Racial Bias in Evaluation of Trainees in Obstetrics and Gynecology: A Scoping Review.

Independent studies demonstrate that racial biases and inferences from facial appearance impact healthcare decisions, especially in pain recognition and treatment, with such biases already detectable among medical students. To address this issue, the present research evaluated the effectiveness of a multifaceted evidence-based educational intervention aimed at mitigating implicit biases by increasing students' knowledge and awareness of these factors in clinical settings and fostering strategies for equitable pain management. A total of 100 medical students were randomly assigned to an experimental or a control group. Both groups completed a pain recognition task twice, evaluating perceived pain intensity and the likelihood of recommending treatment. Between sessions, the experimental group took part in a brief educational intervention combining theoretical input on implicit biases in pain assessment, evidence from empirical studies, and applied reflection on clinical scenarios, whereas the control group received the same lesson after completing the study. The findings reveal that repeated exposure to the pain recognition task influenced responses in both groups, suggesting a task-related learning effect. The educational intervention significantly improved response times, pain intensity ratings, and treatment recommendations across stimuli categories, irrespective of race or facial trustworthiness. This suggests that the intervention heightened students' sensitivity to pain-related cues and encouraged a re-evaluation of clinical judgements. These results underscore the value of targeted educational initiatives in addressing disparities in pain recognition and treatment driven by facial cues, providing evidence that even brief interventions may contribute to mitigating implicit biases and support more equitable healthcare decision-making. This study demonstrates the effectiveness of a brief, evidence-based educational intervention in reducing implicit racial biases in pain recognition among medical students. By enhancing students' sensitivity to pain-related cues, the intervention holds promise for improving equitable healthcare practices and reducing bias-driven disparities in pain management.

Comparing service providers and youth advice on coordinated service delivery in Ontario's child welfare system.

Research Spotlight Abstract Extracting psychological insights from text is vital for modern analytics, yet organizations often rely on analysis tools that are either biased and simplistic or prohibitively expensive to build. Our research demonstrates that Large Language Models (LLMs) offer a superior alternative. They match the accuracy of specialized artificial intelligence (AI), while significantly reducing costs and technical barriers. Crucially for policy considerations, we find LLMs are statistically fairer than traditional methods. In our tests, they reduced racial and gender bias by up to 60%. Beyond assessing performance, we introduce a practical technique called “cognitive-affective prompting.” By instructing the AI to adopt specific human strengths, such as using “superior reasoning” for complex tasks or “emotional intelligence” for sentiment analysis, practitioners can boost accuracy by over 10%. To facilitate adoption, we provide a user-friendly “cookbook” to help nonexperts apply these findings immediately. For policymakers and business leaders, this research validates LLMs as a robust, consistent, and equitable standard for analyzing human behavior at scale.

Background: The objective of this study was to evaluate an intercultural competency lecture delivered at the Reading School of Pharmacy and assess its impact on students’ self-reported knowledge and perceived relevance to practice. Methods: A cross-sectional survey was conducted among MPharm students from September to December 2023 after an intercultural competency lecture. Students completed an anonymised Online Surveys® questionnaire with five-point Likert items (1 = strongly disagree to 5 = strongly agree) assessing clarity, learning outcomes, novelty, and relevance. The internal consistency was high (Cronbach’s α = 0.942). SPSS (v. 25) was used for descriptive statistics, frequencies (%), and regression analysis. Results: A total of 70 out of 226 students participated in the survey, resulting in a 31% response rate. The majority were female (65.7%) and of Asian background (55.7%), with over half in Year 3 (60%) and attending lectures in person (68%). Most were home students (72.9%). Feedback indicated clarity (x̄ = 3.86), achievement of learning outcomes (x̄ = 3.83), novelty (x̄ = 3.23), and relevance to practice (x̄ = 3.75). Suggestions for future sessions included topics on racial biases, religion, women's health, and disability. Conclusion: Students found the intercultural competence lecture valuable but suggested enhancing it and integrating cultural competence more broadly into the MPharm programme.

