against ethnic and migrant groups. This study, therefore, investigated the extent of implicit ethnic biases and willingness to adapt care to migrant patients among trainee GPs, and the factors involved therein, in order to measure explicit bias and explore a dimension of cultural competence.
In 2021, data were collected from 207 trainee GPs in the French-speaking part of Belgium. The respondents passed an Implicit Association Test (IAT), a validated tool used to measure implicit biases against ethnic groups. An explicit attitude of willingness to adapt care to diversity, one of the dimensions of cultural competence, was measured using the Hudelson scale.
The overwhelming majority of trainee GPs (82.6%, 95% CI: 0.77 - 0.88) had implicit preferences for their ingroup to the detriment of ethnic and migrant groups. Overall, the majority of respondents considered it the responsibility of GPs to adapt their attitudes and practices to migrants' needs. More than 50% of trainee GPs, however, considered it the responsibility of migrant patients to adapt to the values and habits of the host country.
This study found that the trainee GPs had high to very high levels of implicit ethnic bias and that they were not always willing to adapt care to the values of migrants. We therefore recommend that they are made aware of this bias and we recommend using the IAT and Hudelson scales as educational tools to address ethnic biases in primary care.
全科医生（GP）是有健康问题的族裔和移民群体的第一接触点。在医疗保健领域可能会出现歧视。然而，很少有研究调查全科实践中针对族裔和移民群体的隐性和显性偏见。因此，本研究调查了实习全科医生对族裔群体的隐性种族偏见和愿意为移民患者调整护理的程度，以及其中涉及的因素，以衡量显性偏见并探索文化能力的一个维度。
2021 年，在比利时法语区收集了 207 名实习全科医生的数据。受访者通过了内隐联想测验（IAT），这是一种用于衡量对族裔群体的隐性偏见的有效工具。使用 Hudelson 量表衡量文化能力的一个维度——愿意为多样性调整护理的明确态度。
绝大多数实习全科医生（82.6%，95%置信区间：0.77-0.88）对自己的内群体有隐性偏好，而对族裔和移民群体则不利。总体而言，大多数受访者认为全科医生有责任根据移民的需求调整他们的态度和实践。然而，超过 50%的实习全科医生认为，移民患者有责任适应东道国的价值观和习惯。
本研究发现，实习全科医生的隐性种族偏见程度较高，而且他们并不总是愿意根据移民的价值观调整护理。因此，我们建议让他们意识到这种偏见，并建议使用 IAT 和 Hudelson 量表作为教育工具来解决初级保健中的族裔偏见。
