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Unconscious Bias among Health Professionals: A Scoping Review

Author

Listed:
  • Ursula Meidert

    (School of Health Sciences, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland)

  • Godela Dönnges

    (School of Health Sciences, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland)

  • Thomas Bucher

    (School of Health Sciences, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland)

  • Frank Wieber

    (School of Health Sciences, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland)

  • Andreas Gerber-Grote

    (School of Health Sciences, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland)

Abstract

Background: Unconscious biases are one of the causes of health disparities. Health professionals have prejudices against patients due to their race, gender, or other factors without their conscious knowledge. This review aimed to provide an overview of research on unconscious bias among health professionals and to investigate the biases that exist in different regions of the world, the health professions that are considered, and the research gaps that still exist. Methods: We conducted a scoping review by systematically searching PubMed/MEDLINE, CINAHL, PsycINFO, PsycARTICLES, and AMED. All records were double-screened and included if they were published between 2011 and 2021. Results: A total of 5186 records were found. After removing duplicates ( n = 300), screening titles and abstracts ( n = 4210), and full-text screening ( n = 695), 87 articles from 81 studies remained. Studies originated from North America ( n = 60), Europe ( n = 13), and the rest of the world ( n = 6), and two studies were of global scope. Racial bias was investigated most frequently ( n = 46), followed by gender bias ( n = 11), weight bias ( n = 10), socio-economic status bias ( n = 9), and mental illness bias ( n = 7). Most of the studies were conducted by physicians ( n = 51) and nurses ( n = 20). Other health care professionals were rarely included in these studies. Conclusions: Most studies show that health professionals have an implicit bias. Racial biases among physicians and nurses in the USA are well confirmed. Research is missing on other biases from other regions and other health professions.

Suggested Citation

  • Ursula Meidert & Godela Dönnges & Thomas Bucher & Frank Wieber & Andreas Gerber-Grote, 2023. "Unconscious Bias among Health Professionals: A Scoping Review," IJERPH, MDPI, vol. 20(16), pages 1-28, August.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:16:p:6569-:d:1216044
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    References listed on IDEAS

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    1. Daniel J. Lee, 2016. "Racial bias and the validity of the Implicit Association Test," WIDER Working Paper Series 053, World Institute for Development Economic Research (UNU-WIDER).
    2. Daniel J. Lee, 2016. "Racial bias and the validity of the Implicit Association Test," WIDER Working Paper Series wp-2016-53, World Institute for Development Economic Research (UNU-WIDER).
    3. 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, American Public Health Association, vol. 102(5), pages 988-995.
    4. Eric Luis Uhlmann & Anthony Greenwald & Andrew Poehlmann & Mahzarin Banaji, 2009. "Understanding and Using the Implicit Association Test: III. Meta-Analysis of Predictive Validity," Post-Print hal-00516146, HAL.
    5. 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.
    6. Wittlin, Natalie M. & Dovidio, John F. & Burke, Sara E. & Przedworski, Julia M. & Herrin, Jeph & Dyrbye, Liselotte & Onyeador, Ivuoma N. & Phelan, Sean M. & van Ryn, Michelle, 2019. "Contact and role modeling predict bias against lesbian and gay individuals among early-career physicians: A longitudinal study," Social Science & Medicine, Elsevier, vol. 238(C), pages 1-1.
    7. Moskowitz, G.B. & Stone, J. & Childs, A., 2012. "Implicit stereotyping and medical decisions: Unconscious stereotype activation in practitioners' thoughts about African Americans," American Journal of Public Health, American Public Health Association, vol. 102(5), pages 996-1001.
    8. 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, American Public Health Association, vol. 102(5), pages 979-987.
    9. Blair, I.V. & Havranek, E.P. & Price, D.W. & Hanratty, R. & Fairclough, D.L. & Farley, T. & Hirsh, H.K. & Steiner, J.F., 2013. "Assessment of biases against latinos and african americans among primary care providers and community members," American Journal of Public Health, American Public Health Association, vol. 103(1), pages 92-98.
    10. Sabin, J.A. & Riskind, R.G. & Nosek, B.A., 2015. "Health care providers' implicit and explicit attitudes toward lesbian women and gay men," American Journal of Public Health, American Public Health Association, vol. 105(9), pages 1831-1841.
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