A mixed-method simulated patient approach to explore implicit bias in health care: A feasibility study in community pharmacy

Collins, J.S.H.; MacKenzie, Megan; Schneider, Carl R.; Chaar, Betty; Moles, Rebekah

doi:10.1016/j.sapharm.2020.05.003

Cited by 7 publications

(5 citation statements)

References 39 publications

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“…A decision to not include a ‘neutral’ option as a discursive frame was made by three authors (WN, SE and RM) as discussion between the authors made it possible to reach consensus and code the data within the dichotomous frames. Despite having been introduced as a frame within some previous discourse analysis methodologies, a ‘neutral’ frame is not always used in studies specifically exploring the language used in suicide assessment [ 22 , 33 , 34 ]. Moreover, a ‘neutral’ frame was considered to have been inappropriate if applied to the discursive frames within this study.…”

Section: Methodsmentioning

confidence: 99%

Observed behaviours and suicide assessment language post-Mental Health First Aid training in Australia and the United States: a mixed methods study using discourse analysis

et al. 2022

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Background Mental Health First Aid (MHFA) training teaches participants how to respond to mental health crises, including suicide. Little is known about the impact of training on participants’ observed MHFA behaviours. This exploratory study aimed to compare MHFA-trained Australian and US student pharmacists’ performance and suicide assessment language during simulated patient role-play (SPRP) assessments. Methods Student pharmacists (n = 265) completed MHFA training and participated (n = 81) in SPRPs with simulated patients (SP) who were people with lived experience of mental illness. Each SPRP was marked by three raters (student, tutor and SP). One-way ANOVA, chi-squared tests and independent samples t-tests were used to compare scores and pass/fail rates, where appropriate. Transcribed audio-recordings of suicide assessments underwent discourse analysis. A chi-squared test was conducted to investigate the differences in how suicide assessment language was coded across six discursive frames (‘confident’/‘timid’, ‘empathetic’/‘apathetic’, and ‘direct’/‘indirect’). Results Three raters assessed 81 SPRPs, resulting in quantitative analysis of 243 rubrics. There were no significant differences between student pharmacists’ mean scores and pass/fail rates across countries. Overall, both cohorts across Australia and the US performed better during the mania scenario, with a low failure rate of 13.9 and 19.0%, respectively. Most students in both countries passed their SPRP assessment; however, 27.8% did not assess for suicide or used indirect language during suicide assessment, despite completing MHFA training. Australian student pharmacists demonstrated, more direct language (76.9% versus 67.9%) and empathy (42.3% versus 32.1%) but less confidence (57.7% versus 60.7%) compared to US student pharmacists, during their suicide assessment; however, these differences were not statistically significant. Conclusions Findings indicate most MHFA-trained student pharmacists from Australia and the US can provide MHFA during SPRPs, as well as assess for suicide directly, empathetically and confidently. This exploratory study demonstrates the importance of practicing skills post-training and the need for further research exploring participants’ hesitance to assess for suicide, despite training completion.

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Section: Methodsmentioning

confidence: 99%

Observed behaviours and suicide assessment language post-Mental Health First Aid training in Australia and the United States: a mixed methods study using discourse analysis

et al. 2022

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“…15 A mixed methods study aimed to explore implicit biases of pharmacists providing assistance to women of different races for various women's health issues, including emergency contraception. 16 It discussed the differences in the pharmacists' responses and the education provided to the actors based on their racial and ethnic backgrounds, and provided interventions to combat implicit bias. 16 One intervention discussed was the use of simulated patient encounters to reveal biases, which allows those running the simulation to provide feedback to pharmacists regarding any detected biases.…”

Section: Introductionmentioning

confidence: 99%

“…16 One intervention discussed was the use of simulated patient encounters to reveal biases, which allows those running the simulation to provide feedback to pharmacists regarding any detected biases. 16 Another study gave an overview of counselor bias on permanent contraception counseling, provided examples of coercion for certain contraceptive methods, and explained the impact of provider bias. 17 The authors provided recommendations on how to educate patients about contraceptive counseling in a manner that promotes shared decision-making, including how to initiate the conversation, educate the patient, correct misinformation, obtain informed consent, and recognize and minimize any barriers to care.…”

Section: Introductionmentioning

confidence: 99%

“…16 It discussed the differences in the pharmacists' responses and the education provided to the actors based on their racial and ethnic backgrounds, and provided interventions to combat implicit bias. 16 One intervention discussed was the use of simulated patient encounters to reveal biases, which allows those running the simulation to provide feedback to pharmacists regarding any detected biases. 16 Another study gave an overview of counselor bias on permanent contraception counseling, provided examples of coercion for certain contraceptive methods, and explained the impact of provider bias.…”

Section: Introductionmentioning

confidence: 99%

“…A mixed methods study aimed to explore implicit biases of pharmacists providing assistance to women of different races for various women’s health issues, including emergency contraception 16 . It discussed the differences in the pharmacists’ responses and the education provided to the actors based on their racial and ethnic backgrounds, and provided interventions to combat implicit bias 16 .…”

Section: Introductionmentioning

confidence: 99%

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Counselor bias and contraceptive counseling for women: a scoping review protocol

McMurtery,

Palokas

2023

JBI Evidence Synthesis

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Objective: The objective of this review is to identify factors, tools, and interventions related to counselor biases and contraceptive counseling in women. Introduction: Contraceptive counseling is the transfer of knowledge regarding contraceptive methods to aid an individual in selecting, discontinuing, or changing contraception. The counselor should deliver information based on the patient’s needs and preferences. The type and quality of the contraceptive information women are provided with should not vary based on social or physical factors, such as age, race, religion, sexual orientation, education level, sexual preference, or weight; however, professional bias continues to be a concern in health care. The results of this review may further the understanding of counselor bias and contraceptive counseling. Inclusion criteria: This scoping review will consider studies that include health care professionals providing contraceptive counseling to female patients in any setting or geographic location. Studies reporting on factors, tools, and interventions related to counselor bias and contraceptive counseling will be included. Methods: Databases to be searched are MEDLINE, CINAHL, Scopus, Web of Science, Science Direct, JBI Evidence-based Practice Database, Europe PubMed Central, and Cochrane Library. Sources of gray literature will include ProQuest Dissertations and Theses, PaperFirst, and MedNar. The review will include studies published in English from 1994 and follow the JBI guidelines for scoping reviews. Two independent reviewers will screen the titles and abstracts, then full texts. Data from relevant studies will be extracted using a tool created by the reviewers. The results will be presented as a narrative summary and in diagrammatic or tabular format. Review registration: Open Science Framework osf.io/judp5

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Design and application of the simulated patient method in pharmacy and health services research

Collins

Chong

Neto³

et al. 2022

Contemporary Research Methods in Pharmacy and Health Services

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A mixed-method simulated patient approach to explore implicit bias in health care: A feasibility study in community pharmacy

Cited by 7 publications

References 39 publications

Observed behaviours and suicide assessment language post-Mental Health First Aid training in Australia and the United States: a mixed methods study using discourse analysis

Observed behaviours and suicide assessment language post-Mental Health First Aid training in Australia and the United States: a mixed methods study using discourse analysis

Counselor bias and contraceptive counseling for women: a scoping review protocol

Design and application of the simulated patient method in pharmacy and health services research

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