Best Intentions: Using the Implicit Associations Test to Promote Reflection About Personal Bias

Abstract

OPEN ACCESSJanuary 19, 2010Best Intentions: Using the Implicit Associations Test to Promote Reflection About Personal Bias Anne Gill, DrPH, Britta Thompson, PhD, Cayla Teal, PhD, Rachel Shada, MHR, Ernest Fruge, PhD, Gracielia Villarreal, MD, Cindy Patton, MS, Paul Haidet, MD, MPH Anne Gill, DrPH Baylor College of Medicine Google Scholar More articles by this author , Britta Thompson, PhD Baylor College of Medicine Google Scholar More articles by this author , Cayla Teal, PhD Baylor College of Medicine Google Scholar More articles by this author , Rachel Shada, MHR Baylor College of Medicine Google Scholar More articles by this author , Ernest Fruge, PhD Baylor College of Medicine Google Scholar More articles by this author , Gracielia Villarreal, MD Baylor College of Medicine Google Scholar More articles by this author , Cindy Patton, MS Baylor College of Medicine Google Scholar More articles by this author , Paul Haidet, MD, MPH Baylor College of Medicine Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.7792 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail AbstractAbstract Introduction: This exercise is a small-group discussion about bias for medical students who have had at least some clinical experience. It is designed to cultivate awareness that bias is inherent in all humans, including physicians, and can impact patient care. The aim is to foster self-reflection through an exercise that challenges assumptions about personal bias. Methods: The Implicit Association Test (IAT) is used as a trigger, and a small-group discussion format is used to create reflection about personal biases and their effects on clinical decisions. Students discuss what it was like to take the IAT, how they felt when they got their results, if their results were expected, when bias can be helpful, clinical experiences with bias, and what they will do with their results. The content is presented as a set of guidelines and features materials for training facilitators and conducting the discussion. These materials comprise an outline of the exercise, advance preparation assignments, instructions for students, and a small-group facilitator guide. The materials also include evaluation tools consisting of pre- and postdiscussion student surveys and facilitator postdiscussion surveys. Results: As evidence that the IAT does generate meaningful discussion in a facilitated small group, we report the analysis of our pilot data (n = 72). Our exercise resulted in an increase in the perception that personal bias could have an impact on patient relationships (p < .001) among students reporting a lower belief that bias can have impact (n = 6). Among students who rated themselves as having a lower self-awareness prior to the exercise (n = 14), there was an increase in self-awareness of personal bias after the exercise (p < .001). Finally, students reported significant increases (p < .01) in the perception that the IAT was an effective tool for generating small-group discussion about personal bias (p < .001) and that the reflection exercises and small-group discussions were effective tools for raising awareness about personal bias (p < .001) after attending the session. Discussion: Our results suggest that the primary value of this exercise lies not simply in taking the IAT but rather in the cognitive processing of the IAT and other potential biases that takes place during the small-group session. The IAT in conjunction with the discussion appears to be what leads to increased self-awareness and self-reflection. Educational Objectives By the end of the module, learners will be able to: Acknowledge that bias is inherent in physicians' perspectives.Recognize the importance of self-reflection as a method for understanding their own biases.Verbalize the impact of stereotyping or personal bias on medical decision-making.List strategies to mitigate physician bias in patient care. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Instructor's Guide.doc Student Instruction 1.doc Student Instruction 2.doc Best Intentions Small Group Session Facilitator's Guide.doc Best Intentions Student Survey.doc Facilitator Training Survey.doc Best Intentions Timeline.doc To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. Copyright & Permissions© 2010 Gill et al. This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike license.KeywordsBiasReflectionCross-CulturalImplicit Association TestStereotypingPrejudiceHealth Equity ResearchIAT Disclosures None to report. Funding/Support None to report. Prior Presentations Crandall S, Gill AC, Marion G, Haidet P. Using Implicit Association Tests in Medical Education: A Method to Promote Self-Reflection and Cultural Humility Society for Teachers of Family Medicine. Presented at: 35th Annual Meeting; January 2009; Savannah, GA. Teal, Gill AC, Thompson, Shada, Fruge, Patton, Haidet P. When Best Intentions Aren't Good Enough: Helping Medical Students Reflect on Personal Bias about Patients. Presented at: Annual Academy of Distinguished Educator's Showcase of Educational Scholarship; October 3, 2008. Loading ...