753
Views
0
CrossRef citations to date
0
Altmetric
Research Article

“It’s Always among Us. I Can’t Act Like It’s Not.”: Women College Students’ Perceptions of Physicians’ Implicit Bias

ORCID Icon

References

  • Ackard, D. M., & Neumark-Sztainer, D. (2001). Health care information sources for adolescents: Age and gender differences on use, concerns, and needs. Journal of Adolescent Health, 29(3), 170–176. https://doi.org/10.1016/S1054-139X(01)00253-1
  • Adams, C. H., Smith, N. J., Wilbur, D. C., & Grady, K. E. (1993). The relationship of obesity to the frequency of pelvic examinations: Do physician and patient attitudes make a difference? Women & Health, 20(2), 45–57. https://doi.org/10.1300/J013v20n02_04
  • Alexander, S. C., Fortenberry, J. D., Pollak, K. I., Bravender, T., Davis, J. K., Østbye, T., Tulsky, J. A., Dolor, R. J., & Shields, C. G. (2014). Sexuality talk during adolescent health maintenance visits. JAMA Pediatrics, 168(2), 163–169. https://doi.org/10.1001/jamapediatrics.2013.4338
  • Baker, S. C., & Watson, B. M. (2015). How patients perceive their doctors’ communication: Implications for patient willingness to communicate. Journal of Language and Social Psychology, 34(6), 621–639. https://doi.org/10.1177/0261927X15587015
  • Barth, K. R., Cook, R. L., Downs, J. S., Switzer, G. E., & Fischhoff, B. (2002). Social stigma and negative consequences: Factors that influence college students’ decisions to seek testing for sexually transmitted infections. Journal of American College Health, 50(4), 153. https://doi.org/10.1080/07448480209596021
  • Bilney, C., & d’Ardenne, P. (2001). The truth is rarely pure and never simple: A study of some factors affecting history-sharing in the GUM clinic setting. Sexual and Relationship Therapy, 16(4), 349–364. https://doi.org/10.1080/14681990126949
  • Blackie, M., Wear, D., & Zarconi, J. (2019). Narrative intersectionality in caring for marginalized or disadvantaged patients: Thinking beyond categories in medical education and care. Academic Medicine, 94(1), 59–63. https://doi.org/10.1097/ACM.0000000000002425
  • Blair, I. V., Steiner, J. F., Fairclough, D. L., Hanratty, R., Price, D. W., Hirsh, H. K., Wright, L. A., Bronsert, M., Karimkhani, E., Magid, D. J., & Havranek, E. P. (2013). Clinicians’ implicit ethnic/racial bias and perceptions of care among black and Latino patients. The Annals of Family Medicine, 11(1), 43–52. https://doi.org/10.1370/afm.1442
  • Blair, I. V., Steiner, J. F., Hanratty, R., Price, D. W., Fairclough, D. L., Daugherty, S. L., Bronsert, M., Magid, D. J., & Havranek, E. P. (2014). An investigation of associations between clinicians’ ethnic or racial bias and hypertension treatment, medication adherence and blood pressure control. Journal of General Internal Medicine, 29(7), 987–995. https://doi.org/10.1007/s11606-014-2795-z
  • Blair, I. V., Steiner, J. F., & Havranek, E. P. (2011). Unconscious (implicit) bias and health disparities: Where do we go from here. The Permanente Journal, 15(2), 71–78. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140753/
  • Bowleg, L. (2012). The problem with the phrase women and minorities: Intersectionality—an important theoretical framework for public health. American Journal of Public Health, 102(7), 1267–1273. https://doi.org/10.2105/AJPH.2012.300750
  • Burd, I. D., Nevadunsky, N., & Bachmann, G. (2006). Impact of physician gender on sexual history taking in a multispecialty practice. The Journal of Sexual Medicine, 3(2), 194–200. https://doi.org/10.1111/j.1743-6109.2005.00168.x
  • Burgess, D. J., Crowley-Matoka, M., Phelan, S., Dovidio, J. F., Kerns, R., Roth, C., Saha, S., & Van Ryn, M. (2008). Patient race and physicians’ decisions to prescribe opioids for chronic low back pain. Social Science & Medicine, 67(11), 1852–1860. https://doi.org/10.1016/j.socscimed.2008.09.009
