Professional Bias Research Articles

Addressing Social and Structural Determinants of Health in the Delivery of Reproductive Health Care: ACOG Committee Statement No. 11.

Social and structural determinants of health include historical, social, political, and economic forces, many of which are rooted in racism and inequality, that shape the relationship between environmental conditions and individual health. Unmet social needs can increase the risk of many conditions treated by obstetrician-gynecologists (ob-gyns), including, but not limited to, preterm birth, unintended pregnancy, infertility, cervical cancer, breast cancer, and maternal mortality. An individual health care professional's biases (whether overt or unconscious) affect delivery of care and may exacerbate and reinforce health disparities through inequitable treatment. Obstetrician-gynecologists and other health care professionals should seek to understand patients' health care decision making not simply as patients' individual-level behavior, but rather as the result of intersecting sociopolitical conditions, structural inequities, and social needs that create and maintain inequalities in health and health care. Recognizing the importance of social and structural determinants of health can help ob-gyns and other health care professionals to better understand patients, effectively communicate about health-related conditions and behavior, and contribute to improved health outcomes, including patients' experience of care and their trust in the health care system.

Deep Learning With Ultrasound Images Enhance the Diagnosis of Nonalcoholic Fatty Liver

ObjectiveThis research aimed to improve diagnosis of non-alcoholic fatty liver disease (NAFLD) by deep learning with ultrasound Images and reduce the impact of the professional competence and personal bias of the diagnostician. MethodThree convolutional neural network models were used to classify and identify the ultrasound images to obtain the best network. Then, the features in the ultrasound images were extracted and a new convolutional neural network was created based on the best network. Finally, the accuracy of several networks was compared and the best network was evaluated using AUC. ResultsModels of VGG16, ResNet50, and Inception-v3 were individually applied to classify and identify 710 ultrasound images containing NAFLD, demonstrating accuracies of 66.2%, 58.5%, and 59.2%, respectively. To further improve the classification accuracy, two features are presented: the ultrasound echo attenuation coefficient (θ), derived from fitting brightness values within sliding region of interest (ROIs), and the ratio of Doppler effect (ROD), identified through analyzing spots exhibiting the Doppler effect. Then, a multi-input deep learning network framework based on the VGG16 model is established, where the VGG16 model processes ultrasound image, while the fully connected layers handle θ and ROD. Ultimately, these components are combined to jointly generate predictions, demonstrating robust diagnostic capabilities for moderate to severe fatty liver (AUC = 0.95). Moreover, the average accuracy is increased from 64.8% to 77.5%, attributed to the introduction of two advanced features with domain knowledge. ConclusionThis research holds significant potential in aiding doctors for more precise and efficient diagnosis of ultrasound images related to NAFLD.

Health professionals implicit bias of patients with low socioeconomic status (SES) and its effects on clinical decision-making: a scoping review

ObjectivesResearch indicates that people with lower socioeconomic status (SES) receive inferior healthcare and experience poorer health outcomes compared with those with higher SES, in part due to health professional (HP)...

The Ladder of Inference as a tool to reduce implicit bias in pediatric clinical practice.

Implicit bias in healthcare professionals is a widespread phenomenon that leads to worse healthcare outcomes for marginalized patient populations. One tool that can help providers identify when biases are impacting the clinical care they are providing and enable them to take corrective action in real time is the "Ladder of Inference" (LOI). The LOI is an instrument that elucidates the process by which we take in information about another person, filter that data through our own interests, needs, perspectives and biases, and then use it to draw conclusions about the individual. These conclusions are often profoundly inaccurate, yet we then act upon them. Thus, we propose the LOI as an "implicit bias detection tool" for neonatal intensive care unit (NICU) clinical practice. We demonstrate on two common NICU cases how utilizing the LOI can uncover mechanisms by which positive and negative feedback loops secondary to unregulated implicit bias lead to a stepwise increase or decrease in the quality of care. As the cases demonstrate, the subtle differences in individual steps up the ladder can lead to care differences of a large magnitude in either direction, hugely positive or detrimentally negative. This shift in the quality of care, then, may contribute to the significant neonatal outcome disparities in infants from minoritized groups. Using the LOI as a practical tool, we demonstrate how it becomes possible to detect one's own implicit biases and thus to consciously monitor the inferences we are making about patients and their families in order to counteract them.

Counselor bias and contraceptive counseling for women: a scoping review protocol.

