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Potential Racial Bias During Pediatric Emergency Care: A Simulation Study
Vaishnavi J Patel1, Elizabeth Byrne2, Jendi Haug2
1Office of Research and Innovation, University of the Incarnate Word School of Osteopathic Medicine, San Antonio, USA.
Cureus
|April 1, 2025
Summary
Implicit bias in pediatric care may affect treatment decisions. High-fidelity simulation revealed differences in managing sepsis based on manikin skin color, impacting oxygen and resuscitation interventions.
Area of Science:
- Medical Education
- Health Disparities
- Pediatric Emergency Medicine
Background:
- Minority populations experience worse health outcomes despite educational interventions.
- Implicit biases are recognized contributors to healthcare disparities, affecting pediatric care.
- High-fidelity simulation offers a controlled method to assess patient management decisions.
Purpose of the Study:
- To evaluate if high-fidelity simulation can identify disparities in pediatric emergency care decisions.
- To investigate differences in managing a pediatric sepsis case based on manikin skin color.
Main Methods:
- A standardized pediatric sepsis simulation scenario was developed.
- Pediatric residents were randomized to interact with either a dark or light skin manikin.
- Interventions and timing were analyzed by physician graders using standardized forms.
Main Results:
- Most care interventions were similar between light- and dark-skinned manikins.
- Dark-skinned infants received oxygen more frequently than light-skinned infants (100% vs. 55.5%).
- Light-skinned infants received compressions more often after asystole than dark-skinned infants (89% vs. 40%).
Conclusions:
- Simulated pediatric sepsis cases showed significant intervention differences based on manikin skin color.
- These disparities may stem from unconscious bias or assumptions about illness etiology.
- Simulation provides a valuable tool for further research into healthcare disparities.
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