P0681 - Implicit bias: Impact of medical staff exposure to an urban patient population over time

Implicit bias has been shown to impact physicians’ clinical decisions, which may in turn further health disparities for racial and ethnic minorities. Implicit biases are inflated when individuals face increases in cognitive loads, complicating care for ethnic minorities during the course of their hospital care. We measure implicit bias using the Implicit Association Test (IAT), where increased scores indicate increased bias against minorities.
Our study evaluated the association medical staff demographics, passion, and time spent working in an urban environment influenced racial and ethnic biases measured with the IAT over the duration of their career. Passion is defined as a self-reported passion to work with an underserved population both at initial employment and over time rated on a 5pt Lickert scale.
This was a cross-sectional study with an online questionnaire distributed to medical staff (N = 461) serving a population majority ethnic minority children at a free-standing urban pediatric hospital in the northeast region of the United States. Demographics, passion, and IAT scores for race and ethnicity were collected.
Medical staff who participated (n = 165) were mainly 67% white and 20% Asian. Further, 95% of participants were non-Hispanic. Spearman Correlations and Kruskal-Wallis Tests were performed. There was no correlation between participant age, race, or ethnicity with scores on racial or ethnic IAT (p > 0.05). Initial passion was significantly correlated with decreases in racial (r = -0.22, p ≤ 0.05) and ethnic bias (r = -0.22, p ≤ 0.05). There was a modest correlation between increases in passion over time and decreases in racial bias (r = -0.15, p = 0.06). There was no relationship between time worked at an urban hospital and IAT scores (p > 0.05).There was no relationship between race/ethnicity and time working at our institution (p>0.05). However, staff who worked fewer years at our institution had higher self-reported initial passion (r = -0.18, p ≤ 0.05). There was a trend for medical staff who lived longer in urban areas to have higher IAT scores (p = 0.08).
Our study concluded that initial passion was statistically significantly associated with decreased racial and ethnic biases. Contrary to existing literature, participant race, age, and exposure to racial and ethnic minorities was not correlated to decreases in racial and ethnic bias. Further prospective research can evaluate the effect of passion on clinician biases over time.