Self-Awareness and Cultural Identity as an Effort to Reduce Bias in Medicine

White, Augustus A.; Logghe, Heather J.; Goodenough, D A; Barnes, Linda L.; Hallward, Anne; Allen, Irving M.; Green, David W.; Krupat, Edward; Llerena–Quinn, Roxana

doi:10.1007/s40615-017-0340-6

Cited by 81 publications

(68 citation statements)

References 86 publications

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“…In science one accepts that a diversity of perspectives is an advantage, not a problem. It is also an ethical imperative because including minority views in scientific institutions is an expectation of modern science (White et al 2018). The intolerance by some invasion biologists of different perspectives, made manifest in fallacious accusations of science denialism, is problematic.…”

Section: Resultsmentioning

confidence: 99%

“…; White et al. ). By reflecting on, and working with those values, medical science and scientists seek to modify and adapt the purpose, objectives, and outcomes of medical science to better serve its globally diverse public.…”

Section: Interdisciplinarity and Inclusion To Advance Invasion Biologymentioning

confidence: 98%

“…In recent years, it has become clear that better science and enhanced public trust in scientists are achieved when a diversity of perspectives is considered evidentially and in ways that represent and encourage the participation of the wider community (White et al. ). Unjustifiable accusations of science denialism, such as those we have identified, ostracise novel, minority, or outside perspectives.…”

Section: Origins Of Accusations Of Science Denialmentioning

confidence: 99%

“…4, 2019 and debated by its scientists. Medical science, for example, is routinely critiqued for its cultural judgments, and the values of its scientists and practitioners, and how those interact with the diversity of values held by patients (e.g., Kristeva et al 2018;Te Karu et al 2018;White et al 2018). By reflecting on, and working with those values, medical science and scientists seek to modify and adapt the purpose, objectives, and outcomes of medical science to better serve its globally diverse public.…”

Section: Interdisciplinarity and Inclusion To Advance Invasion Biologymentioning

confidence: 99%

See 3 more Smart Citations

On allegations of invasive species denialism

Munro

Steer

Linklater

2019

Conservation Biology

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Science denialism retards evidenced‐based policy and practice and should be challenged. It has been a particular concern for mitigating global environmental issues, such as anthropogenic climate change. But allegations of science denialism must also be well founded and evidential or they risk eroding public trust in science and scientists. Recently, 77 published works by scholars, scientists, and science writers were identified as containing invasive species denialism (ISD; i.e., rejection of well‐supported facts about invasive species, particularly the global scientific consensus about their negative impacts). We reevaluated 75 of these works but could find no examples of refutation of scientific facts and only 5 articles with text perhaps consistent with one of the 5 characteristics of science denialism. We found, therefore, that allegations of ISD were misplaced. These accusations of science denialism may have arisen because invasion biology defines its subjects—invasive species—based on multiple subjective and normative judgments. Thus, more than other applied sciences its consensus is one of shared values as much as agreed knowledge. Criticisms of invasion biology have largely targeted those subjective and normative judgments and their global imposition, not the knowledge on which the discipline is based. Regrettably, a few invasion biologists have misinterpreted the critique of their values‐based consensus as a denial of their science when it is not. To make invasion biology a more robust and widely accepted science and to avoid unnecessary misunderstandings and conflicts, invasion biologists could be more accepting of perspectives originating from other disciplines and more open to values‐based critique from scholars and scientists outside their field. This recommendation applies to all conservation sciences, especially those addressing global challenges, because these sciences must serve and be relevant to communities with an extraordinary diversity of cultures and values.

