The Impact of Brief Health Equity/Implicit Bias Education on Patient-Centered Communication Among Clinical Teaching...

A patient-centered approach to clinical care is related to improved outcomes. Patient -centered communication (PCC) includes eliciting the patient's agenda, active listening, partnering with patients and expressing empathy. Clinicians' implicit bias is associated with low quality PCC.

We explored whether brief health equity/implicit bias education improves academic clinicians' PCC and if implicit and explicit race and gender bias are associated with PCC improvement. This mixed methods online survey of clinical teaching faculty included tests of implicit and explicit race and gender bias, demographic and practice characteristics, a brief online health equity implicit bias educational intervention, and a pre-and-post course simulated clinical interaction using case vignettes. Emotional elements (empathy, reassurance, concern and partnering) of PCC were assessed to determine the impact of the course on PCC.

Of 103 participants, 70.9% were female, 71.8% were White and 57.3% were MDs. We found that participants held moderate implicit bias favoring White People versus Black people (Cohen's d = 0.66) and a strong implicit association of males rather than females with the concept of "career" (Cohen's d = 1.15). Overall, brief implicit bias education did not significantly change participant PCC, however, early career clinicians and those who identified as medical doctors showed significantly greater post-course PCC improvement. Implicit and explicit bias were not associated with PCC scores.

The impact of brief health equity/implicit bias education may go beyond knowledge acquisition and influence PCC if tailored to a specific discipline and stage of career, regardless of clinicians' personal biases.