Negative contact between youth and police has increased in the United States, with Black youth disproportionately experiencing police-initiated encounters perceived as racially biased. Although researchers have studied racial bias in policing, limited research exists about how these experiences are perceived by non-justice-involved youth within the United States. The purpose of this qualitative phenomenological study was to explore how cumulative experiences of racial bias policing affect youth perceptions about police. Guided by social identity theory, semi-structured interviews were conducted with eight youths, aged 18 to 24 years old residing in the United States who reported at least one experience of racial-biased policing. Interview data were analyzed using Giorgi’s five-step phenomenological method. Four themes emerged: police-initiated contact based on race, detentions and searches perceived as unjustified, emotional and psychological responses to police encounters, and perceived racial bias and differential treatment. Participants described feelings of fear, anger, embarrassment, and distress, along with diminished trust in police fairness and legitimacy. Despite these negative perceptions, five participants indicated a willingness to contact law enforcement if assistance were needed, reflecting a relationship characterized by distrust alongside perceived necessity. The findings contribute by providing insight into how youth experience racial bias policing.

Individuals with sickle cell disease (SCD) frequently require care in the inpatient setting. Yet, there is no consensus on what comprises quality inpatient SCD care. Understanding patient, caregiver, and healthcare professional perspectives is a foundational step to defining inpatient SCD care quality. Establish a patient, caregiver, and healthcare professional-informed foundation for quality inpatient SCD care by synthesizing qualitative literature related to the inpatient SCD care experience. We searched Embase.com, Global Index Medicus, MEDLINE, APA PsycINFO via Ovid, Scopus, CINAHL, and Web of Science for peer-reviewed articles reporting on qualitative experiences on inpatient SCD care from inception to June 15, 2023. We dually screened studies, extracting key information from included articles before conducting thematic analysis using meta-aggregation. We included 42 studies that explored perspectives of patients (n = 32, 7%), caregivers (n = 12, 29%), and healthcare team members (n = 9, 21%). We synthesized six meta-themes: (1) established inpatient clinical infrastructure is necessary for patient-centered inpatient SCD care, (2) comprehensive SCD care needs to wrap around all healthcare contexts, (3) enabling shared decision-making in pain management, (4) mitigating the impact of bias and stigma, (5) individualized care, (6) mental health and traumatic experiences, and (7) SCD-specific advocacy and education. Themes aligned with the Donabedian model of quality care including structural barriers (e.g., inadequate hospital staffing, limited electronic medical record access), process-related gaps (e.g., ineffective pain management, poor provider-patient communication), and outcome-driven priorities (e.g., timely pain relief, improved continuity of care). Individuals with SCD are forced to experience and navigate the intersectional impacts of having a chronic condition from birth, a higher risk of socioeconomic disadvantage, and healthcare delivery prone to racial bias and opioid-related stigma. This review highlights key areas of quality inpatient SCD care, emphasizing the need for system-wide changes in clinical infrastructure, provider education, and patient-centered policies.

Gender and racial biases continue to be pervasive within the field of medicine. These biases can have significant, lifelong impacts on career trajectory and continue to promote inequities for women and groups that are underrepresented in medicine. There is ample literature demonstrating that a prudent approach to combat these biases is through narrative evaluation of medical trainees. An interactive workshop was developed for all health care providers, including trainees, who currently have, or will have, responsibility for evaluating medical trainees. Its aim was to provide an evidence-based framework for recognizing implicit biases in narrative evaluations and for adapting language to limit them. A toolkit (Be AWARE Anti-bias Toolkit) was developed from existing literature, highlighting 5 key elements of linguistic bias in narrative evaluations: (1) acknowledge that bias exists; (2) word choice matters; (3) active verbs get the job done; (4) resist raising doubt; and (5) emphasize accomplishments over effort. The workshop included interactive small-group activities, with practice in reading and writing narrative evaluations. A postworkshop evaluation survey was distributed after the session to assess relevance and effectiveness. This workshop was presented 5 times (2 local and 3 national conferences) and was attended by 80 participants, 25 of whom completed the postworkshop survey. The responses were overwhelmingly favorable; all respondents agreed or strongly agreed with the survey questions, indicating they found the session useful, relevant, effective, and worthwhile. This workshop provided an effective toolkit to help participants recognize and limit biased language in narrative evaluations of trainees.

