35 / 58
35
over 125,000 healthcare personnel nationwide using a case-based format supported by
evidence from the peer-reviewed literature and believes it is the largest provider. “I think the
government is our closest competitor and they have trained around 40,000 people,” said
Betancourt.
100
The three physicians, two in Boston and Carillo in New York, collaborated in the
early 2000s to create an expansive curriculum to teach medical residents about cross-cultural
medicine as a means to improve existing disparities in care and this became the impetus to
the the founding of Quality Interactions.
Uncovering Unconscious Bias
There are two types of biases: explicit (or conscious) bias and implicit (or unconscious bias).
An explicit bias is the kind of attitude that you deliberately think about and report. Explicit
bias accounts for many cases of discrimination and should not be tolerated. Unconscious
bias is tougher to identify because we want to believe we treat everyone equally and with
respect. However, we now have a vast body of research that is showing us that unconscious
bias or hidden beliefs – attitudes and biases beyond our regular perceptions of ourselves
and others, underlie a great deal of our patterns of behavior. Counteracting unconscious bias
requires awareness, introspection, authenticity, humility, compassion, communication, and a
willingness to act.
Is Bias Always Bad?
As we go out in the world every day, we constantly, automatically, and usually subconsciously
make evaluations of millions of concepts (person, place, thing, or idea). If something or someone
is assessed to be dangerous, a “flight or fight” fear response ensues. Sometimes we can
consciously re-decide the fear is unwarranted, but often we let our emotions override rationale.
From a survival standpoint, this is a necessary trait and one that is hard-wired into human
beings. Sigmund Freud recognized that our unconscious was vastly more powerful than the
conscious. Modern research not only confirms that, but suggests Freud still underestimated the
power of the unconscious!
Is Bias the Same as Prejudice?
Social psychologists use the word prejudice to describe people who report and approve
negative attitudes toward other groups. Most people who show an implicit preference for
one group (eg, White people) over another (eg, Black people) are not prejudiced by this
definition.
101
The challenge is that even knowing that we are inherently biased, we may not be
able to help ourselves. Our implicit biases are not endorsed and may even be contradictory
to what one consciously believes. So, no, we would not say that such people are prejudiced.
It is important to know, however, that implicit biases can predict behavior. When we relax our
active efforts to be egalitarian, our implicit biases can lead to discriminatory behavior, so it is
critical to be mindful of this possibility if we want to avoid prejudice and discrimination.
101
Identifying Implicit Biases – The Implicit Association Test (IAT)
The Implicit Association Test (IAT) was created and maintained by Project Implicit, founded
as a multi-university research collaboration in 1998 by three scientists - Tony Greenwald
(
University of Washington
), Mahzarin Banaji (
Harvard University)
, and Brian Nosek (
University
of Virginia
). In 2001, it was incorporated as a non-profit to foster dissemination and application