  • Bute, J. J., Brann, M., & Hernandez, R. (2017). Exploring societal-level privacy rules for talking about miscarriage. Journal of Social and Personal Relationships, 36(2), 379–399. https://doi.org/10.1177/0265407517731828
  • Chapman, E. N., Kaatz, A., & Carnes, M. (2013). Physicians and implicit bias: How doctors may unwittingly perpetuate health care disparities. Journal of General Internal Medicine, 28(11), 1504–1510. https://doi.org/10.1007/s11606-013-2441-1
  • Cialdini, R. B. (2001). The science of persuasion. Scientific American, 284(2), 76–81. https://doi.org/10.1038/scientificamerican0201-76
  • Cooper, L. A., Roter, D. L., Carson, K. A., Beach, M. C., Sabin, J. A., Greenwald, A. G., & Inui, T. S. (2012). The associations of clinicians’ implicit attitudes about race with medical visit communication and patient ratings of interpersonal care. American Journal of Public Health, 102(5), 979–987. https://doi.org/10.2105/AJPH.2011.300558
  • Dasgupta, N., DeSteno, D., Williams, L. A., & Hunsinger, M. (2009). Fanning the flames of prejudice: The influence of specific incidental emotions on implicit prejudice. Emotion, 9(4), 585. https://doi.org/10.1037/a0015961
  • Dovidio, J. F., Kawakami, K., Johnson, C., Johnson, B., & Howard, A. (1997). On the nature of prejudice: Automatic and controlled processes. Journal of Experimental Social Psychology, 33(5), 510–540. https://doi.org/10.1006/jesp.1997.1331
  • Ebersole, D. S., & Hernandez, R. A. (2016). “Taking good care of our health”: Parent-adolescent perceptions of boundary management about health information. Communication Quarterly, 64(5), 573–595. https://doi.org/10.1080/01463373.2016.1176939
  • Eisenberg, M., Garcia, C., Frerich, E., Lechner, K., & Lust, K. (2012). Through the eyes of the student: What college students look for, find, and think about sexual health resources on campus. Sexuality Research & Social Policy, 9(4), 306–316. https://doi.org/10.1007/s13178-012-0087-0
  • Farmer, M. A., & Meston, C. M. (2006). Predictors of condom use self-efficacy in an ethnically diverse university sample. Archives of Sexual Behavior, 35(3), 313–326. https://doi.org/10.1007/s10508-006-9027-5
  • Fazio, R. H., Jackson, J. R., Dunton, B. C., & Williams, C. J. (1995). Variability in automatic activation as an unobtrusive measure of racial attitudes: A bona fide pipeline? Journal of Personality and Social Psychology, 69(6), 1013. https://doi.org/10.1037/0022-3514.69.6.1013
  • FitzGerald, C. (2014). A neglected aspect of conscience: Awareness of implicit attitudes. Bioethics, 28(1), 24–32. https://doi.org/10.1111/bioe.12058
  • FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: A systematic review. BMC Medical Ethics, 18(1), 19. https://doi.org/10.1186/s12910-017-0179-8
  • Forgiarini, M., Gallucci, M., & Maravita, A. (2011, May). Racism and the empathy for pain on our skin. Frontiers in Psychology, 2, 108. https://doi.org/10.3389/fpsyg.2011.00108
  • Fuller-Rowell, T. E., Curtis, D. S., Doan, S. N., & Coe, C. L. (2015). Racial disparities in the health benefits of educational attainment: A study of inflammatory trajectories among African American and white adults. Psychosomatic Medicine, 77(1), 33–40. https://doi.org/10.1097/PSY.0000000000000128
  • Fuzzell, L., Fedesco, H. N., Alexander, S. C., Fortenberry, J. D., & Shields, C. G. (2016). “I just think that doctors need to ask more questions”: Sexual minority and majority adolescents’ experiences talking about sexuality with healthcare providers. Patient Education and Counseling, 99(9), 1467–1472. https://doi.org/10.1016/j.pec.2016.06.004
  • Gaither, S. E. (2018). The multiplicity of belonging: Pushing identity research beyond binary thinking. Self and Identity, 17(4), 443–454. https://doi.org/10.1080/15298868.2017.1412343
  • Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative theory. Aldine Publishing Co.