In April of 2024, the District Attorney of Alameda County in California revealed evidence of “serious misconduct” by several prosecutors who oversaw a murder trial in 1993, in which the jury found a Black man guilty and sentenced him to death. The evidence of misconduct included the prosecutors’ trial notes. The notes that have been released suggest the prosecutors struck potential jurors from the jury pool because they were Jewish—the notes include: “I liked him better than any other Jew but no way.” The District Attorney is now looking into the county’s other death penalty cases, some of which took place over forty years ago. She indicated that there is further evidence of similar misconduct against Black and Jewish jury veniremen. While dismissing potential jurors in a criminal trial because of race was declared unconstitutional by the United States Supreme Court in Batson v. Kentucky, proving bias or discrimination in the jury selection process is usually quite difficult. Potential jurors who are not dismissed for cause can be removed using a peremptory challenge, which allows a party to remove a potential juror without providing any justification. While the Court attempted to prevent the discriminatory use of peremptory challenges through its decision in Batson, it is abundantly clear that the current Batson process does little to protect defendants and potential jury members alike from constitutional violations. This Note will explore the history of the peremptory challenge, explain how Batson protections fall short, and analyze the effects those shortcomings have through a focus on the recent uncovering of jury discrimination in Alameda County, California. Specifically, this Note argues that the incredibly low bar set by Batson, requiring race-neutral explanations for a challenged peremptory strike, allows discrimination in the jury selection process to persist, even in the face of Supreme Court protections. This Note also argues that the evidence used in Batson challenges is simultaneously too difficult to gather in its entirety at the trial level and is often not meaningfully reviewable on appeal. Finally, this Note argues that the misconduct discovered in Alameda County last year is not merely an isolated incident, as evidenced by similar cases in various parts of the country. These cases viewed together suggest a systemic issue for which there does not seem to be a solution absent a radical change to the Batson challenge process or the eradication of the peremptory strike altogether.

In this study, we use a mixed methods approach to analyze how age-diverse White Americans (N = 344) make meaning of specific instances of personal racial bias. We used a postpositivist research paradigm (Ponterotto, 2010; Ryan, 2006) to better understand how White adults assigned meaning to their past experiences of perpetuating racial bias. By integrating and expanding models of emotions (Ekman, 1992; Ford et al., 2022; Grzanka et al., 2020; Stephan & Stephan, 1985) and bias justifications (Condor et al., 2006; Crandall & Eshleman, 2003; Ford et al., 2022), we examined how White adults reflected on their bias by spontaneously using bias justifications and emotions. Regarding themes of bias, 87% of participants displayed beliefs that a person's racial group provides information about how dangerous or criminal they are. Age-diverse adults offered a range of bias justifications, including attributing their bias to various intergroup processes, like intergroup anxiety. In addition, participants most frequently indicated forms of sadness (including self-conscious emotions such as shame) about their bias. These types of justifications and emotions interrupt motivations to seek out interracial contexts or regulate their bias in the future. Specific types of bias, emotions, and justifications only differed moderately by age. Qualitative analysis demonstrated that most individuals' bias recognition was disconnected from a critical examination of how their racial bias justifications and emotions may help them maintain bias. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Does aggressive policing worsen infant health disparities? Evidence from 'Stop and Frisk' in New York City.

Background:Artificial intelligence is influencing healthcare but carries potential biases from historically trained data. This study was the first to examine racial and gender bias in large language model architecture applied to medical student career advising.Methods:Two hundred synthetic medical student profiles were created with systematically varied demographic and academic characteristics. Each profile was evaluated using a standardized advising prompt that generated the top 3 specialty recommendations. Specialties were assigned competitiveness scores based on National Resident Matching Program data. Univariate and multivariate analyses assessed associations between applicant characteristics and predicted competitiveness and surgical specialty recommendations. A compensatory scoring analysis estimated the additional USMLE Step 2 Clinical Knowledge points required for applicants from different demographic groups to achieve competitiveness equivalent to a White male reference profileResults:Male applicants were rated more competitive than female applicants (P < 0.0001). Black and Hispanic applicants were deemed less competitive than White applicants (P = 0.0019 and P = 0.0108, respectively). Male applicants were more than 10 times more likely to receive surgical specialty recommendations than female applicants (odds ratio = 10.23, P < 0.0001). Black and Hispanic applicants were significantly less likely to receive surgical recommendations compared with White applicants. Compensatory scoring revealed that White female applicants needed 56 additional Step 2 Clinical Knowledge points to match perceived competitiveness, whereas Black and Hispanic female applicants required 95 and 88 additional points, respectively.Conclusions:Our findings demonstrated that, if left unchecked, large language models such as ChatGPT perpetuate racial and gender biases when advising medical students, amplifying historical inequities in medicine.

