Create a Plan to Address Unconscious Bias

It's important to implement a plan for addressing unconscious biases and their potential impact on learners. 

Unconscious bias towards demographic variables and an extensive array of social factors is inherent in all learners. Bias is typically not a stagnant, but a dynamic reaction, activated by environmental and situational factors.

Within a safe environment, awareness of existing implicit bias should be followed by an actionable plan for management, based on the fundamental psychological and neurobiological components of bias. The complete elimination of unconscious bias is not possible, and teaching should include the explicit recognition that the goal of teaching is mitigation of the negative influence of bias on patient outcomes and not removal of such biases from the learner.

Unconscious bias is malleable and can be considered a habit. Modalities include metacognition, mindfulness and self-regulation, and self-monitoring. Evidence-based studies from racial bias include multi-faceted prejudice, habit-breaking interventions with long-term reduction in implicit race bias. A comprehensive approach that includes formal and informal cultural influences should include enhancing awareness of the impact of bias on learners and others on behavior and patient outcomes.

A comprehensive plan for addressing unconscious biases should be mitigation and not complete elimination. With the knowledge that there are neurobiological mechanisms that are outside of conscious awareness, this plan will consist of conscious efforts to overcome implicit bias and enhance awareness of implicit bias influences on others.

Quick Tips

  • A plan for addressing unconscious bias should include the neuroscience basis of such reactions, that is targeted at reduction and not elimination of unconscious bias
  • In a safe environment, increasing self-awareness of existing biases should be based on conscious efforts to overcome implicit bias
  • Personal bias can be addressed with metacognition, mindfulness and self-regulation, and self-monitoring
  • Enhancing awareness of how implicit bias influences others includes social contact, perspective taking and empathy

Authors: Birgit N Khandalavala, MD, Jessica B Koran-Scholl, PhD

References
  1. Sukhera J1, Watling C. A Framework for Integrating Implicit Bias Recognition Into Health Professions Education Acad Med. 2018 Jan; 93(1):35-40.
  2. Devine PG, Forscher PS, Austin AJ, Cox WT. Long-term reduction in implicit race bias: A prejudice habit-breaking intervention. J Exp Soc Psychol. 2012; 48(6):1267-1278.