Session: Managing Implicit Bias in Clinical Interactions with Evidence-Based Strategies
Workshop 7 - Managing Implicit Bias in Clinical Interactions with Evidence-based Strategies
Saturday, November 18, 2023
8:00 AM – 11:00 AM PST
Location: 403 (Cispus), Level 4
Earn 3 Credit
Keywords: Mental Health Disparities, Cognitive Biases / Distortions, Theraputic Relationship Level of Familiarity: Basic Recommended Readings: Zestcott, C. A., Blair, I. V. & Stone, J. Examining the presence, consequences, and reduction of implicit bias in health care: a narrative review. Group Process. Intergroup Relat. 19, 528–542 (2016)., Stone, J., Moskowitz, G. B., Zestcott, C. A. & Wolsiefer, K. J. Testing active learning workshops for reducing implicit stereotyping of Hispanics by majority and minority group medical students. Stigma Health Wash. DC 5, 94–103 (2020)., Liu, F. F., Coifman, J., McRee, E., Stone, J., Law, A., Gaias, L., ... & Lyon, A. R. (2022). A brief online implicit bias intervention for school mental health clinicians. International Journal of Environmental Research and Public Health, 19(2), 679., Tajeu, G. S., Juarez, L., Williams, J. H., Halanych, J., Stepanikova, I., Agne, A. A., ... & Cherrington, A. L. (2022). Development of a Multicomponent Intervention to Decrease Racial Bias Among Healthcare Staff. Journal of General Internal Medicine, 37(8), 1970-1979., Maina, I. W., Belton, T. D., Ginzberg, S., Singh, A. & Johnson, T. J. A decade of studying implicit racial/ethnic bias in healthcare providers using the implicit association test. Soc. Sci. Med. 1982 199, 219–229 (2018).
Assistant Professor University of Washington School of Medicine Seattle, Washington
Clinician implicit bias has been identified as a significant contributor to persistent healthcare inequities in many subspecialties including mental healthcare (Maina et al., 2018). Clinician bias has been shown to negatively impact clinician-patient communication, trust, and relationship, and has been found to be associated with biased decision-making and inequitable care, disproportionally impacting minoritize and marginalized populations (Zescott, Blair, & Stone, 2016). Decades of research on implicit social cognition has led to the identification of some effective strategies for managing the impact of implicit bias in social interactions (Lai et al., 2016). In recent years, these strategies have been adapted for use in clinician-patient interactions in primary care (Stone et al., 2020) and youth mental health (Liu et al., 2022) with promising results for reducing clinician implicit bias.
This 3-hour workshop will provide didactic and practical training on the most effective strategies (per the evidence-base) for managing one’s own biases. The workshop will include a brief introduction to the cognitive processes and evolutionary function underlying implicit prejudice and stereotyping (with experiential exercises and live demonstrations). Then building on this foundational understanding that all human beings have biases, workshop attendees will learn specific bias-management strategies, with step-by-step instructions on how to use each strategy during clinical interactions. Attendees will integrate their learning with structured opportunities to practice through “real plays” and “role plays” work with case vignettes and their lived experience. Workshop will also include a discussion of implementation barrier and facilitators to promote post-training skills use and practice sustainment.
Outline: 1. Background a. Overview of examples of health and mental inequities throughout the literature b. Understanding the broader context of bias in the United States beyond healthcare 2. Bias Literacy a. Social cognitive process underlying implicit bias b. The Implicit Association Test (live demo) c. The role of clinicians bias in inequitable care and outcomes 3. Strategies for Managing Implicit Bias in Clinical Interacations (real plays and role plays) a. Setting the Stage i. Increasing self-awareness (mindfulness) ii. Cultivating willingness and curiosity b. Evidence-based skills practice i. Seeking Commonality ii. Perspective Gaining iii. Counter Stereotyping c. Recovering from missteps d. Systemic approaches 4. Question & Answer 5. Personal Commitment to on-going practice
Learning Objectives:
At the end of the session, the learner will be able to:
Describe how unchecked clinician implicit bias can lead to healthcare inequities and poorer outcomes for minoritized or marginalized patients/clients.
Explain the social cognitive processes involved in implicit biases that makes them difficult to manage.
Demonstrate the effective use of at least 2 out of 3 bias management strategies.
Identify common pitfalls when using bias management strategies during clinical interactions.
Create an implementation and sustainment plan for integrating bias management strategies into one's clinical practice.
Long-term Goals: Help clinicians better understand how implicit bias may function in their clinical interactions and the broader context of our biases and its downstream impact.
