Epistemic injustice in healthcare professional practice: A scoping review

Epistemic injustice, the unfair treatment of individuals in their capacity as knowers, has implications for the credibility, autonomy, and well-being of healthcare professionals. This scoping review addressed the following question: "What is known about epistemic injustice in healthcare professional practice as it relates to the experience of practitioners?". Guided by Arksey & O'Malley's methodology (2005), we searched eight databases for English and French language publications from 2007 to 2024. Of the 4186 records retrieved, 30 papers met the inclusion criteria. Fifteen papers originated in North America, with twenty-seven published between 2020 and 2024. Epistemic injustice was predominantly conceptualized through Miranda Fricker's constructs of testimonial and hermeneutical injustice, with numerous studies building on or extending Fricker's conceptualizations, and introducing other theorists and evolving concepts. The papers used qualitative research methodologies and theoretical analysis/commentary approaches; none used quantitative or mixed methods designs. Five themes related to epistemic injustice in healthcare professional practice were identified: (1) hierarchy of epistemic credibility, (2) epistemic politics, (3) constrained agency of healthcare practitioners, (4) pressures to modify professional self or identity, and (5) complex interplay of intersectional and social identities. A sixth cross-cutting theme highlighted (6) approaches aimed at mitigating epistemic injustice. The findings highlight the contextual, complex, and often obscure nature of epistemic injustice in the knowledge sharing practices of healthcare professionals. The review underscores the need for a more nuanced and justice-oriented conceptualization of these dynamics, greater visibility of their impact in everyday practice, and structural and educational reforms to foster more equitable knowledge sharing environments.