We have developed materials and methods for conducting a workshop designed to foster reflection about and raise awareness of cultural biases among students and physicians, and to brainstorm strategies to mitigate personal biases.
We developed an evaluative measure for the Implicit Association test by incoporating a combination of quantitative surveys (items developed specific to the workshop) and a series of qualitative open-ended responses. Also, there was a follow up focus group. We have a number of qualitative and quantitative stragegies for assessing IATs. See IAT Facilator's Guide here.
Publications
Manuscripts, preparing for submission:
Thompson BM, Teal CR, Rogers JC, Paterniti DA, Haidet P. Opening the ‘black box’ of reflection: a model to guide educators’ efforts. (under review) -- this article outlines a conceptual model that can be used to design and implement activities aimed at creating reflection and reflective practice with respect to cross cultural medical care.
Haidet P,Fecile ML, West HF, Teal CR. Reconsidering the team concept: educational implications for patient-centered cancer care. (under review) -- this essay examines the usual model for the delivery of healthcare in the US, and proposes a critical reframing of the team concept toward a community concept to better describe and impact educational interventions aimed at promoting patient-centered care.
The implicit association test: a good trigger for reflective discussion about biases and healthcare disparities? (under review) -- this article details the results of a test of an educational intervention, using implicit association tests, to produce reflection and insight about students' own internal biases, and steps that they can take to reduce the effects that such biases have on clinical decision making. The study has important implications for the design of educational interventions to reduce the effects of physician bias.
Curricular Material, preparing for submission:
"Best Intentions: A Workshop to Reduce the Effects of Bias in Clinical Care" Teal CR, Gill A, Shada RE, Thompson BM, Fruge E, Villarreal G, Patton C, Haidet P. This is a 1-hour workshop (with advance preparation by learners) that uses implicit association tests to create personal awareness and reflective practice aimed at reducing the effects of bias in clinical care. The workshop has been piloted with medical students (see above article), but is designed to be used with either students, residents, or practicing physicians. Workshop materials include workshop outlines, asssignments for learners, facilitator training materials, facilitation guide,and evaluation materials.
"Practicing Communication Aimed at Understanding Contextual Information" Scott S, Thompson B, Teal C, Shada R, Haidet P. This is a sequence of activities (1-hour large group session, practice session with a standardized patient, 2-hour debriefing) that is aimed at fostering communication abilities aimed at understanding patients' critical contextual information. We define contextual information as that which is critically important for a physician to understand in order to be maximally clinically effective. Such information often includes explanatory models, cultural understandings, socio-economic determinants of health, and other issues that directly impact a given patient's care for a particular problem. These activities will use a number of novel pedagogical methods (e.g., team-based learning, stimulated recall review of videotaped encounters with standardized patients, etc), and will include a number of evaluation strategies to gauge the effects that the sequence has on how learners think about and collect information about patients' illness histories.
Paul Haidet, MD, MPH