  • Green, A. R., Carney, D. R., Pallin, D. J., Ngo, L. H., Raymond, K. L., Iezzoni, L. I., & Banaji, M. R. (2007). Implicit bias among physicians and its prediction of thrombolysis decisions for black and white patients. Journal of General Internal Medicine, 22(9), 1231–1238. https://doi.org/10.1007/s11606-007-0258-5
  • Greenhalgh, T., Snow, R., Ryan, S., Rees, S., & Salisbury, H. (2015). Six ‘biases’ against patients and carers in evidence-based medicine. BMC Medicine, 13(1), 200. https://doi.org/10.1186/s12916-015-0437-x
  • Hagiwara, N., Dovidio, J. F., Eggly, S., & Penner, L. A. (2016). The effects of racial attitudes on affect and engagement in racially discordant medical interactions between non-Black physicians and Black patients. Group Processes & Intergroup Relations, 19(4), 509–527. https://doi.org/10.1177/1368430216641306
  • Hagiwara, N., Penner, L. A., Gonzalez, R., Eggly, S., Dovidio, J. F., Gaertner, S. L., West, T., & Albrecht, T. L. (2013). Racial attitudes, physician–patient talk time ratio, and adherence in racially discordant medical interactions. Social Science & Medicine, 87, 123–131. https://doi.org/10.1016/j.socscimed.2013.03.016
  • Haider, A. H., Schneider, E. B., Sriram, N., Scott, V. K., Swoboda, S. M., Zogg, C. K., Dhiman, N., Haut, E. R., Efron, D. T., Pronovost, P. J., Freischlag, J. A., Lipsett, P. A., Cornwell, E. E., MacKenzie, E. J., & Cooper, L. A. (2015). Unconscious race and class biases among registered nurses: Vignette-based study using implicit association testing. Journal of the American College of Surgeons, 220(6), 1077–1086. https://doi.org/10.1016/j.jamcollsurg.2015.01.065
  • Haider, A. H., Sexton, J., Sriram, N., Cooper, L. A., Efron, D. T., Swoboda, S., Villegas, C. V., Haut, E. R., Bonds, M., Pronovost, P. J., Lipsett, P. A., Freischlag, J. A., & Cornwell, E. E. (2011). Association of unconscious race and social class bias with vignette-based clinical assessments by medical students. Journal of the American Medical Association, 306(9), 942–951. https://doi.org/10.1001/jama.2011.1248
  • Harrell-Levy, M. K., Kerpelman, J. L., & Henry, D. (2016). ‘Minds Were Forced Wide Open’: Black adolescents’ identity exploration in a transformative social justice class. Education, Citizenship and Social Justice, 11(2), 99–113. https://doi.org/10.1177/1746197915626075
  • Head, S. K., Crosby, R. A., Shrier, L. A., & Moore, G. R. (2007). Young women’s misperceptions about sexually transmissible infection testing: A ‘clean and clear’ misunderstanding. Sexual Health, 4(4), 273–275. https://doi.org/10.1071/SH07060
  • Hernandez, R. (2018). Medical students’ implicit bias and the communication of norms in medical education. Teaching and Learning in Medicine, 30(1), 112–117. https://doi.org/10.1080/10401334.2017.1359610
  • Hernandez, R., Haidet, P., Gill, A. C., & Teal, C. R. (2013). Fostering students’ reflection about bias in healthcare: Cognitive dissonance and the role of personal and normative standards. Medical Teacher, 35(4), e1082–e1089. https://doi.org/10.3109/0142159X.2012.733453
  • How STDs Impact Women Differently From Men (Fact Sheet No. CS309928-D). (2019).