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Section: Resultsmentioning

confidence: 99%

Section: Interdisciplinarity and Inclusion To Advance Invasion Biologymentioning

confidence: 98%

Section: Origins Of Accusations Of Science Denialmentioning

confidence: 99%

Section: Interdisciplinarity and Inclusion To Advance Invasion Biologymentioning

confidence: 99%

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On allegations of invasive species denialism

Munro

Steer

Linklater

2019

Conservation Biology

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“…20 Self-reflection can be an important aspect of understanding personal viewpoints, enabling improved proficiency in providing culturally competent care. [21][22][23] Integrated care systematically coordinates general and behavioral health by defragmenting mental health, substance abuse, and primary care services. 24 This fosters a team-based approach where mental health and physical health providers work together to improve care for the patient.…”

Section: Introductionmentioning

confidence: 99%

Self-monitoring checklists: A tool for connecting training to practice

Hughes¹,

McCulloch²,

Valdés³

2018

IGHPE

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A limitation of training is the gap between the knowledge learned in training and the behavior put into practice. Skills checklists are helpful for reducing errors and increasing adherence to safety and may be one tool useful for bridging that gap. There is little research examining the role of skills checklists with self-reflection completed independently, or "self-monitoring checklists," for increasing knowledge and improving skills in areas requiring attentional behavior in healthcare. Two randomized controlled studies incorporated self-monitoring checklists along with online training in cultural competence and integrated care, respectively, for health professionals. At least ninety percent of participants in both studies found self-monitoring checklists to be helpful. Healthcare educators and practitioners should consider self-monitoring checklists as an additional tool for online training when developing educational strategies for healthcare professionals.

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Racial Implicit Bias and Communication Among Physicians in a Simulated Environment

Gonzalez,

Ark,

Fisher

et al. 2024

JAMA Netw Open

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ImportanceRacial implicit bias can contribute to health disparities through its negative influence on physician communication with Black patients. Interventions for physicians to address racial implicit bias in their clinical encounters are limited by a lack of high-fidelity (realistic) simulations to provide opportunities for skill development and practice.ObjectiveTo describe the development and initial evaluation of a high-fidelity simulation of conditions under which physicians might be influenced by implicit racial bias.Design, Setting, and ParticipantsThis cross-sectional study, performed on an online platform from March 1 to September 30, 2022, recruited a convenience sample of physician volunteers to pilot an educational simulation.ExposuresIn the simulation exercise, physicians saw a 52-year-old male standardized patient (SP) (presenting as Black or White) seeking urgent care for epigastric pain, nausea, and vomiting. The case included cognitive stressors common to clinical environments, including clinical ambiguity, stress, time constraints, and interruptions. Physicians explained their diagnosis and treatment plan to the SP, wrote an assessment and management plan, completed surveys, and took the Race Implicit Association Test (IAT) and Race Medical Cooperativeness IAT. The SPs, blinded to the purpose of the study, assessed each physician’s communication using skills checklists and global rating scales.Main Outcomes and MeasuresAssociation between physicians’ IAT scores and SP race with SP ratings of communication skills.ResultsIn 60 physicians (23 [38.3%] Asian, 4 [6.7%] Black, 23 [38.3%] White, and 10 [16.7%] other, including Latina/o/x, Middle Eastern, and multiracial; 31 [51.7%] female, 27 [45.0%] male, and 2 [3.3%] other), the interaction of physicians’ Race IAT score and SP race was significant for overall communication (mean [SD] β = −1.29 [0.41]), all subdomains of communication (mean [SD] β = −1.17 [0.52] to −1.43 [0.59]), and overall global ratings (mean [SD] β = −1.09 [0.39]). Black SPs rated physicians lower on communication skills for a given pro-White Race IAT score than White SPs; White SP ratings increased as physicians’ pro-White bias increased.Conclusions and RelevanceIn this cross-sectional study, a high-fidelity simulation calibrated with cognitive stressors common to clinical environments elicited the expected influence of racial implicit bias on physicians’ communication skills. The outlined process and preliminary results can inform the development and evaluation of interventions that seek to address racial implicit bias in clinical encounters and improve physician communication with Black patients.

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Self-Awareness and Cultural Identity as an Effort to Reduce Bias in Medicine

Cited by 81 publications

References 86 publications

On allegations of invasive species denialism

On allegations of invasive species denialism

Self-monitoring checklists: A tool for connecting training to practice

Racial Implicit Bias and Communication Among Physicians in a Simulated Environment

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