Pre-clinical medical student reflections on implicit bias: Implications for learning and teaching

Area of Science:

• Medical Education
• Health Disparities
• Psychology

Background:

• Implicit bias significantly impacts healthcare professionals' clinical decisions.
• Limited published curricula address implicit bias in medical education.

Purpose of the Study:

• To document a novel approach for teaching implicit bias to medical students.
• To assess student understanding and reactions to implicit bias instruction.

Main Methods:

• Medical students (2014-2015) received implicit bias instruction within a determinants of health course.
• Students submitted reflective essays analyzing their Implicit Association Test (IAT) experience and course content.
• Grounded theory methodology was used to analyze essay themes, with inter-rater reliability assessed on 25% of essays.

Main Results:

• 75% of 250 essays discussed IAT results, focusing on the test experience, bias in medicine, and prescriptive actions.
• 84% of comments acknowledged the importance of recognizing implicit bias.
• 60% recognized bias's impact on clinical decision-making; 19% advocated for physician responsibility in dismantling bias.

Conclusions:

• Implicit Association Test (IAT) and implicit bias education enhance medical students' insight into clinical decision-making.
• Early exposure to implicit bias concepts through the IAT can establish a foundation for future discussions on human tendencies in medicine.