Implicit Bias and Recognition of Biases Among Vascular Surgeons

Implicit bias can influence behavior and decision-making, such as treatment decisions in clinical settings. Given documented Black-White disparities in vascular care, the purpose of this study was to describe the prevalence and degree of implicit bias and recognition of bias among vascular surgeons.

The sample included vascular surgeons in the Vascular Quality Initiative. Participants completed a survey of demographic questions, race implicit association test, and six bias recognition questions. Implicit bias was categorized as no preference, or slight, moderate, or strong pro-White or pro-Black. We stratified implicit and bias recognition findings by physician race/ethnicity, sex, years of experience, and region; and examined the relationship between implicit bias and bias recognition.

The survey was completed by 304 participants. Most participants (71.6%) showed a pro-White bias with 73.0% of this group in moderate and strong categories. Bias magnitude varied based on physician race/ethnicity, years of experience, and region. Although 77.5% of respondents showed recognition of biases, of those whose results showed lack of recognition, 67.8% had moderate or strong bias. Women were more likely than men to report recognition of biases and of the potential impact of bias on decision-making.

Most people have some level of implicit bias, developed from early life reinforcements, social stereotypes, and learned experiences. However, these are important findings in a profession that takes care of a high proportion of individuals from structurally vulnerable groups. Given the lack of association between implicit bias and recognition of biases, recognition may be an important first step to minimize documented disparities.