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Helping medical learners recognise and manage unconscious bias toward certain patient groups

Authors

  • Cayla R Teal,

    1. Office of Undergraduate Medical Education, Baylor College of Medicine, Houston, Texas, USA
    2. Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
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  • Anne C Gill,

    1. Office of Undergraduate Medical Education, Baylor College of Medicine, Houston, Texas, USA
    2. Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
    3. Department of Medical Ethics, Baylor College of Medicine, Houston, Texas, USA
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  • Alexander R Green,

    1. The Disparities Solution Center, Massachusetts General Hospital, Boston, Massachusetts, USA
    2. Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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  • Sonia Crandall

    1. Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    2. Department of Physician Assistant Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Dr Cayla R Teal, Office of Undergraduate Medical Education, Baylor College of Medicine, 1 Baylor Plaza, MS: BCM300, Houston, Texas 77030-3411, USA. Tel: 00 1 713 798 7975; Fax: 00 1 713 798 8522; E-mail: cteal@bcm.edu

Abstract

Medical Education 2012: 46: 80–88

Context  For the last 30 years, developments in cognitive sciences have demonstrated that human behaviour, beliefs and attitudes are shaped by automatic and unconscious cognitive processes. Only recently has much attention been paid to how unconscious biases based on certain patient characteristics may: (i) result in behaviour that is preferential toward or against specific patients; (ii) influence treatment decisions, and (iii) adversely influence the patient–doctor relationship. Partly in response to accreditation requirements, medical educators are now exploring how they might help students and residents to develop awareness of their own potential biases and strategies to mitigate them.

Methods  In this paper, we briefly review key cognition concepts and describe the limited published literature about educational strategies for addressing unconscious bias.

Discussion  We propose a developmental model to illustrate how individuals might move from absolute denial of unconscious bias to the integration of strategies to mitigate its influence on their interactions with patients and offer recommendations to educators and education researchers.

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