Although consensus on a medical treatment plan is ideally achieved through a process of shared decision making, disagreements about whether life-sustaining interventions should be initiated or continued can occur and are sometimes difficult to resolve. When parents (or other appropriate surrogate decision makers) desire treatments for their child that are not medically recommended, these "potentially nonbeneficial" interventions must be systematically considered in the context of contemporary ethical principles and relevant laws and regulations while keeping in mind the historical and cultural underpinnings that might be playing a role, the potential for racial bias and socioeconomic disparities, the role of spirituality and values in consideration of quality-of-life determinations and end-of-life care, and the nuance of probabilistic uncertainty. This technical report accompanies a clinical report of the same name and offers a stepwise approach for responding to parental requests for potentially nonbeneficial treatment to support pediatricians and other physicians in engaging and supporting patients, their families, and care teams in navigating these disagreements.

In public health, we are dedicated to training the next generation of leaders at local, national, and global levels. To achieve this goal, it was essential to integrate antiracist principles into our curricula and address issues related to racial justice, bias, white privilege, and systemic oppression. A report from the Association of Schools and Programs in Public Health (ASPPH) called on schools and programs of public health to “adopt and adapt public health curricula to highlight how racism and other forms of discrimination impact the health and well-being of populations and individuals.” Starting in the spring of 2024, our six core courses explored antiracism from various perspectives, fostering a comprehensive understanding of the topic. This interdisciplinary approach encouraged diverse viewpoints and facilitated dynamic discussions, emphasizing the interconnectedness of racism with all aspects of our society.

Racial disparities in healthcare continue to profoundly impact the experiences and outcomes of black patients, reflecting long-standing systemic inequities and biased clinical and organizational practices. This qualitative exploratory study examined how healthcare managers mitigate racially biased treatment within healthcare organizations by analyzing semi-structured interviews with ten healthcare leaders representing diverse care settings. The findings revealed seven interconnected strategies used by managers to promote equitable care: continuous bias awareness and education, inclusive leadership modeling, policy enforcement, patient advocacy, open communication, workforce diversity development, and structural integration of equity principles. These strategies reflect the influential role managers play in shaping organizational culture and sustaining systemic reform. The study highlights the importance of transformational leadership in creating equitable healthcare environments and underscores the need for continued research integrating policy, structural accountability, and community voice.

Toxicology testing is frequently performed on newborns with known or suspected prenatal substance exposure, even though research shows that these tests often add no new clinically relevant information to that gathered during pregnancy and are rarely clinically actionable. Yale New Haven Children’s Hospital lacked a protocol for newborn toxicology testing. The authors suspected that test-ordering patterns demonstrated clinically inappropriate overuse and racial and socioeconomic discrimination, leading to harm to newborns and families, including unnecessary involvement of child protective services. Their hypothesis was that reduced testing, with continued social support, would lead to no change in newborn outcomes or safety. Prior to implementation, they identified wide disproportionality in testing by race and insurance status as a marker of poverty. Compared with all babies born at Yale New Haven Children’s Hospital, Black non-Hispanic newborns and newborns with Medicaid insurance were tested at 2 times and 2.6 times the average frequency, respectively. After implementation, the authors evaluated the protocol’s impact on the testing volume and racial and socioeconomic distribution of tests ordered, and tracked outcomes in the institution’s newborn population. By the time the protocol went live in January 2022, after extensive discussion and education among staff, testing rates had already decreased from 3.2% to 0.3%. The absolute decrease in testing rates for Black newborns was 6.7% to 0.6%, while that for white newborns was 2.5% to 0.2%. The testing rate for newborns with Medicaid insurance decreased from 8.2% to 0.5%, while the rate for newborns with commercial insurance decreased from 0.4% to 0.1%. There were so few tests ordered after the protocol was in place that differences in testing frequency by race and type of insurance could not be statistically evaluated. These reduced testing rates have persisted since that time, with no further interventions. Importantly, there were no identified hospital readmissions for withdrawal symptoms or adverse events for newborns who had no previously identified prenatal substance exposure before or after the protocol was adopted. This work succeeded due to a close evaluation of the clinical utility of newborn toxicology testing, institutional support, interdisciplinary collaboration, a culture accepting of change, and recognition of quality improvement as a health equity tool.

