title: A deeper look at implicit weight bias in medical students.
abstract: The Implicit Relational Assessment Procedure (IRAP, Barnes-Holmes et al. in Psychol Rec 60:527-542, 2010) was utilized as a relatively new tool to measure implicit weight bias in first- and third-year medical students. To date, only two studies (Miller et al. in Acad Med 88:978-982, 2013; Phelan et al. in Med Educ 49:983-992, 2015) have investigated implicit weight bias with medical students and both have found pro-thin/anti-fat implicit attitudes, on average, using the Implicit Association Test (IAT, Greenwald and Banaji in Psychol Rev 102:4-27, 1995) as the assessment tool. The IRAP, however, allows for a deeper analysis of implicit attitudes with respect to both thin and fat in isolation, and it was found that medical students are, on average, actually both pro-thin and pro-fat, and on average are more pro-thin than pro-fat, as opposed to anti-fat. Additionally, it was found that medical students' implicit weight bias against fat/obese individuals improved over the first 2 years of medical training, and this improvement was specifically driven by improved implicit attitudes toward overweight and obese, while implicit attitudes toward thin remained constant over that time. The implications of more sensitive implicit bias assessment and specific changes in bias over time are discussed within the context of medical education curriculum development.
authors.affiliation: University of Nevada, School of Medicine, Reno, NV, USA.
authors.forename: Timothy K
authors.initials: TK
authors.lastname: Baker
authors.affiliation: Department of Psychology, University of Nevada, Reno, NV, USA. gscottsmith@unr.edu.
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Smith
authors.affiliation: University of Nevada, School of Medicine, Reno, NV, USA.
authors.forename: Negar Nicole
authors.initials: NN
authors.lastname: Jacobs
authors.affiliation: Department of Psychology, University of Nevada, Reno, NV, USA.
authors.forename: Ramona
authors.initials: R
authors.lastname: Houmanfar
authors.affiliation: University of Nevada, School of Medicine, Reno, NV, USA.
authors.forename: Robbyn
authors.initials: R
authors.lastname: Tolles
authors.affiliation: University of Nevada, School of Medicine, Reno, NV, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Kuhls
authors.affiliation: University of Nevada, School of Medicine, Reno, NV, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Piasecki
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001835:Body Weight; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000523:psychology; D050177:Overweight / Q000523:psychology*; D011287:Prejudice / Q000523:psychology*; D013337:Students, Medical / Q000523:psychology*; D013851:Thinness / Q000523:psychology; D013997:Time Factors; D055815:Young Adult
keywords: IRAP; Implicit bias; Implicit relational assessment procedure; Medical education; Medical students; Obesity; Weight bias