P0666 - Addressing Health Equity and Bias Training in Resident Education

Background: Health disparities amongst racial/ethnic minorities and individuals of low socioeconomic status plague the US healthcare system. These disparities often arise in childhood and persist into adulthood. As such, pediatricians are well positioned to affect change. However pediatric residents do not receive robust education regarding health equity and bias. In order to effectively advocate and meet the needs of their patients, residents must better understand the barriers minority patients face and how personal bias affects healthcare.

Intervention: We developed and implemented two different trainings to address this gap in resident education. In fall 2019, we developed implicit bias training, wherein residents completed 3 implicit association tests (IAT) and participated in a 2-hour in-person session on implicit bias and microaggressions in healthcare. All residents received a survey before and after the training, which assessed the importance and efficacy of implicit bias training.

To provide health equity training, we developed a health equity simulation. During this simulation, residents are randomly assigned to a minority race/ethnicity that is different than their own. Each participant then plays out real-life scenarios in which they face the odds of various health disparities based on current health statistics and prior decisions made throughout the simulation. To assess health disparity knowledge and attitudes, pre and post-simulation surveys are administered to participants.

Results: With respect to implicit bias training, 97/117 (83%) participants completed the pre-survey (74% female, 79% white) and 70 (60%) completed the post-survey. Pre-survey data demonstrated that residents “agree” or “strongly agree” that implicit bias training is important (93%), worthwhile (85%), and would have a positive outcome on reducing bias in our community (82%). After completing the training, respondents “agree” or “strongly agree” that they were more aware of their own biases (79%) and had learned strategies to mitigate their biases (74%). Health equity simulation data collection is ongoing.

Impact: In order to begin to address health disparities, we must both confront the systemic inequity that exists and the provider bias that compounds its effects. After completing implicit bias training our residents gained a deeper understanding of bias and feel that they have more tools to mitigate it. Through our health equity simulation, residents occupy the space of a different race/ethnicity and experience the structural inequality that leads to health disparities. Ultimately, through their participation in this simulation, we hope to foster a more empathetic understanding of the health barriers our patients face.