Understanding Healthcare Students’ Experiences of Racial Bias: A Narrative Review of the Role of Implicit Bias and Potential Interventions in Educational Settings

Abstract

Implicit racial bias is a persistent and pervasive challenge within healthcare education and training settings. A recent systematic review reported that 84% of included studies (31 out of 37) showed evidence of slight to strong pro-white or light skin tone bias amongst healthcare students and professionals. However, there remains a need to improve understanding about its impact on healthcare students and how they can be better supported. This narrative review provides an overview of current evidence regarding the role of implicit racial bias within healthcare education, considering trends, factors that contribute to bias, and possible interventions. Current evidence suggests that biases held by students remain consistent and may increase during healthcare education. Sources that contribute to the formation and maintenance of implicit racial bias include peers, educators, the curriculum, and placements within healthcare settings. Experiences of implicit racial bias can lead to psychosomatic symptoms, high attrition rates, and reduced diversity within the healthcare workforce. Interventions to address implicit racial bias include an organizational commitment to reducing bias in hiring, retention, and promotion processes, and by addressing misrepresentation of race in the curriculum. We conclude that future research should identify, discuss, and critically reflect on how implicit racial biases are enacted and sustained through the hidden curriculum and can have detrimental consequences for racial and ethnic minority healthcare students.

Students Perspectives of the Effect of Ethnicity On Experiences in a Graduate Entry Medicine Course in Wales: A Qualitative Study

“…Previous studies in medical schools in England have found that ethnic minority healthcare students have higher stress compared to their white peers and qualitative interviews with trainee doctors showed strained relationships with seniors due to a perceived bias during work-based assessments and the psychological impact of stereotypes [5,6]. This study describes the experience of BAME medical students in Wales, combining the impact of a less ethnically diverse local population than in the UK in general with being on a graduate-entry course, which tends to have signi cantly lower proportions of BAME entrants compared to undergraduate medical courses [7,8].…”

CE: Reducing Bias Against People with Substance Use Disorders

“…34 Ground rules, such as respect and confidentiality, create a nonthreatening space to foster vulnerability and learning. [43][44][45] This atmosphere enables sensitive discussions to take place among nurses and colleagues and encourages growth. Implicit bias is part of being human; however, overcoming one's misconceptions is necessary to prevent harmful clinical decisions.…”

Learning Clinical Judgments With a Lens of Inclusivity

“…Systematic racist beliefs spread through hierarchy, power, and media, make it more likely that White nursing students will think or act in a biased manner (Roberts & Rizzo, 2021). It was found that White students exposed to demonstrations of racial bias expressed racial bias themselves (Joseph et al, 2021). An additional concern is that implicit bias plays a role in recruiting and retaining nurses of color (Joseph et al, 2021).…”

“…It was found that White students exposed to demonstrations of racial bias expressed racial bias themselves (Joseph et al, 2021). An additional concern is that implicit bias plays a role in recruiting and retaining nurses of color (Joseph et al, 2021). Being aware of the role that these biases play will lead to more optimal nursing care.…”