Confronting implicit bias toward patients: A scoping review of post-graduate physician curricula

Authors

S T. Gleicher, Neurology, University of Washington, Seattle, USA. Gleicher@uw.edu.
M A. Chalmiers, School of Medicine, University of California San Diego, San Diego, USA.
B Aiyanyor, Pediatric Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, USA.
R Jain, Pediatric Hematology/Oncology, University of California San Francisco, San Francisco, USA.
N Kotha, School of Medicine, University of California San Diego, San Diego, USA.
K Scott, Neonatal Intensive Care, Children's Hospital of Philadelphia, Philadelphia, USA.
R S. Song, Emory University, Atlanta, USA.
J Tram, School of Medicine, University of California San Diego, San Diego, USA.
C L. Vuong, Advocate Aurora HealthFollow
J Kesselheim, DFCI/BCH Cancer and Blood Disorders Center, Harvard Medical School, Boston, USA.

Recommended Citation

Gleicher ST, Chalmiers MA, Aiyanyor B, et al. Confronting implicit bias toward patients: a scoping review of post-graduate physician curricula. BMC Med Educ. 2022;22(1):696. Published 2022 Sep 29. doi:10.1186/s12909-022-03720-0

Affiliations

Advocate Christ Medical Center

Abstract

Background: Physicians' behavior may unknowingly be impacted by prejudice and thereby contribute to healthcare inequities. Despite increasingly robust data demonstrating physician implicit bias (The Office of Minority Health. Minority Population Profiles, 2021; COVID-19 Shines Light on Health Disparities, National Conference of State Legislatures 2021), the evidence behind how to change this with training programs remains unclear. This scoping review therefore reports on the implementation, outcomes, and characteristics of post-graduate physician implicit bias curricula.

Methods: The authors conducted a literature review using scoping review methodology. They searched 7 databases in February and November 2020 for English-language academic and gray literature on implicit bias curricula for physicians at all levels of post-graduate training. Ten reviewers screened studies for eligibility independently, then extracted data from these studies and compiled it into a chart and analytical summary.

Results: Of the 4,599 articles screened, this review identified 90 articles on implicit bias interventions for post-graduate physicians. Inductive data analysis revealed a spectrum of educational approaches, which were categorized int o 4 educational models called Competence, Skills-Based, Social Contact, and Critical Models. The most commonly reported strength was the interactive nature of the curricula (26%), and the most frequently identified challenges were related to time and resources available (53%). Half of the interventions discussed facilitator preparation, and the majority (62%) evaluated outcomes using pre and post self-assessments.

Conclusions: This review provides a comprehensive synthesis of the literature on physician implicit bias curricula. It is our goal that this supports medical educators in applying and improving aspects of these interventions in their own programs.

Type

Article

PubMed ID

36175856