Unconscious Bias

Our society teaches and reinforces many biases about groups and individuals that may be harmful for patient care. These biases may also be harmful to teaching and learning processes in clinical environments. Many of these biases are not consciously held by the person and may be counter to how the person believes groups and individuals should be treated by society and medicine. Having a bias is not the same as being racist, sexist, ageist, or opposed to any individual. Biases are a normal part of the human brain’s ability to interpret complex data streams.

Everyone has implicit or unconscious bias as a result of messages and information we receive on a daily basis as we go about our lives. Unconscious bias can be measured via Implicit Association Tests, like Project Implicit from Harvard, and appears as a preference for one group over another along the lines of identity (gender, race, age, size, etc). Even though these beliefs are not conscious, they can, and often do, impact the way physicians care for patients and interact with learners. Studies show that unconscious bias can lead to the delivery of poorer health care, harm to patients, and increased health disparities. Strategies exist for physicians to reduce the impact of their implicit bias while caring for patients.

Quick Tips

  • Be aware of the existence of unconscious bias and that it may be influencing their behavior towards patients and learners
  • Reflect on the information and messages you receive throughout the day in media, news, advertisements, etc and consider how this might be unconsciously influencing your views towards particular groups or individuals
  • Explore the concepts of thinking fast and slow (also known as system 1 and system 2 thinking when applied to clinical reasoning).  Thinking fast is unconscious and leads quickly to an answer, thinking slow takes deliberation

Authors: Sean P Haley, MD MPH, Amanda Kost, MD MEd

Reference
  1. Chapman, E.N., Kaatz, A. & Carnes, M. J GEN INTERN MED (2013) 28: 1504. https://doi.org/10.1007/s11606-013-2441-1