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A Skills-Based Longitudinal Intervention for Clinician Educators: Addressing Implicit Bias in Patient Care and the
Hana Khidir1, Savanna Carson, Stefanie Vassar
1Dr. Khidir: Assistant Professor of Medicine at Olive View - UCLA Medical Center, Los Angeles, CA. Dr. Carson: Program Director of Community Research for the UCLA Clinical and Translational Science Institute's Community Engagement & Research Program, Los Angeles, CA. Ms. Vassar: Program Director for the UCLA Clinical and Translational Science Institute's Community Engagement & Research Program, Los Angeles, CA. Dr. Nafisi: Professor of Medicine at Olive View - UCLA Medical Center and Assistant Program Director for the UCLA Internal Medicine Primary Care Residency Program, Los Angeles, CA. Dr. Abdullahi: Associate Professor of Medicine at Olive View - UCLA Medical Center and Assistant Program Director for the UCLA-Olive View Internal Medicine Residency Program, Los Angeles, CA. Dr. Shah: Associate Professor of Pediatrics at David Geffen School of Medicine at UCLA, Los Angeles, CA. Dr. Belani: Associate Clinical Professor of Medicine at University of California Los Angeles David Geffen School of Medicine and Clinical Assistant Professor of Medicine at Charles R. Drew University of Medicine and Science, and Director of Primary Care for the Los Angeles County Health Services Ambulatory Care Network and Health Sciences, Los Angeles, CA. Dr. Meza: Assistant Professor of Medicine at the UCLA David Geffen School of Medicine, Los Angeles, CA. Dr. Brown: Professor of Medicine at the UCLA David Geffen School of Medicine and Co-Director of the UCLA Clinical and Translational Science Institute, Los Angeles, CA. Dr. Gonzalez: Associate Director for Medical Education at the Institute for Excellence in Health Equity and Professor of Medicine and Population Health at New York University Grossman School of Medicine, New York, NY.
Introduction:
Implicit bias contributes to health care disparities. Addressing implicit bias is one focus of health professions education and learners desire instruction in the topic. Few faculties received skills-based instruction in addressing implicit bias during their own education and training and often feel ill-equipped to facilitate this instruction. Recognizing faculty are both learners and teachers in addressing implicit bias, the authors developed a longitudinal faculty development program informed by the implicit bias recognition and management (IBRM) framework.
Methods:
The program, IBRM for Faculty (IBRM4Fac), comprised 8 sixty-minute sessions delivered virtually from November 2020 to March 2021 at an academic safety-net health system. Program goals were skills development, including restoring rapport with patients, debriefing biased encounters, and addressing bias from patients. An external expert in IBRM led each session; materials included slides, worksheets to guide skills-development, and an audience response system. The mixed-methods program evaluation used preprogram/postprogram surveys.
Results:
Approximately 50 faculty primarily from the department of medicine were invited to participate in the program, N = 17 (34%) participated. Significant improvements occurred in 9/10 surveyed domains of IBRM (P < .05). Narrative responses analyzed through reflexive thematic analysis yielded three themes: (1) Personal strategy development; (2) Personal obstacles to sustained organizational change; and (3) Systemic barriers to sustained organizational change.
Discussion:
IBRM4Fac enhanced faculty confidence in addressing implicit bias, and helped faculty overcome identified challenges to implement strategies for teaching, role-modeling, and systems change in addressing implicit bias. Despite a small sample, our program could inform faculty development in addressing implicit bias in clinical and teaching encounters.
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