  • Huizinga, M. M., Cooper, L. A., Bleich, S. N., Clark, J. M., & Beach, M. C. (2009). Physician respect for patients with obesity. Journal of General Internal Medicine, 24(11), 1236–1239. https://doi.org/10.1007/s11606-009-1104-8
  • Hunt, J. B., Eisenberg, D., Lu, L., & Gathright, M. (2015). Racial/ethnic disparities in mental health care utilization among US college students: Applying the institution of medicine definition of health care disparities. Academic Psychiatry, 39(5), 520–526. https://doi.org/10.1007/s40596-014-0148-1
  • Khan, A., Plummer, D., Hussain, R., & Minichiello, V. (2008). Does physician bias affect the quality of care they deliver? Evidence in the care of sexually transmitted infections. Sexually Transmitted Infections, 84(2), 150–151. https://doi.org/10.1136/sti.2007.028050
  • Levinson, S., & Giami, A. (2006). From sexuality to sexual health: The use of history in psychosocial training programmes for physicians. Sexual and Relationship Therapy, 21(3), 347–357. https://doi.org/10.1080/14681990600815301
  • Lewis, C., Matheson, D. H., & Brimacombe, C. A. E. (2011). Factors influencing patient disclosure to physicians in birth control clinics: An application of the communication privacy management theory. Health Communication, 26(6), 502–511. https://doi.org/10.1080/10410236.2011.556081
  • Liang, J., Wolsiefer, K., Zestcott, C. A., Chase, D., & Stone, J. (2019). Implicit bias toward cervical cancer: Provider and training differences. Gynecologic Oncology, 153(1), 80–86. https://doi.org/10.1016/j.ygyno.2019.01.013
  • Lichtwarck-Aschoff, A., Finkenauer, C., Van De Vorst, H., & Engels, R. C. (2012). Being mum’s confidant, a boon or bane? Examining gender differences in the association of maternal disclosure with adolescents’ depressive feelings. Journal of Youth and Adolescence, 41(4), 449–459. https://doi.org/10.1007/s10964-011-9661-7
  • Madan, A. K., Aliabadi-Wahle, S., & Beech, D. J. (2001). Age bias: A cause of underutilization of breast conservation treatment. Journal of Cancer Education, 16(1), 29–32. https://doi.org/10.1080/08858190109528720
  • Madan, A. K., Cooper, L., Gratzer, A., & Beech, D. J. (2006). Ageism in breast cancer surgical options by medical students. Tennessee Medicine: Journal of the Tennessee Medical Association, 99(5), 37–38. https://europepmc.org/article/med/1679625
  • Making excellence inclusive. (2016). Association of American Colleges & Universities. https://www.aacu.org/making-excellence-inclusive
  • Mayer, K. H., Bradford, J. B., Makadon, H. J., Stall, R., Goldhammer, H., & Landers, S. (2008). Sexual and gender minority health: What we know and what needs to be done. American Journal of Public Health, 98(6), 989–995. https://doi.org/10.2105/AJPH.2007.127811
  • Mehrotra, A., Zaslavsky, A., & Ayanian, J. (2007). First gynecological visit among females in the United States. Archives of Internal Medicine, 167(17), 1876–1883. https://doi.org/10.1001/archinte.167.17.1876
  • Metz, M., & Seifert, M. (1988). Women’s expectations of physicians in sexual health concerns. Family Practice Research Journal, 7(3), 141–152. https://psycnet.apa.org/record/1989-16737-001
  • Meyer, P. A., Yoon, P. W., & Kaufmann, R. B. (2013). Introduction: CDC health disparities and inequalities report-United States, 2013. MMWR Supplements, 62(3), 3–5. https://europepmc.org/article/med/24264483
  • Nelson, A. (2002). Unequal treatment: Confronting racial and ethnic disparities in health care. Journal of the National Medical Association, 94(8), 666. https://doi.org/10.17226/12875
  • Nosek, B. A., Greenwald, A. G., & Banaji, M. R. (2007). The implicit association test at age 7: A methodological and conceptual review. In J. A. Bargh (Ed.), Social psychology and the unconscious: The automaticity of higher mental processes (pp. 265–292). Psychology Press.
