1. Unconscious Bias: What Every Hospitalist Should Know
Source:

2. The Team Vanessa Durand, DO Jorge Ganem, MD Anika Kumar, MD
Kimberly Reynolds, MD

3. Disclosures
All presenters for this workshop have no financial relationships to disclose or Conflicts of Interest (CIO) to resolve.

4. Objectives Define bias Define unconscious bias
Utilize Implicit Association Test as a tool to measure unconscious bias
Share stories of how unconscious bias plays out in practice
Small group sharing

5. Implicit Association Test
CLAP
INSECTS or
Unpleasant
words
TAP
FLOWERS or
Pleasant
words
Have students practice first!
Please *TAP* on the right side of the desk for flowers or pleasant words. Clap for insects or unpleasant words.
Wasp
Poison
Tulip
Enjoy

6. Implicit Association Test
CLAP
INSECTS or
Pleasant
words
TAP
FLOWERS or
Unpleasant
words
Wasp
Poison
Tulip
Enjoy

7. Definitions
Bias:
Positive or negative evaluation of one group and its members relative to another
There are 2 ways to think about bias: in terms of expression and process

8. Expression vs. Cognitive Process
Direct  “I like men more than women”
Indirect  Sitting closer to a man than a woman at a meeting
Cognitive Process
Explicit
Bias
Implicit
Bias

9. Biases Explicit Bias Implicit Bias
Person is aware of his/her positive or negative evaluation of a group, believes that value to be correct.
Manifests as overt discrimination
Considered by general society to be unacceptable
Person holds a positive or negative mental attitude at an unconscious level towards a person, thing, or group.
Manifestations are subtle and often unintentional.
Not making eye contact
Speaking over someone in a meeting

10. These associations are automatic— outside of the realm of consciousness.
Our ancestors needed to know that lion=dangerous=fight or flight! Or else the human race would cease to exist.

11. Implicit Bias and Academia
Am J Public Health, 2015

12. Implicit Bias and Academia
JGIM, 2007

13. Implicit Bias and Academia
Am J Public Health, 2012

14. We all have biases, and although they are unconscious, it is important to work toward recognizing them so that we can work toward consciously mediating them.

15. Personal Story
Dr. Jorge Ganem

16. Small Group Discussion

17. Summary Implicit Bias – having bias is inherently human.
It doesn’t make you a
Racist
Bad person
Hypocrite

18. Acknowledgments
Maya Eady, MD

19. References
Green, A. R., Carney, D. R., Pallin, D. J., Ngo, L. H., Raymond, K. L., Iezzoni, L. I., & Banaji, M. R. (2007). Implicit bias among physicians and its prediction of thrombolysis decisions for black and white patients. Journal of general internal medicine, 22(9),
Penner, L. A., Dovidio, J. F., West, T. V., Gaertner, S. L., Albrecht, T. L., Dailey, R. K., & Markova, T. (2010). Aversive racism and medical interactions with Black patients: A field study. Journal of Experimental Social Psychology,46(2),
Haider, A. H., Sexton, J., Sriram, N., Cooper, L. A., Efron, D. T., Swoboda, S., & Cornwell, E. E. (2011). Association of unconscious race and social class bias with vignette-based clinical assessments by medical students. JAMA,306(9),
Pletcher, M. J., Kertesz, S. G., Kohn, M. A., & Gonzales, R. (2008). Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments. Jama, 299(1),
Banaji, M. R., & Greenwald, A. G. (2013). Blindspot: Hidden biases of good people. Delacorte Press.
Sabin, J. A., & Greenwald, A. G. (2012). The influence of implicit bias on treatment recommendations for 4 common pediatric conditions: pain, urinary tract infection, attention deficit hyperactivity disorder, and asthma. American journal of public health, 102(5),
Blair, I. V., Steiner, J. F., Fairclough, D. L., Hanratty, R., Price, D. W., Hirsh, H. K., & Havranek, E. P. (2013). Clinicians’ implicit ethnic/racial bias and perceptions of care among black and Latino patients. The Annals of Family Medicine, 11(1),
Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. (1998). Measuring individual differences in implicit cognition: the implicit association test. Journal of personality and social psychology, 74(6), 1464.
Lane, K. A., Banaji, M. R., Nosek, B. A., & Greenwald, A. G. (2007). Understanding and using the implicit association test: IV. Implicit measures of attitudes,
Dasgupta, N., & Greenwald, A. G. (2001). On the malleability of automatic attitudes: combating automatic prejudice with images of admired and disliked individuals. Journal of personality and social psychology, 81(5), 800.
Lebrecht, et al. (2009). Perceptual Other Race Training Reduces Implicit Racial Bias. PloS ONE, 4(1),
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