Microaggressions and Implicit Bias in Hand Surgery

Area of Science:

• Medical Education
• Health Equity
• Surgical Specialties

Background:

• Implicit bias and microaggressions are recognized contributors to health care disparities.
• These biases manifest in various interactions within Hand Surgery, including patient-surgeon, peer, staff, and training environments.
• While racial and gender biases are studied, other factors like age, sexual orientation, socioeconomic status, and rank also contribute.

Purpose of the Study:

• To examine the presence and impact of implicit bias and microaggressions within the field of Hand Surgery.
• To highlight how these biases contribute to disparities in trainee, physician, and leadership demographics.
• To underscore the need for cultural change and actionable strategies beyond awareness.

Main Methods:

• Literature review and synthesis of existing research on implicit bias and microaggressions in medicine and academia.
• Analysis of documented evidence within Hand Surgery concerning demographic disparities.
• Qualitative assessment of interaction types where bias and microaggressions occur.

Main Results:

• Implicit bias and microaggressions are prevalent in Hand Surgery interactions.
• These biases contribute to documented disparities in the demographics of trainees, physicians, and leaders.
• Evidence suggests biases extend beyond race and gender to include age, sexual orientation, socioeconomic background, and rank.

Conclusions:

• Awareness of implicit bias and microaggressions is the first step toward combating them.
• Systemic actions are necessary to mitigate the negative effects of bias and microaggressions.
• A cultural shift is required to foster a more equitable and inclusive environment in Hand Surgery.