The objective of this review is to identify factors, tools, and interventions related to counselor biases and contraceptive counseling in women. Contraceptive counseling is the transfer of knowledge regarding contraceptive methods to aid an individual in selecting, discontinuing, or changing contraception. The counselor should deliver information based on the patient's needs and preferences. The type and quality of the contraceptive information women are provided should not vary based on social or physical factors, such as age, race, religion, sexual orientation, education level, sexual preference, or weight; however, professional bias continues to be a concern in health care. The results of this review may further the understanding of counselor bias and contraceptive counseling. This scoping review will consider studies that include health care professionals providing contraceptive counseling to female patients in any setting or geographic location. Studies reporting on factors, tools, and interventions related to counselor bias and contraceptive counseling will be included. Databases to be searched are MEDLINE, CINAHL, Scopus, Web of Science, ScienceDirect, JBI Evidence-based Practice Database, Europe PubMed Central, and Cochrane Library. Sources of gray literature will include ProQuest Dissertations and Theses, PaperFirst, and MedNar. The review will include studies published in English from 1994 onward and follow the JBI methodology for scoping reviews. Two independent reviewers will screen the titles and abstracts, then full texts. Data from relevant studies will be extracted using a tool created by the reviewers. The results will be presented as a narrative summary and in diagrammatic or tabular format. Open Science Framework https://osf.io/judp5.

Cultivating narrative humility in medical education through community‐based narrative encounters

AbstractThis chapter discusses how community‐based narrative encounters can enhance medical students’ narrative humility, the practice of recognizing the value of multiple narratives of health and reducing narrative privileging. The study in this chapter suggests that through exposure to individuals’ lived experience of health, medical students are able to recognize both professional and personal narrative bias, leading to reflection on improved patient‐centered care centered on testimonial justice and narrative respect.

“No, This Is Not My Boyfriend’s Computer”: Elevating the Voices of Youth in STEM Education Research Leveraging Photo-Elicitation

AbstractWe aim to elevate the stories and voices of youth in integrated STEM education, particularly those who have been historically marginalized and excluded from STEM spaces. Our research uses photo-elicitation to decenter the power of researchers and educators and elevate the experiences and expertise of youth in STEM. Findings are presented from three instrumental case studies, examining the perspectives of youth on what it means to do STEM, who belongs in STEM, and why STEM is important. The findings reveal that youth often perceive STEM as a siloed approach but also emphasize the need for greater integration of mathematics in STEM. Furthermore, the study highlights the importance of STEM identity development, showing that belonging in STEM is not just about future careers but also about fostering a sense of belonging in the present. Additionally, the study uncovers that youth invoke empathy and social consciousness when explaining the importance of integrated STEM, emphasizing the need to address racial, gender, and professional biases in STEM educational spaces. This prompts a reconsideration of the motivations behind integrated STEM education, emphasizing the value of developing STEM literacy for the well-being of all youth, not just as future workforce preparation.

The Research on the Characteristics and Influence of Stereotypes in Movies ---Taking the Movie "Zootopia" as an Example

Stereotypes exist in public life, and by analyzing the ways in which stereotypes are presented in movies and measures to reduce them in real life can have a sustained positive impact. This article takes the movie "Zootopia" as the research object, and uses literature research and case study methods to analyze the ways in which stereotypes are presented in movies, as well as the negative effects and related countermeasures against stereotypes. Through research results, it was found that the types of stereotypes in the movie "Zootopia" include gender stereotypes, occupational stereotypes, and racial Stereotypes. The negative effects of stereotypes include hindering the ideological development of young people, influence the direction of social public opinion and causes professional bias and makes it easy to generalize. The public can mitigate negative impacts through two channels: one is through movies such as using public figures and set contrasting personality, and the other is through real life such as using the Internet for Publicity and promote gender education.

PROFESSIONALLY ORIENTED FOREIGN LANGUAGE TRAINING IN THE SYSTEM OF SECONDARY VOCATIONAL EDUCATION ON THE BASIS OF CLIL APPROACH

The relevance of the research is due to the need to modernize foreign language (FL) training in the system of secondary vocational education (herein after referred to as SVE) as part of the implementation of the new Federal State Educational Standards in the context of strengthening the career guidance potential of FL learning. Accentuating the FL learning professional bias in college is aimed at developing students’ FL communicative competence in situations of professional communication and also for the sake of developing students’ professional self-determination. However, the development of the foundations of professionally-oriented FL training of SVE students has not been the subject of a separate study, which determines the urgency of the presented work. The purpose of the study is to work out the content and organizational foundations of professionally-oriented FL training, based on the CLIL approach. The study identifi es principles, requirements, didactic tools and materials that ensure the students’ mastering FL professional communication and the professional self-determination of students in the process of specialized FL training in the SVE system. It has been established that the electronic educational training manual on information technology and telecommunication systems, based on the CLIL approach, developed in the course of study has proven its effectiveness. The proposed principles, stages and content of teacher and student activities ensure the integrity of educational and personality developmental aspects of professionally-oriented FL training of SVE students, parallel and simultaneous mastery of all types of speech activity in the process of solving problem quasi-professional tasks in a specialized fi eld, and can be successfully used in a real educational process in a FL class at a SVE institution.