  • Oswalt, S. B., & Wyatt, T. J. (2013). Sexual health behaviors and sexual orientation in a US national sample of college students. Archives of Sexual Behavior, 42(8), 1561–1572. https://doi.org/10.1007/s10508-012-0066-9
  • Penner, L. A., Dovidio, J. F., West, T. V., Gaertner, S. L., Albrecht, T. L., Dailey, R. K., & Markova, T. (2010). Aversive racism and medical interactions with Black patients: A field study. Journal of Experimental Social Psychology, 46(2), 436–440. https://doi.org/10.1016/j.jesp.2009.11.004
  • Petronio, S. (2002). Boundaries of privacy: Dialectics of disclosure. State University of New York Press. http://muse.jhu.edu/books/9780791487853/
  • Petronio, S. (2013). Brief status report on Communication Privacy Management theory. Journal of Family Communication, 13(1), 6–14. https://doi.org/10.1080/15267431.2013.743426
  • Petronio, S., Martin, J., & Littlefield, R. (1984). Prerequisite conditions for self-disclosing: A gender issue. Communication Monographs, 51(3), 268–273. https://doi.org/10.1080/03637758409390200
  • Pletcher, M. J., Kertesz, S. G., Kohn, M. A., & Gonzales, R. (2008). Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments. Journal of the American Medical Association, 299(1), 70–78. https://doi.org/10.1001/jama.2007.64
  • Reuben, D. B., Fullerton, J. T., Tschann, J. M., & Croughan-Minihane, M. (1995). Attitudes of beginning medical students toward older persons: A five-campus study. Journal of the American Geriatrics Society, 43(12), 1430–1436. https://doi.org/10.1111/j.1532-5415.1995.tb06626.x
  • Richardson, L. (2000). Writing: A method of inquiry. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (2nd ed., pp. 923–948). Sage.
  • Risk Factors for Type 2 Diabetes. (2016, November 1). National institute of diabetes and digestive and kidney diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/risk-factors-type-2-diabetes
  • Roberts, S. T., & Kennedy, B. L. (2006). Why are young college women not using condoms? Their perceived risk, drug use, and developmental vulnerability may provide important clues to sexual risk. Archives of Psychiatric Nursing, 20(1), 32–40. https://doi.org/10.1016/j.apnu.2005.08.008
  • Rose, E., DiClemente, R. J., Wingood, G. M., Sales, J. M., Latham, T. P., Crosby, R. A., Zenilman, J., Melendez, J., & Hardin, J. (2009). The validity of teens’ and young adults’ self-reported condom use. Archives of Pediatrics & Adolescent Medicine, 163(1), 61–64. https://doi.org/10.1001/archpediatrics.2008.509
  • Sabin, J. A., & Greenwald, A. G. (2012). The influence of implicit bias on treatment recommendations for 4 common pediatric conditions: Pain, urinary tract infection, attention deficit hyperactivity disorder, and asthma. American Journal of Public Health, 102(5), 988–995. https://doi.org/10.2105/AJPH.2011.300621
  • Sabin, J. A., Rivara, F. P., & Greenwald, A. G. (2008). Physician implicit attitudes and stereotypes about race and quality of medical care. Medical Care, 46(7), 678–685. https://doi.org/10.1097/MLR.0b013e3181653d58
  • Saha, S., Arbelaez, J. J., & Cooper, L. A. (2003). Patient–physician relationships and racial disparities in the quality of health care. American Journal of Public Health, 93(10), 1713–1719. https://doi.org/10.2105/AJPH.93.10.1713
  • Scholly, K., Katz, A. R., Gascoigne, J., & Holck, P. S. (2005). Using social norms theory to explain perceptions and sexual health behaviors of undergraduate college students: An exploratory study. Journal of American College Health, 53(4), 159–166. https://doi.org/10.3200/JACH.53.4.159-166
