Implicit Bias in Learners

Unconscious bias needs to be addressed in an open and inclusive environment while simultaneously mitigating potential impact of adverse bias to learners at risk. 

A key distinguishing element from diversity or cultural competence education is a proactive shift away from guilt and towards building awareness and responsibility. A climate of safety is requisite and the learning environment should proactively avoid reinforcing feelings of resentment or anxiety for all learners, as well as those at increased risk who do not belong to traditionally privileged groups.

A six-point actionable framework for integration of implicit bias recognition and management into health professional education begins with:

  1. Inculcating a safe environment and nonthreatening learning environment
  2. Increasing knowledge about the basis of implicit bias
  3. Understanding the impact on behavior and patient outcomes
  4. Increasing self-awareness of such biases
  5. Improving conscious efforts to mitigate the inherent bias
  6. Enhancing awareness of how implicit bias influences others
Such teaching should consist of an approachable teacher, sufficient time and respect for confidentiality, and understanding of inherent risks. These risks include confrontation and challenges that can reinforce counterproductive biases. 

Promote a nonthreatening learning environment for exploring implicit bias by openly addressing the discomfort that may accompany discussions about bias and privilege in both learners with bias and who are the subjects of bias.

Quick Tips

  • Open discussions should be optimally conducted by an approachable instructor who is inclusive, inspiring, open-minded, encouraging, and knowledgeable about bias
  • Core values of respect, integrity and confidentiality should be emphasized
  • Sufficient time should be taken for reflection and discussion by learners with bias or subjects of bias

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

  1. Sukhera J, Watling C. A Framework for Integrating Implicit Bias Recognition Into Health Professions Education Acad Med. 2018 Jan; 93(1):35-40. doi:10.1097/ACM.0000000000001819.