Most implicit bias training in health care lacks proper foundation, research finds

The hands of two individuals sitting at a desk. — Though an increasing number of medical schools and health care organizations are starting to incorporate implicit bias training in their curriculums, current training is not grounded in a framework where research findings translate to clinical treatment, according to a VCU psychology professor’s latest research. (Getty Images)

May 20, 2020

Most implicit bias training in health care lacks proper foundation, research finds

In a forthcoming paper in The Lancet, a VCU psychology professor says such training should be grounded in a clinical translational framework to address racial and ethnic disparities in health care.

An increasing number of medical schools and other health care organizations are starting to incorporate implicit bias training in their curriculums to help health care professionals recognize any unconscious prejudice and attitudes they may have toward certain groups of people. However, current training is not grounded in a framework where research findings translate to clinical treatment, raising a serious concern about the effectiveness of the training, according to new research by a Virginia Commonwealth University psychology professor.

Nao Hagiwara, Ph.D., an associate professor in the Department of Psychology, was principal author of the paper, “A Call for Grounding Implicit Bias Training in Clinical and Translational Frameworks,” which will publish in The Lancet in June.

It is necessary for health care professionals to be aware of their internal bias and be intrinsically motivated to reduce it, but that is not sufficient in addressing the negative impacts bias can have on patient care, Hagiwara said.

Effective implicit bias training should draw from basic research in social psychology and social cognition and follow the translational stages from research to clinical treatment. Failure to recognize and address gaps in this approach reduces the effectiveness of the training, Hagiwara said.

Hagiwara’s work, as well as that by other researchers, provides evidence that higher levels of provider implicit bias, particularly prejudice, are associated with more negative communication behaviors during interactions with minority patients and can contribute to racial and ethnic disparities in health care through poor patient-provider communication, Hagiwara said.

The key to improving patient care for minorities and reducing health care disparities is to develop evidence- and theory-based training programs to help providers manage their communication behaviors, she said.

“We believe training should focus on replacing negative communication behaviors associated with implicit prejudice with positive communication behaviors and providing relevant opportunities to practice new communication behaviors over time,” Hagiwara said.

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