Pre-clinical medical student reflections on implicit bias: Implications for learning and teaching

Autoři: Christine Motzkus aff001;  Racquel J. Wells aff002;  Xingyue Wang aff003;  Sonia Chimienti aff004;  Deborah Plummer aff005;  Janice Sabin aff006;  Jeroan Allison aff007;  Suzanne Cashman aff008
Působiště autorů: Clinical and Population Health Research, University of Massachusetts Medical School, Worcester, MA, United States of America aff001;  Division of Nephrology, Duke University, Durham, NC, United States of America aff002;  Department of Family Medicine, University of Washington Medical School, Seattle, WA, United States of America aff003;  Office of Student Affairs, University of Massachusetts Medical School, Worcester, MA, United States of America aff004;  Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, United States of America aff005;  Department of Biomedical Informatics and Medical Education, University of Washington, School of Medicine, Seattle, WA, United States of America aff006;  Department of Population and Quantitative Health Sciences University of Massachusetts Medical School, Worcester, MA, United States of America aff007;  Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, United States of America aff008
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225058



Implicit bias affects health professionals’ clinical decision-making; nevertheless, published reports of medical education curricula exploring this concept have been limited. This research documents a recent approach to teaching implicit bias.


Medical students matriculating during 2014 and 2015 participated in a determinants of health course including instruction about implicit bias. Each submitted a reflective essay discussing implicit bias, the experience of taking the Implicit Association Test (IAT), and other course content. Using grounded theory methodology, student essays that discussed reactions to the IAT were analyzed for content themes based on specific statements mapping to each theme. Twenty-five percent of essays underwent a second review to calculate agreement between raters regarding identification of statements mapping to themes.


Of 250 essays, three-quarters discussed students’ results on the IAT. Theme comments related to: a) experience taking the IAT, b) bias in medicine, and c) prescriptive comments. Most of the comments (84%) related to students’ acknowledging the importance of recognizing implicit bias. More than one-half (60%) noted that bias affects clinical decision-making, and one-fifth (19%) stated that they believe it is the physician’s responsibility to advocate for dismantling bias.


Through taking the IAT and developing an understanding of implicit bias, medical students can gain insight into the effect it may have on clinical decision-making. Having pre-clinical medical students explore implicit bias through the IAT can lay a foundation for discussing this very human tendency.

Klíčová slova:

Decision making – Medical education – Medicine and health sciences – Patient advocacy – Patients – Physicians – Professions – Reflection


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2019 Číslo 11