“I knew what implicit bias is … but I didn’t know what to do about it before.”
New hands-on training is helping health care professionals recognize and act upon implicit bias to improve patient care. Feedback has been overwhelmingly positive.
Everyone has bias (yes, even highly skilled professionals like doctors) and it can unwittingly lead to inequal care. But what is implicit bias and why do we have it?
We tend to think of biases as being bad, but that’s not always the case. Implicit bias refers to the unconscious mental shortcuts our minds use to filter the massive amount of information we are bombarded with each day (and health care professionals can certainly relate to that). Thanks to implicit bias, we can make decisions more effectively. But the danger of implicit bias is that most of us don’t recognize we have it—and it can hinder our ability to see details that matter, skewing our perspectives and clouding our judgement.
“Of course, no provider is saying ‘we care less about our patients of color,’” says Rae Chaloult, Associate Director at March of Dimes. “But when we’re looking at implicit bias, we’re investigating longstanding false beliefs, the kind of thing you absorb without even realizing it.”
That’s why March of Dimes created Awareness to Action: Dismantling Bias in Maternal and Infant Healthcare™ for health care professionals.
Horizon offering free implicit bias training to New Jersey doctors
Horizon Blue Cross Blue Shield of New Jersey (Horizon) has engaged March of Dimes and Rutgers University to offer implicit bias training, available to every doctor in Horizon’s network.
March of Dimes leads the fight for the health of all moms and babies, so their training focuses on the impact implicit bias can have on maternity care. For example, it shows how structural racism— forms of racism that are deeply embedded in our systems, laws, policies and beliefs— plays a role in shaping care and patient-provider encounters.
The need is critical. According to the U.S. Department of Health and Human Services/Maternal and Child Health, New Jersey is one of the most racially and ethnically diverse states in the nation. And while New Jersey has an overall lower infant mortality than the national average, there is a significant, persistent disparity between race and ethnicity. In fact, according the 2022 March of Dimes Report Card, the preterm birth rate among Black women in New Jersey is rate is 55% higher than the rate among all other women.
Health disparities persist nationwide as well. According to data compiled by the Kaiser Family Foundation, Black Americans have shorter lifespans, are more likely to have and die from HIV, and are more likely to die from diabetes and heart disease than white Americans. Other racial groups fare poorly in comparison to white Americans in certain categories as well—for instance, American Indian and Alaska Native people are twice as likely to die from diabetes, and the infant mortality rate for Non-Hispanic or Other Pacific Islanders is double that of their white counterparts.
“It’s the action piece that’s so important”
Of course, the statistics are influenced by many factors, such as income disparities and availability of healthy food, that health care providers can’t fix—at least, not on their own. That said, they can strive to overcome implicit bias. But how, knowing that it is unconscious? The March of Dimes training suggests using tools such as Harvard University’s Implicit Association Test (IAT), developed to help individuals and organizations strengthen their ability to identify and acknowledge their biases.
The training also helps providers tune into the situations that bias tends to pop up the most: namely, high-stress situations. It’s during these times that techniques such as active listening are most important.
To date, March of Dimes has trained more than 53,000 medical professionals. “Feedback has been overwhelmingly positive,” says Rae. “Participants often say, ‘I knew what implicit bias is and that it exists, but I didn’t know what to do about it before.’ It’s the action piece that’s so important.”
Seasoned care providers aren’t the only ones who benefit from this training: it’s helping medical and nursing students as well, giving them the chance to gain real experience and a leg up on this important, emerging area of patient-facing medicine.
What about the role of patients in reducing bias?
“We want patients to be educated and ready when they meet with providers, but it’s not on the patient to mitigate bias from their provider,” Rae says. “We tell providers we want them to be able to connect and listen to patients. And we would encourage patients to identify a place where they feel that connection when seeking care.”
While trainings like this are improving the current landscape of provider/patient relations, Rae is cautious about declaring victory over bias. “There’s not going to be a point in time where we say, ‘I’m bias-free.’ It’s an ongoing journey. For now, we want to do our best to create a culture where people support each other, and where we can set providers up for success.”
Awareness to Action: Dismantling Bias in Maternal and Infant Healthcare™ is a registered mark of March of Dimes, Inc.
March of Dimes and Rutgers University are independent from and not affiliated with Horizon Blue Cross Blue Shield of New Jersey.