title: When best intentions aren't enough: helping medical students develop strategies for managing bias about patients.
abstract: OBJECTIVE
  Implicit bias can impact physician-patient interactions, alter treatment recommendations, and perpetuate health disparities. Medical educators need methods for raising student awareness about the impact of bias on medical care.
  
  
  METHODS
  Seventy-two third-year medical student volunteers participated in facilitated small group discussions about bias.
  
  
  METHODS
  We tested an educational intervention to promote group-based reflection among medical students about implicit bias.
  
  
  RESULTS
  We assessed how the reflective discussion influenced students' identification of strategies for identifying and managing their potential biases regarding patients. 67% of the students (n = 48) identified alternate strategies at post-session. A chi-square analysis demonstrated that the distribution of these strategies changed significantly from pre-session to post-session (chi(2)(11) = 27.93, p < 0.01), including reductions in the use of internal feedback and humanism and corresponding increases in the use of reflection, debriefing and other strategies.
  
  
  CONCLUSIONS
  Group-based reflection sessions, with a provocative trigger to foster engagement, may be effective educational tools for fostering shifts in student reflection about bias in encounters and willingness to discuss potential biases with colleagues, with implications for reducing health disparities.
authors.affiliation: Houston VA HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA. cteal@bcm.edu
authors.forename: Cayla R
authors.initials: CR
authors.lastname: Teal
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Shada
authors.forename: Anne C
authors.initials: AC
authors.lastname: Gill
authors.forename: Britta M
authors.initials: BM
authors.lastname: Thompson
authors.forename: Ernest
authors.initials: E
authors.lastname: Frugé
authors.forename: Graciela B
authors.initials: GB
authors.lastname: Villarreal
authors.forename: Paul
authors.initials: P
authors.lastname: Haidet
mesh_terms: D001291:Attitude of Health Personnel / Q000208:ethnology*; D054521:Cultural Competency / Q000523:psychology*; D054625:Healthcare Disparities; D006801:Humans; D033182:Intention; D011287:Prejudice; D013337:Students, Medical / Q000523:psychology*