Implicit Bias in Health Professionals: A Scoping Review

Area of Science:

• Health Professions Education
• Health Equity Research
• Psychometrics

Background:

• Implicit bias, characterized by unconscious attitudes and stereotypes, can significantly affect clinical decision-making and perpetuate health disparities.
• Assessing implicit bias among healthcare professionals and students is crucial for understanding and mitigating its impact on patient care.

Purpose of the Study:

• To conduct a scoping review mapping the measurement strategies used to assess implicit bias in healthcare professionals and students.
• To identify common bias domains, instruments used, and gaps in the evidence base regarding implicit bias measurement in healthcare settings.

Main Methods:

• A comprehensive scoping review was performed using Joanna Briggs Institute guidance and PRISMA-ScR methodology.
• Searches were conducted across multiple databases (PubMed, Embase, BVS, Google Scholar) up to November 2025, with data independently screened and charted by two reviewers.
• Included 93 studies from 28 countries, analyzing 57 bias domains and 42 unique measurement instruments.

Main Results:

• Race/ethnicity, weight, and sexual orientation were the most frequently studied bias domains.
• The Implicit Association Test was the predominant instrument, though psychometric validation and administration details were often limited, hindering comparability.
• Evidence gaps were noted in primary care and community settings, with underrepresentation of biases related to age, disability, and intersectionality.

Conclusions:

• The evidence base for measuring implicit bias in healthcare is expanding but remains fragmented.
• Standardized administration, reporting, and robust psychometric validation are essential for improving the quality and interpretability of implicit bias measures.
• Future research should focus on diverse care settings and identities to develop effective, equity-oriented interventions and educational strategies.