Patient perspectives on racial and ethnic implicit bias in clinical encounters: Implications for curriculum development

PATIENT EDUCATION AND COUNSELING

卷:101

Article

Gonzalez, Cristina M.^1,2  Deno, Maria L.^1,3  Kintzer, Emily⁴  Marantz, Paul R.¹  Lypson, Monica L.^5,6  McKee, M. Diane¹ 

[1] Albert Einstein Coll Med, 1300 Morris Pk Ave, Bronx, NY 10461 USA

[2] Montefiore Med Ctr, Weiler Div, 1825 Eastchester Rd,DOM 2-76, Bronx, NY 10461 USA

[3] Univ Iberoamer, Albert Einstein Coll Med, 1300 Morris Pk Ave, Bronx, NY 10461 USA

[4] Montefiore Med Ctr, Bronx, NY 10467 USA

[5] Univ Michigan, Sch Med & Hlth Sci, George Washington Univ, Med Sch, 1500 E Med Ctr Dr, Ann Arbor, MI 48109 USA

[6] Off Acad Affiliat, Dept Vet Affairs, 1500 E Med Ctr Dr, Ann Arbor, MI 48109 USA

关键词: Implicit bias;    Unconscious bias;    Health disparities;    Healthcare disparities;    Qualitative research;   

DOI  :  10.1016/j.pec.2018.05.016

来源: Elsevier

【 摘 要 】

Objective: Patients describe feelings of bias and prejudice in clinical encounters; however, their perspectives on restoring the encounter once bias is perceived are not known. Implicit bias has emerged as a target for curricular interventions. In order to inform the design of novel patient-centered curricular interventions, this study explores patients' perceptions of bias, and suggestions for restoring relationships if bias is perceived. Methods: The authors conducted bilingual focus groups with purposive sampling of self-identified Black and Latino community members in the US. Data were analyzed using grounded theory. Results: Ten focus groups (in English (6) and Spanish (4)) with N = 74 participants occurred. Data analysis revealed multiple influences patients' perception of bias in their physician encounters. The theory emerging from the analysis suggests if bias is perceived, the outcome of the encounter can still be positive. A positive or negative outcome depends on whether the physician acknowledges this perceived bias or not, and his or her subsequent actions. Conclusions: Participant lived experience and physician behaviors influence perceptions of bias, however clinical relationships can be restored following perceived bias. Practice implications: Providers might benefit from skill development in the recognition and acknowledgement of perceived bias in order to restore patient-provider relationships. (C) 2018 Elsevier B.V. All rights reserved.

【 授权许可】

Free