Why It's Hard to Admit Our Bias
How to Overcome 4 Common Objections to Implicit Bias Training
When I first received my health coaching certifications, I did what most people who want to practice online do: I started following online business coaches running highly successful online businesses. As many of these coaches began in the health industry themselves, I felt that much of what they were teaching would be translatable to my business. I was more naive than I realized.
Many of these coaches were, in fact, successful, but I slowly realized that their success didn’t translate to cultural competence. By this, I mean there was little, if any, understanding of the differences across cultures, which meant that interventions were solely based on Westernized standards of health that weren’t inclusive of Black, Indigenous, and Peoples of Color (BIPOC). It wasn’t until the coronavirus 2019 (COVID-19) pandemic that these business coaches I had long followed and invested in would be forced to reckon with their lack of cultural competency and acknowledgment of implicit bias.
However, the reckoning wasn’t just for business coaches and the healthcare industry. As it became apparent during the COVID-19 pandemic that morbidity and mortality rates were highest amongst BIPOC populations and other minoritized groups, the healthcare industry was compelled to understand the reason behind these healthcare disparities (Linos et al., 2022). In no uncertain terms, it became evident that geographical barriers, difficulty affording medical care, and the inability to access culturally appropriate care were just a few factors contributing to increased morbidity and mortality amongst BIPOC populations.
Having had the opportunity to work at Partners In Health during the COVID-19 pandemic, I discovered early on that BIPOC populations would be the most impacted. This realization marked a significant shift for me. I transitioned from focusing exclusively on what individuals can do to improve health outcomes to addressing the systemic issues that contribute to healthcare disparities among BIPOC populations. For me, that meant admitting something that I didn’t want to admit: I, too, had implicit bias.
Why We Must Understand the Impact of Implicit Bias in Healthcare
Implicit biases are unconscious attitudes or stereotypes that affect our understanding, actions, and decision-making. In general, implicit bias is harmful but can be deadly in healthcare. In healthcare, implicit biases can influence the quality of care provided to patients, leading to disparities in health outcomes. The reason that implicit biases are so pervasive is that providers don’t want to admit that they have them. Instead, they’d prefer to act as if they don’t exist and that their good intentions are enough to address any potential harm they could cause. The harsh reality is that due to implicit biases, healthcare providers may unknowingly treat patients differently based on these biases.
However, some healthcare providers resist implicit bias training because they believe their intention not to harm is enough. These providers would be right regarding “explicit” bias, intentional attitudes, or stereotypes affecting our understanding, actions, and decision-making. Because implicit bias is unconscious, we cannot assume that being fair and impartial professionals dedicated to providing the best care means we won’t unintentionally make biased decisions. For instance, making assumptions about pain tolerance or compliance are unintentional ways that providers can harm patients. Thus, believing that good intentions are all we need can create a barrier to recognizing and addressing implicit biases.
How to Overcome 4 Common Objections to Implicit Bias Training
While implicit bias training is practical for raising awareness of implicit bias, organizations may sometimes face resistance from providers or patients. Here are four common objections to and ways to address implicit bias training.
Objection 1. I don’t have any biases.
While I’d hate to break it to you, everyone has biases. More importantly, we must recognize that our backgrounds, experiences, and societal influences shape these biases. Implicit bias training isn’t solely about pointing out our biases but giving us practical management tools.
For this reason, when I compile a presentation for an organization I’m speaking to, I use data and research to show that implicit biases are a universal phenomenon. In addition, I leverage tools like the Implicit Association Test, which can help healthcare providers see their own biases in action. Therefore, when hiring a presenter, ensure they can clearly articulate that biases exist and that there are strategies we can implement to mitigate their impact.
Objection 2. My good intentions are enough.
The harsh reality is that good intentions don’t always translate into equitable actions. As implicit biases operate subconsciously, they counteract our conscious beliefs and intentions. Thus, implicit bias training ensures that we operate from a place of awareness rather than complacency.
Hence, implicit bias training enables us to align our good intentions with equitable actions. For instance, we might intend to be inclusive by hiring BIPOC healthcare providers - which is especially important when working with diverse populations. However, if those BIPOC healthcare providers aren’t aware of their own implicit biases, they can still perpetuate harm. Therefore, when hiring providers, we must ensure they’re ready, willing, and able to address their implicit biases.
Objection 3. Implicit bias training is ineffective.
While no single training can eliminate biases, ongoing education, and awareness can significantly mitigate their impact. Implicit bias training helps you develop skills to address implicit biases. Therefore, healthcare providers can move beyond awareness of implicit bias to actions they can take to mitigate it in their practices.
For example, when I’m hired to conduct implicit bias training, I prefer a series where staff members can build upon their skills. By this, I mean the first session focuses on the fundamental theory, whereas the ongoing sessions focus more on practical application. By encouraging staff to engage in practical application, they can see this as not just training but experience how this directly relates to their work. Thus, when hiring a facilitator, ensure they focus on continuous learning and improvement through training and practical application.
Objection 4. I’m too busy for training.
Even though implicit bias training can leave some healthcare providers feeling like it’s an additional burden, organizations should reframe it as a crucial part of professional development. Beyond the obvious fact that we have a moral obligation to “do no harm,” implicit bias training has tangible benefits. Through implicit bias training, we can address biases which can improve patient outcomes and enhance job satisfaction.
However, it’s essential to be practical by offering flexible training options. Even though my training is often live, there are benefits of having online modules that staff can complete at their own pace. There is often the ability to integrate lessons during regular meetings to become part of the regular day-to-day. While it will initially feel like an obligation, when rolling out training for your staff, it’s important to stress its benefits in reducing biases for them and their patients in the long term.
Overcoming objections to implicit bias training in healthcare requires education, empathy, and evidence-based strategies. By acknowledging that biases are a natural part of being human and providing the tools to manage them, healthcare organizations can foster a more inclusive and equitable environment. This benefits patients and enhances the professional growth and satisfaction of healthcare providers.
Implicit bias training becomes vital to our mission as we strive to deliver equitable care to Black women and marginalized populations. Join us in this journey towards more inclusive healthcare by subscribing to our newsletter.
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Reference
Linos, N., Bassett, M. T., Salemi, A., Matache, M., Tararas, K., Kort, R., Gomez, S., Zaghi, M., Lane, R., Harrison, B., Lucke, K., Sanchez, G., Althaus, A., Amaya, M. P., & Koller, T. S. (2022). Opportunities to tackle structural racism and ethnicity-based discrimination in recovering and rebuilding from the COVID-19 pandemic. Nature Communications, 13(1), 3277. https://doi.org/10.1038/s41467-022-30791-w