Implicit and Explicit Bias in Healthcare – a Study in Communication

Charles Edwards

doi:10.7273/000005227

There is a growing body of evidence that supports disparities in our healthcare system with examples ranging from inequalities in health outcomes to structural racism found in healthcare education. Implicit and explicit biases in healthcare have been shown to cause demonstrable harm to BiPOC patients and significant loss of revenue for healthcare institutions. What is less understood, however, is the personal impact that these biases have on individual patients and perceptions of bias from Healthcare Professionals. The overall objective of this PhD dissertation was to explore the lived experiences of Black Americans and how bias may affect their ability to access healthcare in the US, as well as the lived experiences of Healthcare Professionals and their associated understanding of bias and its impact on patient care and outcomes. Following the “three manuscript option”, the first manuscript presented results from a hermeneutic study on the lived experiences of Black Americans and their interactions with Healthcare Professionals. The second manuscript presented results from a hermeneutic study of Healthcare Professionals and their understandings of bias within healthcare and how this bias affects patient outcomes. The third manuscript was a grant to develop new training materials to counter these biases, based on the results of the hermeneutic studies. Manuscript one found themes of “iatrophobia” (fear of the healthcare system and providers), “invisible social conformity” (feeling the need to “hide” one’s race), “intersubjectivity” (the influence of childhood experiences), “racial inferiority” (feeling “less than” due to race), “geographic racial bias” (different experiences of bias based on geographical location) and “racial dichotomy” (the struggle to find providers of the same race). Manuscript two demonstrated themes of “general confusion of bias,” “poor communication,” and a “lack of understanding of bias”. The grant proposal was an R21 developing the themes from manuscripts one and two into a new set of “Counter Bias Training” scenarios that will be used to help reduce the impact of bias in our healthcare system. The grant proposal has been fully developed and is pending submission. These three manuscripts contribute to the body of research regarding implicit and explicit bias in Healthcare and suggest that there is an ongoing need for further research into perspectives of bias from Healthcare Professionals and the impact that bias has on minority patients. Additionally, there is a clear need to develop new and refined approaches to anti-bias education and training.

Implicit and Explicit Bias in Healthcare – a Study in Communication

Files and links (1)

Abstract

Metrics

Details