Blackface, Implicit Bias, and the Informal Curriculum: Shaping the Healthcare Workforce, and Improving Health

Blackface, Implicit Bias, and the Informal Curriculum: Shaping the Healthcare Workforce, and Improving Health.

Health disparities disproportionately affect minority populations and are due to multiple factors including discrimination and implicit bias. Biases are ubiquitous throughout society, including the educational and healthcare environment. In health care it is at the patient-provider level that our biases play a major role in patient care exhibiting a rippling effect going beyond individual provider biases affecting not only patients and families but all members of the healthcare team.

Although biases are in play across the entire medical school curriculum the most significant impact is during clerkships. During clerkships students are exposed to and prone to adopt and internalize identities and traits that may run counter to the basic tenants of medicine and the Hippocratic tradition of non-maleficence, beneficence, and compassion. Implicit biases develop early, are difficult to change and as shown by recent allegations of political figures appearing in blackface remain intact into adulthood.

At the institutional level biases can be addressed and mitigated through cultural humility and implicit bias training, training in culturally and linguistically appropriate services, increased workforce diversity through support of STEM- based enrichment programs and curriculum changes that include clinical vignettes emphasizing the effects of race, gender, sexual orientation, and ethnicity, on access and quality of care; reflective writing and small group sessions that provide safe spaces for students; and experiential learning in underserved communities. Resulting in an educational environment that directly addresses the role of implicit bias, racism, and discrimination in individual and population health.