Longitudinal outcomes one year following implicit bias training in medical students

Abstract

Purpose

Training in implicit bias is broadly recognized as important in medical education and is mandated by some accrediting bodies. This study examined medical students’ retention of concepts immediately following and one-year post participation in an implicit bias workshop.

Methods

Study subjects were 272 third-year medical students who participated in workshops held between 2018–2020 that used the Implicit Associations Test (IAT) as a trigger for discussions in small groups. We developed a survey and administered it to students to capture their awareness of implicit bias pre-, post-, and one-year post-workshop attendance. Repeated Measures Analyses and independent-samples t-tests were used to examine for differences in responses on each of the seven survey items and a tabulated 7-item average of these seven items.

Results

Six of seven survey items and the tabulated 7-item average examined by Repeated Measures Analyses showed statistically significant increases between the pre-, post-, and one-year post-surveys (ps range: 0.01–0.07), with a small to moderate effect sizes (ƞ_p²s range: 0.01–0.07). Pairwise comparisons among these three surveys’ results indicated statistically significant improvements between the pre- and the post-workshop surveys (ps range: 0.01–0.03) but no statistically significant differences between the post- and the one-year post-workshop surveys (ps range: 0.57–0.99). A separate sample of 17 off-cycle students who took the one-year post- workshop survey two years after the workshop did not differ statistically on the level of awareness of bias compared to those taking the same survey one year later, as examined by the two-group independent t-tests for the seven one-year post-workshop survey items (ps range: 0.56–0.99).

Conclusions

The findings support one-year retention of knowledge and attitudes gained from an implicit bias workshop and suggest similar retention at two years. Future educational interventions that train learners to recognize and manage implicit and explicit behaviors in clinical practice are needed.

Keywords:

• Ethics/attitudes
• undergraduate
• medicine
• small group
• implicit bias

Ethical approval

This research was approved by the Baylor College of Medicine Institutional Review Board on 2/8/2019 (protocol #H-45073) and 1/19/2021.

Acknowledgements

The authors wish to thank, Dr. B. Lee Ligon for her editing assistance and Amy Addams for her generous assistance critically reviewing the manuscript.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Implicit Associations Test (IAT): A test that can be used to assess unconscious biases.

Additional information

Notes on contributors

Anne C. Gill

A.C. Gill, DrPH, MS, is an Assistant Dean of Interprofessional Education and Professor, Department of Pediatrics, and Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas.

Yuanyuan Zhou

Y. Zhou, PhD, is a Senior Data Analyst in the Division of Evaluation, Assessment and Education Research, and Instructor in the Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas.

Jocelyn T. Greely

J.T. Greely, MD, is an Assistant Professor in the Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston, Texas.

Anitra D. Beasley

A.D. Beasley, MD, MPH, is an Associate Professor in the Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston, Texas.

Joel Purkiss

J. Purkiss, PhD, is an Assistant Dean of Evaluation, Assessment and Educational Research, and Assistant Professor, Department of Education, Innovation, and Technology, Baylor College of Medicine, Houston, Texas.

Malvika Juneja

M. Juneja, MD, is an Associate Professor, Family and Community Medicine, Baylor College of Medicine, Houston, Texas.