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Understanding Healthcare Students’ Experiences of Racial Bias: A Narrative Review of the Role of Implicit Bias and Potential Interventions in Educational Settings

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  • Olivia Rochelle Joseph

    (School of Psychology, University of Leeds, Leeds LS2 9JU, UK
    Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford BD9 6RJ, UK)

  • Stuart W. Flint

    (School of Psychology, University of Leeds, Leeds LS2 9JU, UK
    Scaled Insights, Nexus, University of Leeds, Leeds LS2 3AA, UK)

  • Rianna Raymond-Williams

    (School of Health and Life Sciences, Glasgow Caledonian University, London E1 6PX, UK)

  • Rossby Awadzi

    (Postgraduate Graduate Medical Education, Northwick Park Hospital, London HA1 3UJ, UK)

  • Judith Johnson

    (School of Psychology, University of Leeds, Leeds LS2 9JU, UK
    Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford BD9 6RJ, UK
    School of Public Health and Community Medicine, University of New South Wales, Sydney 2052, Australia)

Abstract

Implicit racial bias is a persistent and pervasive challenge within healthcare education and training settings. A recent systematic review reported that 84% of included studies (31 out of 37) showed evidence of slight to strong pro-white or light skin tone bias amongst healthcare students and professionals. However, there remains a need to improve understanding about its impact on healthcare students and how they can be better supported. This narrative review provides an overview of current evidence regarding the role of implicit racial bias within healthcare education, considering trends, factors that contribute to bias, and possible interventions. Current evidence suggests that biases held by students remain consistent and may increase during healthcare education. Sources that contribute to the formation and maintenance of implicit racial bias include peers, educators, the curriculum, and placements within healthcare settings. Experiences of implicit racial bias can lead to psychosomatic symptoms, high attrition rates, and reduced diversity within the healthcare workforce. Interventions to address implicit racial bias include an organizational commitment to reducing bias in hiring, retention, and promotion processes, and by addressing misrepresentation of race in the curriculum. We conclude that future research should identify, discuss, and critically reflect on how implicit racial biases are enacted and sustained through the hidden curriculum and can have detrimental consequences for racial and ethnic minority healthcare students.

Suggested Citation

  • Olivia Rochelle Joseph & Stuart W. Flint & Rianna Raymond-Williams & Rossby Awadzi & Judith Johnson, 2021. "Understanding Healthcare Students’ Experiences of Racial Bias: A Narrative Review of the Role of Implicit Bias and Potential Interventions in Educational Settings," IJERPH, MDPI, vol. 18(23), pages 1-15, December.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:23:p:12771-:d:694527
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    References listed on IDEAS

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    1. David R. Williams & Lisa A. Cooper, 2019. "Reducing Racial Inequities in Health: Using What We Already Know to Take Action," IJERPH, MDPI, vol. 16(4), pages 1-26, February.
    2. Hall, W.J. & Chapman, M.V. & Lee, K.M. & Merino, Y.M. & Thomas, T.W. & Payne, B.K. & Eng, E. & Day, S.H. & Coyne-Beasley, T., 2015. "Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: A systematic review," American Journal of Public Health, American Public Health Association, vol. 105(12), pages 60-76.
    3. Maina, Ivy W. & Belton, Tanisha D. & Ginzberg, Sara & Singh, Ajit & Johnson, Tiffani J., 2018. "A decade of studying implicit racial/ethnic bias in healthcare providers using the implicit association test," Social Science & Medicine, Elsevier, vol. 199(C), pages 219-229.
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