Non-conscious bias in medical decision making: What can be done to reduce it?

Jeffrey A Stone, Gordon B. Moskowitz

Research output: Contribution to journalArticle

101 Citations (Scopus)

Abstract

Context Non-conscious stereotyping and prejudice contribute to racial and ethnic disparities in health care. Contemporary training in cultural competence is insufficient to reduce these problems because even educated, culturally sensitive, egalitarian individuals can activate and use their biases without being aware they are doing so. However, these problems can be reduced by workshops and learning modules that focus on the psychology of non-conscious bias. The Psychology of NON-Conscious Bias Research in social psychology shows that over time stereotypes and prejudices become invisible to those who rely on them. Automatic categorisation of an individual as a member of a social group can unconsciously trigger the thoughts (stereotypes) and feelings (prejudices) associated with that group, even if these reactions are explicitly denied and rejected. This implies that, when activated, implicit negative attitudes and stereotypes shape how medical professionals evaluate and interact with minority group patients. This creates differential diagnosis and treatment, makes minority group patients uncomfortable and discourages them from seeking or complying with treatment. Pitfalls in Cultural Competence Training Cultural competence training involves teaching students to use race and ethnicity to diagnose and treat minority group patients, but to avoid stereotyping them by over-generalising cultural knowledge to individuals. However, the Culturally and Linguistically Appropriate Services (CLAS) standards do not specify how these goals should be accomplished and psychological research shows that common approaches like stereotype suppression are ineffective for reducing non-conscious bias. To effectively address bias in health care, training in cultural competence should incorporate research on the psychology of non-conscious stereotyping and prejudice. Training in Implicit Bias Enhances Cultural Competence Workshops or other learning modules that help medical professionals learn about non-conscious processes can provide them with skills that reduce bias when they interact with minority group patients. Examples of such skills in action include automatically activating egalitarian goals, looking for common identities and counter-stereotypical information, and taking the perspective of the minority group patient.

Original languageEnglish (US)
Pages (from-to)768-776
Number of pages9
JournalMedical Education
Volume45
Issue number8
DOIs
StatePublished - Aug 2011

Fingerprint

Cultural Competency
Minority Groups
Stereotyping
decision making
Psychology
prejudice
trend
minority
stereotype
psychology
Group
Research
Healthcare Disparities
Learning
Education
Social Psychology
health care
Teaching
Emotions
Differential Diagnosis

ASJC Scopus subject areas

  • Medicine(all)
  • Education

Cite this

Non-conscious bias in medical decision making : What can be done to reduce it? / Stone, Jeffrey A; Moskowitz, Gordon B.

In: Medical Education, Vol. 45, No. 8, 08.2011, p. 768-776.

Research output: Contribution to journalArticle

@article{e15dacf89d86463e9c23d3d1100cd75b,
title = "Non-conscious bias in medical decision making: What can be done to reduce it?",
abstract = "Context Non-conscious stereotyping and prejudice contribute to racial and ethnic disparities in health care. Contemporary training in cultural competence is insufficient to reduce these problems because even educated, culturally sensitive, egalitarian individuals can activate and use their biases without being aware they are doing so. However, these problems can be reduced by workshops and learning modules that focus on the psychology of non-conscious bias. The Psychology of NON-Conscious Bias Research in social psychology shows that over time stereotypes and prejudices become invisible to those who rely on them. Automatic categorisation of an individual as a member of a social group can unconsciously trigger the thoughts (stereotypes) and feelings (prejudices) associated with that group, even if these reactions are explicitly denied and rejected. This implies that, when activated, implicit negative attitudes and stereotypes shape how medical professionals evaluate and interact with minority group patients. This creates differential diagnosis and treatment, makes minority group patients uncomfortable and discourages them from seeking or complying with treatment. Pitfalls in Cultural Competence Training Cultural competence training involves teaching students to use race and ethnicity to diagnose and treat minority group patients, but to avoid stereotyping them by over-generalising cultural knowledge to individuals. However, the Culturally and Linguistically Appropriate Services (CLAS) standards do not specify how these goals should be accomplished and psychological research shows that common approaches like stereotype suppression are ineffective for reducing non-conscious bias. To effectively address bias in health care, training in cultural competence should incorporate research on the psychology of non-conscious stereotyping and prejudice. Training in Implicit Bias Enhances Cultural Competence Workshops or other learning modules that help medical professionals learn about non-conscious processes can provide them with skills that reduce bias when they interact with minority group patients. Examples of such skills in action include automatically activating egalitarian goals, looking for common identities and counter-stereotypical information, and taking the perspective of the minority group patient.",
author = "Stone, {Jeffrey A} and Moskowitz, {Gordon B.}",
year = "2011",
month = "8",
doi = "10.1111/j.1365-2923.2011.04026.x",
language = "English (US)",
volume = "45",
pages = "768--776",
journal = "Medical Education",
issn = "0308-0110",
publisher = "Wiley-Blackwell",
number = "8",

}

TY - JOUR

T1 - Non-conscious bias in medical decision making

T2 - What can be done to reduce it?