Vegetarianism and eating disorders: The subjective experience of healthcare professionals

Vegetarianism is growing dramatically among adolescents and young adults. Professionals specialized in eating disorders (ED) may routinely face patients adhering to these popular vegetarian practices. This qualitative study aimed to investigate healthcare professionals' subjective experience of vegetarianism in ED patients. Interviews of practitioners specialized in ED, recruited from the French federation of anorexia and bulimia (FFAB), were conducted using a semi-structured guide. We reached data saturation. Thematic analysis was used to identify and analyze patterns of meaning in the dataset. Eighteen professionals (dieticians, physician-nutritionists, and a psychiatrist) with private or institutional practices were interviewed. Three meta-themes emerged from our thematic analysis: (1) heterogeneous perceptions of vegetarianism among healthcare professionals, (2) diverse nutritional care practices, (3) factors influencing professionals' nutritional strategies and approaches. This original qualitative and exploratory study reported vegetarianism is a fast-growing phenomenon observed in a majority of adolescent patients with anorexia nervosa, with various underlying motivations reported. In all cases, the nature of the timing and relation between the vegetarian practices and the ED should be carefully assessed, using specific tools. Because of the ethical dimension of this issue and the risk of professional bias, institutional policy based on specific practice guidelines, to be developed, are strongly encouraged.

Perceived Needs Among Healthcare Providers Caring for Seriously Ill Adults Regarding Electronic Health Record Triggers for Palliative Care Referral.

Many healthcare facilities in the United States currently utilize electronic health record triggers to promote and facilitate palliative care referral. The purpose of this study was to explore perceived needs regarding electronic health record trigger criteria for palliative care referral among healthcare providers caring for seriously ill adult hospitalized patients in a teaching hospital in New York State. A qualitative descriptive approach was utilized with use of individual semistructured interviews. Braun and Clarke's Reflexive Thematic Analysis method was used to analyze data. Data analysis generated one overarching theme, I'm in Favor of an Electronic Health Record Automatic Trigger for Palliative Care, and three key themes, Build a Checklist Screening Tool Into Epic With Predefined Conditions and a Palliative Consult in the Admission Order Set, If Providers Call a Palliative Care Consult Sooner, We Give Patients a Better Quality of Life, and Providers Need to Be Aware of the Different Facets of What Palliative Care Actually Does. Findings revealed that all participants supported incorporating electronic health record palliative care triggers. Future research is needed exploring provider palliative care education approaches to promote understanding of palliative care services and to address personal and/or professional bias.

Realizing Inclusion and Systemic Equity in Medicine: Upstanding in the Medical Workplace-A Curriculum Update.

Racism is a public health crisis. Bias towards patients adversely affects health outcomes 1 FitzGerald C. Hurst S. Implicit bias in healthcare professionals: a systematic review. BMC Med Ethics. 2017; 18 (Mar 1) (PMID: 28249596; PMCID: PMC5333436.): 19https://doi.org/10.1186/s12910-017-0179-8 Crossref PubMed Scopus (984) Google Scholar and access to care while structural racism in medicine has led to decreased diversity of the healthcare workforce, burnout, and negative career outcomes. 2 Filut A. Alvarez M. Carnes M. Discrimination Toward Physicians of Color: A Systematic Review. J Natl Med Assoc. 2020; 112 (Apr): 117-140https://doi.org/10.1016/j.jnma.2020.02.008 Crossref PubMed Scopus (46) Google Scholar Growing evidence shows that curricula addressing racism within medical education can increase providers’ perceived capacity to address racism and limit its impact on patients and staff. 3 Jindal M. Mistry K.B. McRae A. Unaka N. Johnson T. Thornton R.L.J. "It Makes Me a Better Person and Doctor": A Qualitative Study of Residents' Perceptions of a Curriculum Addressing Racism. Acad Pediatr. 2022; 22 (Mar): 332-341https://doi.org/10.1016/j.acap.2021.12.012 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar

