Racial Implicit Bias and Communication Among Physicians in a Simulated Environment

Area of Science:

• Medical Education
• Health Disparities Research
• Psychology of Healthcare

Background:

• Racial implicit bias contributes to health disparities by negatively impacting physician communication with Black patients.
• Current interventions for physician bias are limited by a lack of realistic simulation tools for skill development.

Purpose of the Study:

• To develop and evaluate a high-fidelity simulation for assessing physician implicit racial bias.
• To understand how implicit bias influences physician-patient communication in simulated clinical encounters.

Main Methods:

• A cross-sectional study using an online platform with physician volunteers.
• Physicians interacted with standardized patients (SPs) of Black or White race in a simulated urgent care scenario with cognitive stressors.
• Physicians completed the Race Implicit Association Test (IAT) and Race Medical Cooperativeness IAT; SPs rated communication skills.

Main Results:

• A significant interaction was found between physicians' Race IAT scores and SP race on communication ratings.
• Black SPs received lower communication ratings than White SPs for a given pro-White bias.
• Physician communication ratings decreased as pro-White bias increased when interacting with Black SPs.

Conclusions:

• High-fidelity simulation effectively demonstrated the influence of racial implicit bias on physician communication.
• This simulation can inform the development of interventions to mitigate bias and improve care for Black patients.