AU - Stone, Jeffrey A

AU - Moskowitz, Gordon B.

PY - 2011/8

Y1 - 2011/8

N2 - Context Non-conscious stereotyping and prejudice contribute to racial and ethnic disparities in health care. Contemporary training in cultural competence is insufficient to reduce these problems because even educated, culturally sensitive, egalitarian individuals can activate and use their biases without being aware they are doing so. However, these problems can be reduced by workshops and learning modules that focus on the psychology of non-conscious bias. The Psychology of NON-Conscious Bias Research in social psychology shows that over time stereotypes and prejudices become invisible to those who rely on them. Automatic categorisation of an individual as a member of a social group can unconsciously trigger the thoughts (stereotypes) and feelings (prejudices) associated with that group, even if these reactions are explicitly denied and rejected. This implies that, when activated, implicit negative attitudes and stereotypes shape how medical professionals evaluate and interact with minority group patients. This creates differential diagnosis and treatment, makes minority group patients uncomfortable and discourages them from seeking or complying with treatment. Pitfalls in Cultural Competence Training Cultural competence training involves teaching students to use race and ethnicity to diagnose and treat minority group patients, but to avoid stereotyping them by over-generalising cultural knowledge to individuals. However, the Culturally and Linguistically Appropriate Services (CLAS) standards do not specify how these goals should be accomplished and psychological research shows that common approaches like stereotype suppression are ineffective for reducing non-conscious bias. To effectively address bias in health care, training in cultural competence should incorporate research on the psychology of non-conscious stereotyping and prejudice. Training in Implicit Bias Enhances Cultural Competence Workshops or other learning modules that help medical professionals learn about non-conscious processes can provide them with skills that reduce bias when they interact with minority group patients. Examples of such skills in action include automatically activating egalitarian goals, looking for common identities and counter-stereotypical information, and taking the perspective of the minority group patient.

AB - Context Non-conscious stereotyping and prejudice contribute to racial and ethnic disparities in health care. Contemporary training in cultural competence is insufficient to reduce these problems because even educated, culturally sensitive, egalitarian individuals can activate and use their biases without being aware they are doing so. However, these problems can be reduced by workshops and learning modules that focus on the psychology of non-conscious bias. The Psychology of NON-Conscious Bias Research in social psychology shows that over time stereotypes and prejudices become invisible to those who rely on them. Automatic categorisation of an individual as a member of a social group can unconsciously trigger the thoughts (stereotypes) and feelings (prejudices) associated with that group, even if these reactions are explicitly denied and rejected. This implies that, when activated, implicit negative attitudes and stereotypes shape how medical professionals evaluate and interact with minority group patients. This creates differential diagnosis and treatment, makes minority group patients uncomfortable and discourages them from seeking or complying with treatment. Pitfalls in Cultural Competence Training Cultural competence training involves teaching students to use race and ethnicity to diagnose and treat minority group patients, but to avoid stereotyping them by over-generalising cultural knowledge to individuals. However, the Culturally and Linguistically Appropriate Services (CLAS) standards do not specify how these goals should be accomplished and psychological research shows that common approaches like stereotype suppression are ineffective for reducing non-conscious bias. To effectively address bias in health care, training in cultural competence should incorporate research on the psychology of non-conscious stereotyping and prejudice. Training in Implicit Bias Enhances Cultural Competence Workshops or other learning modules that help medical professionals learn about non-conscious processes can provide them with skills that reduce bias when they interact with minority group patients. Examples of such skills in action include automatically activating egalitarian goals, looking for common identities and counter-stereotypical information, and taking the perspective of the minority group patient.

UR - http://www.scopus.com/inward/record.url?scp=79960347556&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79960347556&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2923.2011.04026.x

DO - 10.1111/j.1365-2923.2011.04026.x

M3 - Article

C2 - 21752073

AN - SCOPUS:79960347556

VL - 45

SP - 768

EP - 776

JO - Medical Education

JF - Medical Education

SN - 0308-0110

IS - 8

ER -