Racial Bias in the Assessment of Pain

Abstract

<h3>Research Objectives</h3> To assess whether U.S. medical students and resident physicians (trainees) at Historically Black Colleges & Universities (HBCUs) displayed any racial bias in the assessment of pain or treatment recommendations; if they held any false beliefs about biological differences between Blacks and Whites, and if they were equally, more, or less accurate in their treatment recommendations for pain in Black vs White patients as a result of their beliefs and/or biases. <h3>Design</h3> This was a descriptive cross-sectional study. Each trainee was asked to read 2 mock-medical cases about a Black patient and a White patient, asked to estimate each patient's pain in each of 2 scenarios which are generally known by medical trainees to be significantly painful in nature, and then asked for their treatment recommendations based on this estimate. They were then given a 15-question survey to measure their preexisting beliefs about biological differences between Black and White people. <h3>Setting</h3> The study took place among U.S. medical students and resident physicians (trainees) at Howard University. <h3>Participants</h3> 96 medical students & residents. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> The presence of false beliefs between races; the impact of false beliefs on treatment recommendations, and treatment recommendations based on the patient's race. <h3>Results</h3> When compared to the landmark 2016 UVA study, significantly less HBCU-affiliated (predominantly BIPOC) students and residents held any false beliefs about biological differences between Blacks and Whites; their false beliefs (if any) did not impact the treatment of the sample patients, and their assessment of pain was not impacted by the patient's race. Interestingly, the White respondents at Howard also did not exhibit any racial bias in pain assessment or treatment recommendations, indicating that perhaps active teaching and implicit bias training by HBCUs counteracts racial bias in these individuals. <h3>Conclusions</h3> These findings strongly support the need for pipeline programs to improve exposure, recruitment, development, and retention of Black students in medicine, as well as continued support of HBCU medical schools. <h3>Author(s) Disclosures</h3> The authors have no conflicts to disclose.