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When Best Intentions Aren’t Enough: Helping Medical Students Develop Strategies for Managing Bias about Patients

  • Innovations in Education
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Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

Introduction/Aims

Implicit bias can impact physician–patient interactions, alter treatment recommendations, and perpetuate health disparities. Medical educators need methods for raising student awareness about the impact of bias on medical care.

Setting

Seventy-two third-year medical student volunteers participated in facilitated small group discussions about bias.

Program Description

We tested an educational intervention to promote group-based reflection among medical students about implicit bias.

Program Evaluation

We assessed how the reflective discussion influenced students’ identification of strategies for identifying and managing their potential biases regarding patients. 67% of the students (n = 48) identified alternate strategies at post-session. A chi-square analysis demonstrated that the distribution of these strategies changed significantly from pre-session to post-session \( \left( {{X^2}\left( {11} \right) = 27.93,\,p < 0.01} \right) \), including reductions in the use of internal feedback and humanism and corresponding increases in the use of reflection, debriefing and other strategies.

Discussion

Group-based reflection sessions, with a provocative trigger to foster engagement, may be effective educational tools for fostering shifts in student reflection about bias in encounters and willingness to discuss potential biases with colleagues, with implications for reducing health disparities.

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Acknowledgements

This work was supported in part by the Houston VA HSR&D Center of Excellence (HFP90-020, from the Office of Research and Development, U.S. Department of Veterans Affairs. This work was also supported by K07-HL85622 from the National Heart, Lung, and Blood Institute, and K07 HL082629-01 from the National Institutes of Health Office of Behavioral and Social Sciences Research. The funders had no role in writing or the decision to submit this report for publication. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

Conflict of Interest

The authors report no conflicts of interest. Dr. Haidet has been a consultant for Merck Inc. during the last 3 years.

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Authors and Affiliations

  1. Houston VA HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA

    Cayla R. Teal PhD & Rachel E. Shada MHR

  2. Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Cayla R. Teal PhD & Rachel E. Shada MHR

  3. Office of Undergraduate Medical Education, Baylor College of Medicine, Houston, TX, USA

    Anne C. Gill DrPH

  4. Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA

    Anne C. Gill DrPH, Ernest Frugé PhD & Graciela B. Villarreal MD

  5. Office of Educational Development and Support, The University of Oklahoma College of Medicine, Oklahoma City, OK, USA

    Britta M. Thompson PhD

  6. Department of Pediatrics, The University of Oklahoma College of Medicine, Oklahoma City, OK, USA

    Britta M. Thompson PhD

  7. The Office of Medical Education, The Pennsylvania State University College of Medicine, Hershey, PA, USA

    Paul Haidet MD, MPH

  8. Department of Medicine, The Pennsylvania State University College of Medicine, Hershey, PA, USA

    Paul Haidet MD, MPH

Authors
  1. Cayla R. Teal PhD
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  2. Rachel E. Shada MHR
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  3. Anne C. Gill DrPH
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  4. Britta M. Thompson PhD
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  5. Ernest Frugé PhD
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  6. Graciela B. Villarreal MD
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  7. Paul Haidet MD, MPH
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Corresponding author

Correspondence to Cayla R. Teal PhD.

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Teal, C.R., Shada, R.E., Gill, A.C. et al. When Best Intentions Aren’t Enough: Helping Medical Students Develop Strategies for Managing Bias about Patients. J GEN INTERN MED 25 (Suppl 2), 115–118 (2010). https://doi.org/10.1007/s11606-009-1243-y

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  • DOI: https://doi.org/10.1007/s11606-009-1243-y

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