Non-conscious bias in medical decision making: what can be done to reduce it?
CONTEXT Non-conscious stereotyping and prejudice contribute to racial and ethnic disparities in health care. Contemporary training in cultural competence is insufficient to reduce these problems because even educated, culturally sensitive, egalitarian individuals can activate and use their biases wi...
| Publicado en: | Medical Education Vol. 45; no. 8; pp. 768 - 777 |
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| Autores principales: | , |
| Formato: | Journal Article |
| Publicado: |
Wiley-Blackwell
Aug2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104662310&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104662310 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03080110 ESF jtl: Medical Education issn: 03080110 maglogo: Y pubinfo: dt: Aug2011 vid: 45 iid: 8 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104662310 2011216479 10.1111/j.1365-2923.2011.04026.x NLM21752073 104662310 ppf: 768 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Non-conscious bias in medical decision making: what can be done to reduce it? aug: au: Stone, Jeff Moskowitz, Gordon B affil: Department of Psychology, School of Mind, Brain & Behavior, College of Science, University of Arizona, Tucson, Arizona, USA sug: subj: Decision Making, Clinical Cultural Competence Education Education, Medical Trends Stereotyping Prevention and Control Professional-Patient Relations Black Persons Hispanic Americans White Persons Teaching Methods ab: CONTEXT Non-conscious stereotyping and prejudice contribute to racial and ethnic disparities in health care. Contemporary training in cultural competence is insufficient to reduce these problems because even educated, culturally sensitive, egalitarian individuals can activate and use their biases without being aware they are doing so. However, these problems can be reduced by workshops and learning modules that focus on the psychology of non-conscious bias. THE PSYCHOLOGY OF NON-CONSCIOUS BIAS Research in social psychology shows that over time stereotypes and prejudices become invisible to those who rely on them. Automatic categorisation of an individual as a member of a social group can unconsciously trigger the thoughts (stereotypes) and feelings (prejudices) associated with that group, even if these reactions are explicitly denied and rejected. This implies that, when activated, implicit negative attitudes and stereotypes shape how medical professionals evaluate and interact with minority group patients. This creates differential diagnosis and treatment, makes minority group patients uncomfortable and discourages them from seeking or complying with treatment. PITFALLS IN CULTURAL COMPETENCE TRAINING Cultural competence training involves teaching students to use race and ethnicity to diagnose and treat minority group patients, but to avoid stereotyping them by over-generalising cultural knowledge to individuals. However, the Culturally and Linguistically Appropriate Services (CLAS) standards do not specify how these goals should be accomplished and psychological research shows that common approaches like stereotype suppression are ineffective for reducing nonconscious bias. To effectively address bias in health care, training in cultural competence should incorporate research on the psychology of non-conscious stereotyping and prejudice. TRAINING IN IMPLICIT BIAS ENHANCES CULTURAL COMPETENCE Workshops or other learning modules that help medical professionals learn about non-conscious processes can provide them with skills that reduce bias when they interact with minority group patients. Examples of such skills in action include automatically activating egalitarian goals, looking for common identities and counterstereotypical information, and taking the perspective of the minority group patient. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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