The University of Texas Dell Medical School, Austin, Texas, United States of America.
PLoS One. 2024 Oct 24;19(10):e0310119. doi: 10.1371/journal.pone.0310119. eCollection 2024.
Evidence is mounting that the biopsychosocial paradigm is more accurate and useful than the biomedical paradigm of care. Habits of thought can hinder the implementation of this knowledge into daily care strategies. To understand and lessen these potential barriers, we asked: 1) What is the relative implicit and explicit attitudes of musculoskeletal surgeons towards the biomedical or biopsychosocial paradigms of medicine? 2) What surgeon factors are associated with these attitudes?
An online survey-based experiment was distributed to members of the Science of Variation Group (SOVG) with a total of 163 respondents. Implicit bias towards the biomedical or biopsychosocial paradigms was measured using an Implicit Association Test (IAT) designed by our team using open-source software; explicit preferences were measured using ordinal scales.
On average, surgeons demonstrated a moderate implicit bias towards the biomedical paradigm (d-score: -0.21; Interquartile range [IQR]: -0.56 to 0.19) and a moderate explicit preference towards the biopsychosocial paradigm (mean: 14; standard deviation: 14). A greater implicit bias towards the biomedical paradigm was associated with male surgeons (d-score: -0.30; IQR: -0.57 to 0.14; P = 0.005). A greater explicit preference towards the biomedical paradigm was independently associated with a European practice location (Regression coefficient: -9.1; 95% CI: -14 to -4.4; P <0.001) and trauma subspecialty (RC: -6.2; 95% CI: -11 to -1.0; P <0.001).
The observation that surgeons have an implicit bias favoring the biomedical paradigm might inform strategies for implementation of care strategies based on evidence favoring the biopsychosocial paradigm.
越来越多的证据表明，心理社会生物医学模式比生物医学模式更准确、更有用。思维习惯可能会阻碍将这些知识应用于日常护理策略中。为了理解和减轻这些潜在的障碍，我们提出了以下两个问题：1）肌肉骨骼外科医生对生物医学或心理社会生物医学模式的相对隐含和明确态度是什么？2）哪些外科医生的因素与这些态度有关？
我们向 Science of Variation Group（SOVG）的成员分发了一项基于在线调查的实验，共有 163 名受访者。使用我们团队使用开源软件设计的内隐联想测验（IAT）来衡量对生物医学或心理社会生物医学模式的内隐偏见；使用有序量表来衡量明确的偏好。
平均而言，外科医生对生物医学模式表现出中等程度的内隐偏见（d 评分：-0.21；四分位距 [IQR]：-0.56 至 0.19），对心理社会生物医学模式表现出中等程度的明确偏好（平均值：14；标准差：14）。对生物医学模式的内隐偏见越大，男性外科医生的可能性就越大（d 评分：-0.30；IQR：-0.57 至 0.14；P = 0.005）。对生物医学模式更大的明确偏好与欧洲的执业地点（回归系数：-9.1；95%置信区间：-14 至 -4.4；P <0.001）和创伤亚专科（RC：-6.2；95%置信区间：-11 至 -1.0；P <0.001）独立相关。
观察到外科医生对内隐生物医学模式的偏见可能会为实施基于心理社会生物医学模式的证据支持的护理策略提供策略。
