Clinicians should be able to reflect on their beliefs and opinions to ensure that their thoughts are clear of bias. It can be challenging to be clear of bias and judgment, which leads us to the definition of unconscious bias. The definition of bias is the evaluation of someone that can be positive or negative, implicit or unconscious, when a person is unaware of their evaluation of another person. Although implicit bias is unconscious, it negatively impacts treatment in the healthcare setting (Gopal et al., 2021). Cultural humility is a term that is often used in the mental and physical healthcare disciplines. One should be able to learn from and integrate other cultures when providing treatment.
The Implicit Association Test (IAT) is a tool for monitoring if implicit bias exists. I had taken the IAT before, specifically on race, and was surprised about the results, as I did not expect the score I received related to unconscious bias of skin color. The evaluation design was slightly confusing, which I believe is the point. For example, it asks you to respond to the pictures of Black people and White people within a short time as it relates to “good” and “bad,” then the test changed the prompts, and it became increasingly difficult to stop and think before answering. There are findings on how media shapes people’s opinions of others and/or events, and they are not always aware of how social networking websites influence their views (Pansenella et al., 2023).
Most recently I took the IAT and decided to look test my unconscious bias on disability. I did not have any expectations about what my possible unconscious bias would be about disability. Therefore, I welcome the results. The process of the test is as follows: the participant sorts pictures and words into groups as fast as they can, and in addition to the IAT, there are some questions about one’s beliefs, attitudes, and opinions, and some standard demographic questions. The participant can decline to answer the demographics, but the opinions go well with determining the results.
Taking the opinion part of the test reminded me of how difficult it can be to answer a question. The questions presented with few options, like slightly agree, agree, neither agree nor disagree, etc., make me feel that, at times, I want to answer with a response and example. Likert tests are great at simplifying the responses for measurable results. I sometimes wonder if my responses are accurate based on how I view the question.
I took the test twice, as I was distracted the first time. The second time, I could give my full attention; ironically, the results were the same. The sorting part of the test revealed overall results confirming unconscious bias; I am glad to have learned this. Reflecting on beliefs, engagement, and practice is vital in healthcare. In being aware of unconscious bias, the following three steps are helpful ways to create a culturally sensitive practice:
- Become a lifelong learner. Clinicians and practitioners are responsible for using evidence-based practices when working with patients. Considering a patients’ age, gender, ability, religion, race/ethnicity and sexual orientation is a vital part of their treatment.
- Be open to others’ experiences. The patient is the expert on their experience, and only they can share their feelings about their symptoms in their daily life. Active listening is an important step in caring for the patient as addressing health disparities can impact decision making.
- One size does not fit all. What one sees or thinks should not equal a generic solution without gathering specific information from the patient. The research and evidence on treating a 25 year old White male with symptoms of gastrointestinal issues is not applicable to treating a 50 year old Latinx woman with gastrointestinal symptoms.
Overall, research-based evidence is ever-changing, and it is part of the job of a mental and physical healthcare provider to remain updated. Being curious and asking questions opens a dialog to learn from the patient and understand their perspective of their symptoms and their disparities of health. Solutions emerge with patient information and the clinician or physician’s education in making clinical decisions. Integrating the patient’s culture, intersecting identities and lived experiences into their treatment plan provides individualized care.
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Gopal, D. P., Chetty, U., O’Donnell, P., Gajria, C., & Blackadder-Weinstein, J. (2021). Implicit bias in healthcare: clinical practice, research and decision making. Future healthcare journal, 8(1), 40–48. https://doi.org/10.7861/fhj.2020-0233
Pansanella, V., Sîrbu, A., & Kertesz, J. (2023). Mass media impact on opinion evolution in biased digital environments: a bounded confidence model. Sci Rep 13, 14600. https://doi.org/10.1038/s41598-023-39725-y
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