  • Shafii, T., & Burstein, G. (2009). The adolescent sexual health visit. Obstetrics and Gynecology Clinics of North America, 36(1), 99–117. https://doi.org/10.1016/j.ogc.2009.01.001
  • Shimkowski, J. (2018). Investigating the effects of parents’ inappropriate disclosures on young adults’ emotion regulation and rumination. Southern Communication Journal, 83(5), 283–292. https://doi.org/10.1080/1041794X.2018.1492627
  • Singh, G. K., Daus, G. P., Allender, M., Ramey, C. T., Martin, E. K., Perry, C., De Los Reyes, A. A., & Vedamuthu, I. P. (2017). Social determinants of health in the United States: Addressing major health inequality trends for the nation, 1935-2016. International Journal of MCH and AIDS, 6(2), 139. https://doi.org/10.21106/ijma.236
  • Sprecher, S., Harris, G., & Meyers, A. (2008). Perceptions of sources of sex education and targets of sex communication: Sociodemographic and cohort effects. Journal of Sex Research, 45(1), 17–26. https://doi.org/10.1080/00224490701629522
  • Staton, L. J., Panda, M., Chen, I., Genao, I., Kurz, J., Pasanen, M., Mechaber, A. J., Menon, M., O’Rorke, J., & Wood, J. (2007). When race matters: Disagreement in pain perception between patients and their physicians in primary care. Journal of the National Medical Association, 99(5), 532. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2576060/
  • Steuber, K. R., & Solomon, D. H. (2011). Factors that predict married partners’ disclosures about infertility to social network members. Journal of Applied Communication Research, 39(3), 250–270. https://doi.org/10.1080/00909882.2011.585401
  • Tafari, D. N. H. (2016). Teaching social justice ain’t easy: The unique challenges and opportunities of teaching social justice at an HBCU. The International Journal of Critical Pedagogy, 7(2), 15–36. http://libjournal.uncg.edu/ijcp/article/view/1082
  • Tarr, M. E., & Gilliam, M. L. (2008). Sexually transmitted infections in adolescent women. Clinical Obstetrics and Gynecology, 51(2), 306–318. https://doi.org/10.1097/GRF.0b013e31816d7386
  • Teal, C. R., Gill, A. C., Green, A. R., & Crandall, S. (2012). Helping medical learners recognise and manage unconscious bias toward certain patient groups. Medical Education, 46(1), 80–88. https://doi.org/10.1111/j.1365-2923.2011.04101.x
  • Tracy, S. J. (2012). Qualitative research methods: Collecting evidence, crafting analysis, communicating impact. John Wiley & Sons.
  • Trawalter, S., Hoffman, K. M., & Waytz, A. (2012). Racial bias in perceptions of others’ pain. PloS One, 7(11), e48546. https://doi.org/10.1371/journal.pone.0048546
  • Uncapher, H., & Areán, P. A. (2000). Physicians are less willing to treat suicidal ideation in older patients. Journal of the American Geriatrics Society, 48(2), 188–192. https://doi.org/10.1111/j.1532-5415.2000.tb03910.x
  • Van Ryn, M., & Fu, S. S. (2003). Paved with good intentions: Do public health and human service providers contribute to racial/ethnic disparities in health? American Journal of Public Health, 93(2), 248–255. https://doi.org/10.2105/AJPH.93.2.248
  • Weinstock, H., Berman, S., & Cates, W. (2004). Sexually transmitted diseases among American youth: Incidence and prevalence estimates, 2000. Perspectives on Sexual and Reproductive Health, 36(1), 6–10. https://doi.org/10.1363/3600604
  • Zhang, Z. T., & Dailey, R. M. (2018). Wanna hear a secret?: The burden of secret concealment in personal relationships from the confidant’s perspective. Journal of Relationships Research, 9(e1), 1–11. https://doi.org/10.1017/jrr.2017.22

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.