SELECTION OF LEARNING MATERIAL FOR BUILDING LEXICAL COMPETENCE IN ENGLISH PROFESSIONALLY ORIENTED ORAL COMMUNICATION OF PROSPECTIVE ECOLOGISTS

The analysis of topical issue in teaching English for specific purposes, namely the problem of selection of learning material for building lexical competence in English professionally oriented oral communication of prospective ecologists, has been carried out. The aim of the article is to substantiate units, sources and selection criteria of learning material for building lexical competence in English professionally oriented oral communication of prospective ecologists. During the investigation the following research methods are used: analysis of scientists’ findings, generalization, arrangement with the aim of finding out how this issue is being elaborated and giving grounds to units, sources, and selection criteria of learning material for building lexical competence in English professionally oriented oral communication of prospective ecologists. It has become evident that use of learning material is designed to build and develop in prospective ecologists system of lexical knowledge, language and speech abilities and skills, lexical awareness, communicative and learning strategies ‒ the components of lexical competence in English professionally oriented oral communication. The units of learning material selected for building lexical competence in English professionally oriented oral communication of prospective ecologists are envisaged as lexical units. It has been proved that authentic texts, audio-texts and videos of English professionally oriented oral communication that occur between prospective ecologists are the sources from which learning material is selected. A number of selection criteria and criteria of incorporation of lexical units into lexical glossary have been defined: professional bias, thematic and semantic value, stylistic appropriateness, ability to collocate, frequency and functionality.
 Keywords: foreign language for specific purposes; selection of learning material; units of selection; sources of selection; selection criteria; lexical competence; English professionally oriented oral communication; prospective ecologists.

Combating Weight Stigma in Healthcare: A Cross-Country Analysis and Intervention Initiative

Abstract Background Rising global obesity rates coincide with increasing weight stigmatization, affecting various life aspects, including healthcare. Discrimination impacts patient well-being and care quality, leading to suboptimal treatment. This research compares weight stigma among healthcare professionals in Romania, UK, and Greece, addressing personal and second-hand weight bias. Methods The study used cross-sectional data from the Breaking Weight Bias survey, including 125 healthcare professionals from Romania, Greece, and the UK. Data collection occurred between June and August 2021 via an online survey. Measures included the Universal Measure of Bias-FAT (UMF-FAT) questionnaire, personal experience with weight bias, and experiences of weight bias in medical settings. Results More women participated in the study across all countries. The mean age was 37.12 years (SD = 10.92). Bachelor's degrees were most common (43.4%), with Greece having the highest percentage of Master's (41.7%). Romania had the highest Doctoral degrees (32.4%). Private healthcare settings were the most common (51.3%). UMB-FAT results showed varying bias between countries. Romania had the highest rates (M = 3.08, SD = 0.768). Statements indicating more bias included poor hygiene (M = 2.40, SD = 1.832) and lacking consideration for others (M = 1.74, SD = 1.459). Over half of the participants (53.3%) experienced personal weight-related teasing. Greece had the highest rate (62.9%). Regarding second-hand weight bias experiences in medical settings, a high level of agreement (30-50%) was observed. Conclusions This study confirms weight bias in healthcare professionals across multiple countries, revealing moderate bias levels. Despite limitations, the findings contribute to understanding weight bias across different regions and fields. There is a need for weight-bias education among healthcare professionals, as it can harm patient-provider relationships and care quality. Key messages • Research confirms moderate weight bias in healthcare professionals across Romania, UK, and Greece. • Study highlights the need for weight-bias education in medical training to improve patient-provider relationships.

Exploring Professional Anticipatory Socialization: Who Are the Messengers Influencing Future Physicians' Perceptions of Advanced Practice Providers?

Evidence exists that physicians in training and practice often do not understand advanced practice providers (APPs) and their roles in professional practice. This study asked the question: What are the messages and messengers during the anticipatory professional socialization period that potentially influence how residents perceive APPs? Semistructured interviews were conducted with 15 residents in one academic setting. Transcripts were analyzed using an inductive approach to coding to identify the messages and sources of those messages (messengers) that had influenced how residents perceived APPs. Participants reported limited exposure to APPs before medical school, although most had heard of APPs from family, friends, or advisors or through their own experience in a clinical setting. The messages that participants received were related to how physicians and APPs compare in their training and clinical roles, and how APPs and physicians (and the people who pursue these professions) differ based on their presumed personal attributes. Some messages appeared to support biases against APPs. While interprofessional education in medical school aims to prepare physicians to collaborate across professions, attention to anticipatory professional socialization occurring before medical school may also be important to mitigate professional biases that interfere with effective teamwork.

