Patient perspectives on racial and ethnic implicit bias in clinical encounters: Implications for curriculum development.
Cristina M Gonzalez, Maria L Deno, Emily Kintzer and 3 others
PMID 29843933WHAT IT FOUND
Black and Latino patients said everyday discrimination and subtle slights could make them notice bias in care.
Respect, courtesy, interpreter use, and acknowledging a perceived biased incident with apology were described as ways to preserve trust.
Key findings
01Participants linked everyday discrimination and subtle slights to being primed to notice bias in routine clinical behaviors.
02When participants perceived bias, they described lost trust, delayed care, or avoidance of care.
03Participants said acknowledging a perceived biased incident and apologising were important for restoring the relationship.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was qualitative and did not test whether acknowledgement, apology, or communication changes improve patient outcomes. Participants were purposively sampled only as Black and Latino English or Spanish speakers in the Bronx, so perspectives may differ for other racial, ethnic, language, geographic, and disability groups. The paper focuses on patient physician encounters and medical curriculum; relevance to nurses rests on patients' descriptions of nurses and support staff. Perceived bias may reflect actual bias or interpretations of routine clinical behavior, and the study could not separate these. Member checking used selected participants, and themes are not generalizable in the way a trial outcome would be.
Declared interests
The authors declared no conflict of interest. The supplied publication types indicate NIH and other government research support.
The easy way to misread this
Do not read these themes as proof that apology or communication changes improve patient outcomes. This qualitative study reports patient perceptions and suggestions, not a tested intervention.