Abstract Research Summary Pretrial reform is vital, as nearly 500,000 unconvicted people are held in U.S. jails while awaiting trial. Risk assessment instruments (RAIs) offer data‐driven identification of defendants who are unlikely to reoffend and can safely be released, yet face criticism from across the political spectrum—for potentially perpetuating racial bias or endangering public safety. Moreover, inconsistent judicial application undermines the effectiveness of RAIs. Using data on 146,841 federal defendants, we apply causal analyses with machine learning to estimate the effects of a policy that presumptively releases defendants classified as relatively low risk by the Pretrial Risk Assessment (PTRA). Compared to magistrate judges’ status quo decisions, this approach would reduce pretrial detention by 34.2% and increase successful community releases by 31.8%, with only a 1.6% rise in public safety risk. Black defendants would experience greater benefits (39.0% detention reduction vs. 27.3% for White defendants). Detention cost savings would be approximately $3.5 billion. Policy Implications Although the PTRA outperforms unstructured judgment, it should strongly guide rather than replace judicial discretion. The central challenge is structuring judgment in pretrial decision making. As an initial step, the federal system should expand inclusion of PTRA risk estimates in pretrial reports beyond the current 15% of districts, implementing standardized reporting formats to ensure clear communication and consistent application. For greater impact, policy makers should consider a risk‐based presumptive release framework where defendants below a specified risk threshold are released unless magistrate judges identify specific statutory factors justifying detention. This approach addresses inconsistent RAI application while preserving judicial authority. Implementation will require investment in trust‐building and practice fidelity, but structuring pretrial decisions around validated risk measures promises to enhance fairness, reduce costs, and maintain public safety—outcomes with broad political appeal.

ABSTRACT This article examines two key ethical issues surrounding the use of automated facial recognition technology in policing – data protection and discrimination. It investigates how these issues are mobilised and understood in a landmark UK case, Ed Bridges v South Wales Police. By closely analysing legal documents, I show how the court relied on policy as a performative and corrective measure to address ethical issues. I argue that this approach overlooks the broader range of social justice concerns that arise when AI technologies intersect with sociopolitical contexts and institutional practices. These include the intrusiveness of AI in everyday life, racial biases embedded in its design and application, and the institutional racism within which the technology operates. Ultimately, these juridical questions reveal deeper tensions between reformist and abolitionist perspectives.

Breastfeeding enhances maternal-newborn bonding, supports newborn nutritional requirements, and is recommended in mothers undergoing medication-assisted treatment (MAT) for opioid use disorder (OUD). Breastfeeding decision-making is complex and may be influenced by implicit biases among healthcare providers, negatively impacting maternal quality of care and breastfeeding outcomes in mothers with OUD. This integrative review aimed to synthesize current evidence on how healthcare professionals' implicit bias affects breastfeeding initiation, support, and continuation among women with OUD. Included studies focused on women with OUD, specifically those on MAT, and examined bias in relation to breastfeeding. Studies were excluded if they did not involve pregnant or postpartum women on MAT, focused solely on polysubstance use, or addressed only racial bias. A total of 117 articles underwent title and abstract review. Of the 117 articles initially identified through the database search, only 28met the preestablished inclusion and exclusion criteria and were ultimately included in this integrative review. Key themes emerged: stigma and discrimination, lack of social and institutional support, provider knowledge gaps, and maternal fears related to recovery. Studies included qualitative, quantitative, and mixed methods research. Educating healthcare providers with accurate, evidence-based information can reduce bias and better support women with OUD in achieving their breastfeeding goals. Future studies should examine how implicit bias impacts breastfeeding in this population to inform provider training and resource development.

Racial prejudice during the selection of jurors continues to impair the impartiality and fairness of the legal system, with far-reaching effects on judicial decisions as well as public confidence. Though legal reforms like Batson v. Kentucky have sought to de-emphasize explicit discrimination, unconscious racial prejudices remain, frequently unalleviated by conventional legal systems. This research examines how intercultural communication approaches based on communication theories of framing theory, narrative persuasion, and critical discourse analysis can help address systemic racial differences in jury formation proceedings. Through redefining the problem from a legal perspective to a communication-oriented research inquiry, this research addresses how juror decision-making is shaped by cultural stories, cognitive biases, and mediation representation of race and justice. Following a qualitative approach, the current research utilizes a Systematic Literature Review (SLR) that adheres to the PRISMA guidelines. The 50 identified studies yielded eight that qualified and were included based on inclusion criteria and analyzed via thematic analysis. The results identify three main themes: (1) the persistent persistence of racial discrimination in jury formation throughout jurisdictions; (2) the contribution of intercultural communication to providing culturally competent juridical atmospheres; and (3) the effect of structural reforms, which include intercultural training and diverse compositions of juries, to induce fairness. Moreover, this research compares global outlook, examining jury selection procedures and communication-oriented interventions within Europe, South America, and Asia. The implications support institutional incorporation of intercultural communication tactics towards countering racial bias and increasing the legitimacy of legal decision-making world-wide.