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    Role identifier badges can assist patients, reduce perceptions of bias in health care setting, Mayo Clinic study finds

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ROCHESTER, Minn. — Patients see a wide variety of medical professionals during a hospital stay, and it can be challenging for them to remember the titles and roles of everyone involved in their care. Many hospitals use name tags and other visual cues to help patients know who's providing their care, but misidentification remains an issue.

Resident physicians are often misidentified by patients and colleagues in hospitals, and it's especially common for female residents, according to an article published in Mayo Clinic Proceedings. Mayo researchers set out to learn whether the use of prominent role identifier badges can help reduce misidentification as well as resident physicians' perceptions of gender or racial bias.

"We had heard recurring concerns from our trainees who were being misidentified by patients and other health care workers and not being recognized as resident doctors," says Amy Oxentenko, M.D., a Mayo Clinic gastroenterologist and chair of Internal Medicine at Mayo Clinic in Arizona. "Because of conscious or unconscious biases, women are often assumed to be nurses or other allied health staff, and trainees from underrepresented backgrounds had shared that they were asked if they were from other hospital services, such as janitorial or phlebotomy."

As health care training programs become increasingly diverse in terms of gender, race and ethnicity, the issue has become even more important, says Dr. Oxentenko, the study's senior author. "Misidentification of trainees has a negative impact on the culture of inclusion we are trying to build," she says. "It's essential to reduce workplace bias if we're going to improve diversity and inclusivity efforts in training programs."

The study involved 341 resident physicians at Mayo Clinic in Rochester from October to December 2019. Of the 159 residents who returned surveys before and after, 128 wore prominent badges that said "Doctor" for eight weeks. According to the results, residents who wore the badges were significantly less likely to report role misidentification at least once a week from patients, physicians and nonphysician team members. The 66 female residents reported significantly fewer episodes of gender bias.

Bias takes on a variety of forms, but may be as subtle as language differences and word choices, according to Emily Olson, M.D., an internal medicine physician and chief medical resident at Mayo Clinic in Rochester. Consistent failure to be recognized as physicians by patients and other team members leads to differential use of professional titles as well as racial and gender bias. Ultimately, it can lead to job dissatisfaction, burnout and changes in career paths.

"While our study focused on resident physicians, misidentification and perceptions of bias are experienced by many physicians," says Dr. Olson. "It is very common to hear from women and those who are underrepresented in medicine who say they are misidentified in terms of role, and may experience bias because of it."

The authors call for universal implementation of role badges as an opportunity for health care institutions to support diversity and inclusivity efforts, and to limit the negative impact of stereotypes and bias in the clinical learning environment.

Journalists: A video of Dr. Olson discussing the study is available here.

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About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a monthly peer-reviewed journal that publishes original articles and reviews on clinical and laboratory medicine, clinical research, basic science research, and clinical epidemiology. The journal, sponsored by Mayo Foundation for Medical Education and Research as part of its commitment to physician education, has been published for 95 years and has a circulation of 127,000.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

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