• By Joel Streed

Targeting Unconscious Bias in Health Care

April 21, 2015

Unconscious bias, also called implicit bias, affects health care providers every day, especially when they are stressed or tired. Swift and automatic, it can reduce quality of care and even lead to medical errors.

Michelle van Ryn, Ph.D., who is the director of Mayo’s Research Program on Equity and Inclusion in Health Care, says, “All of us, despite the best of all possible intentions, are affected by unconscious processes. It affects what we see, how we react, how we feel, how we behave. If we’re not aware of it and taking measures to counter it, it affects quality of care.”

Implicit bias stems from subconscious associations gathered over a lifetime that can override conscious beliefs and cause people to unknowingly act in ways that are inconsistent with their true values.

In health care, unconscious bias might affect a provider’s line of questioning and lead to misdiagnosis. Or, it can affect body language and other subtle cues that cause patients to lose trust, withhold information or fail to follow medical advice.

The Research Program on Equity and Inclusion in Health Care team at Mayo Clinic, led by Dr. van Ryn, is studying unconscious bias and testing interventions to prevent its influence on patient care. In collaboration with Yale University and the University of Minnesota, the Mayo team is conducting a national study on environment and training in 49 medical schools and how student attitudes change over time. Researchers are exploring interventions to reduce implicit bias, including:

Medical school and institutional environments that are accepting and inclusive
Increased diversity in the health care workforce
Health care settings that minimize provider stress and fatigue
Provider training on skills that prevent them from being hijacked by implicit biases: emotion regulation, perspective-taking (putting one-self in the patient’s shoes), and partnership-building with patients

The Medical Student Cognitive Habits and Growth Evaluation Study (CHANGES) study also examines the health and well-being of minority; female; low income; lesbian, gay, bisexual and transgender (LGBT); and obese students in medical schools, consistent with a National Institutes of Health priority to reduce health disparities by increasing diversity in health professions.

Learn more at the Mayo Clinic Office of Health Disparities Research website.

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