Abstract:
One criticism of published curricula addressing implicit bias is that few achieve skill development in implicit bias recognition and management (IBRM). To inform the development of skills-based curricula addressing IBRM, we conducted a scoping review of the literature inquiring, \"What interventions exist focused on IBRM in professions related to social determinants of health: education, law, social work, and the health professions inclusive of nursing, allied health professions, and medicine?\"Authors searched eight databases for articles published from 2000 to 2020. Included studies: (1) described interventions related to implicit bias; and (2) addressed knowledge, attitude and/or skills as outcomes. Excluded were interventions solely focused on reducing/neutralizing implicit bias. Article review for inclusion and data charting occurred independently and in duplicate. Investigators compared characteristics across studies; data charting focused on educational and assessment strategies. Fifty-one full-text articles for data charting and synthesis, with more than 6568 learners, were selected. Educational strategies included provocative/engagement triggers, the Implicit Association Test, reflection and discussion, and various active learning strategies. Most assessments were self-report, with fewer objective measures. Eighteen funded studies utilized federal, foundation, institutional, and private sources. This review adds to the literature by providing tangible examples of curricula to complement existing frameworks, and identifying opportunities for further research in innovative skills-based instruction, learner assessment, and development and validation of outcome metrics. Continued research addressing IBRM would enable learners to develop and practice skills to recognize and manage their implicit biases during clinical encounters, thereby advancing the goal of improved, equitable patient outcomes.
摘要:
对解决隐性偏见的已发布课程的一种批评是,很少有人在隐性偏见识别和管理(IBRM)中实现技能发展。为针对IBRM的技能课程的开发提供信息,我们对文献查询进行了范围审查,“在与健康的社会决定因素相关的专业中,存在哪些针对IBRM的干预措施:教育,法律,社会工作,包括护理在内的健康专业,专职医疗专业,和医学?“作者搜索了八个数据库,寻找2000年至2020年发表的文章。纳入的研究:(1)描述了与内隐偏见相关的干预措施;(2)解决了知识,态度和/或技能作为结果。排除了仅专注于减少/消除内隐偏见的干预措施。纳入的文章审查和数据图表独立发生,一式两份。研究人员比较了研究中的特征;数据图表侧重于教育和评估策略。51篇数据图表和综合全文文章,拥有超过6568名学习者,被选中。教育策略包括挑衅/参与触发器,隐式关联测试,反思和讨论,和各种主动学习策略。大多数评估是自我报告,客观措施较少。18项资助的研究利用联邦,基金会,机构,私人来源。这篇综述通过提供具体的课程例子来补充现有的框架,从而增加了文献,并确定进一步研究创新技能教学的机会,学习者评估,以及结果指标的开发和验证。针对IBRM的持续研究将使学习者能够发展和实践技能,以在临床遇到时识别和管理他们的内隐偏见,从而推进改进的目标,公平的患者结果。