Disparities in Breast Cancer Patients with Disabilities: Care Gaps, Accessibility, and Best Practices.

Significant disparities exist in detecting and treating breast cancer in women with disabilities, leading to cancer detection at advanced stages. This paper provides an overview of disparities for women with disabilities related to breast cancer screening and care, primarily focusing on significant mobility disabilities. Current care gaps include screening barriers related to accessibility and inequitable treatment options, with race/ethnicity, socioeconomic status, geographic location, and disability severity factors, mediating the disparities for this population. The reasons for these disparities are myriad and stem from both system-level deficiencies and individual-level provider bias. Although structural changes are warranted, individual healthcare providers must also be incorporated in the requisite change. Intersectionality is critical to disparities and inequities and should be central to any discussion of strategies for improving care for people with disabilities, many of whom have intersectional identities. Efforts to reduce screening rate disparities for breast cancer in women with significant mobility disabilities should start with improving accessibility through removing structural barriers, establishing comprehensive accessibility standards, and addressing healthcare provider bias. Future interventional studies are needed to implement and assess the value of programs to improve breast cancer screening rates in women with disabilities. Increasing the representation of women with disabilities in clinical trials may provide another avenue for reducing treatment disparities, as these trials often provide breakthrough treatment to women with cancer diagnosed at later stages. Ultimately, attention to the specific needs of patients with disabilities should be improved across the US to promote inclusive and effective cancer screening and treatment.

‘You feel like you’ve been duped’: is the current system for health professionals declaring potential conflicts of interest in the UK fit for purpose? A mixed methods study

ObjectiveTo understand: if professionals, citizens and patients can locate UK healthcare professionals’ statements of declarations of interests, and what citizens understand by these.DesignThe study sample included two groups of participants...

Scoping of advanced clinical practitioner role implementation using national job advertisements: Document analysis.

The aim of this study is to profile the contemporary advanced clinical practitioner (ACP) role through standardized document sets. Documentary analysis of job descriptions (JDs), person specification and advertisements. England based jobs advertised on NHS jobs website from 22 January to 21 April 2021. A toatal of 143 trainee and qualified ACP roles were identified. A wide range of sectors and specialities were represented from across all English regions. The most common roles were urgent care, emergency medicine and primary care. Most qualified roles were agenda for change band 8A, although this did vary across specialities. Many roles were restricted to a small number of professions, notably nursing, physiotherapy and paramedic. Inconsistent role titles were noted. A lack of understanding of regulation across different professions was noted. The ACP role has become an accepted across healthcare providers in England. Implementation remains varied across specialities and organizations. Eligibility criteria may relate to professional bias. ACP roles are expanding but this may be at the detriment to advanced nursing posts. Inconsistency in role eligibility suggests some professional bias exists. This was scoping of ACP roles across England using job advertisements. ACP roles are common across sectors and specialities but eligibility varies. The research will have impact on those looking to recruit to ACP roles as well as those refining JDs. No EQUATOR guideline exists for document analysis. No Patient or Public Contribution. The research relates to organizational human resource information only.

Applying Integral Thinking to Music Therapy Education

Educating music therapy students is a complex task as a result of laws and regulations, professional biases, and a desire to produce students who will be competent and thoughtful music therapists. The purpose, or outcome, of this article is to outline a curriculum re-design implementing Integral Thinking in Music Therapy (ITMT) as applied to the academic and clinical aspects of two university music therapy training programs in the United States. The history and philosophy of ITMT are explained to give context to this approach. An overview of the innovative curriculum design and teaching resources are included for direct implementation of experiences into the classroom. Recommendations include the uses of ITMT in music therapy education as well as possible limitations to this pedagogical approach.

Weight bias and stigma in healthcare professionals: a narrative review with a Singapore lens.

Addressing weight stigma is essential to obesity management as it causes inequalities in healthcare and impacts the outcomes of health. This narrative review summarises systematic review findings about the presence of weight bias in healthcare professionals, and interventions to reduce weight bias or stigma in these professionals. Two databases (PubMed and Cumulative Index to Nursing and Allied Health Literature [CINAHL]) were searched. Seven eligible reviews were identified from 872 search results. Four reviews identified the presence of weight bias, and three investigated trials to reduce weight bias or stigma in healthcare professionals. The findings may help further research and the treatment, health and well-being of individuals with overweight or obesity in Singapore. Weight bias was prevalent among qualified and student healthcare professionals globally, and there is a lack of clear guidance for effective interventions to reduce it, particularly in Asia. Future research is essential to identify the issues and inform initiatives to reduce weight bias and stigma among healthcare professionals in Singapore.