Non-conscious bias in medical decision making: What can be done to reduce it?

Medical Education

Volumn 45, Issue 8, 2011, Pages 768-776

  Stone, Jeff ^a   Moskowitz, Gordon B ^b  

^a University of Arizona   (United States)

^b LEHIGH UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CULTURAL COMPETENCE; DOCTOR PATIENT RELATION; EDUCATION; HEALTH CARE DISPARITY; HEALTH CARE PERSONNEL; HEALTH PERSONNEL ATTITUDE; HUMAN; MEDICAL EDUCATION; MINORITY GROUP; PERCEPTION; PSYCHOLOGICAL ASPECT; SOCIAL PSYCHOLOGY;

ATTITUDE OF HEALTH PERSONNEL; CULTURAL COMPETENCY; EDUCATION, MEDICAL; HEALTH PERSONNEL; HEALTHCARE DISPARITIES; HUMANS; MINORITY GROUPS; PHYSICIAN-PATIENT RELATIONS; PREJUDICE; SOCIAL PERCEPTION; STEREOTYPING;

EID: 79960347556     PISSN: 03080110     EISSN: 13652923     Source Type: Journal    
DOI: 10.1111/j.1365-2923.2011.04026.x     Document Type: Article

References (44)

1. US Department of Health and Human Services Agency. National Healthcare Disparities Report. Rockville, MD: US DHHS Agency 2009.
2. Bach PB, Cramer LD, Warren JL, Begg CB. Racial differences in the treatment of early-stage lung cancer. N Engl J Med 1999;341:1198-205.
3. Johnson RL, Saha S, Arbelaez JJ, Beach MC, Cooper LA. Racial and ethnic differences in patient perceptions of bias and cultural competence in health care. J Gen Intern Med 2004;19:101-10.
4. Gordon HA, Street RL, Sharf BF, Souchek J. Racial differences in doctors' information-giving and patients' participation. Cancer 2006;107:1313-20.
5. Mikuls TR, Saag KG, George V, Mudano AS, Banerjee S. Racial disparities in the receipt of osteoporosis-related healthcare among community-dwelling older women with arthritis and previous fracture. J Rheumatol 2005;32:870-5.
6. Schulman KA, Berlin JA, Harless W etal. The effect of race and sex on physicians' recommendations for cardiac catheterisation. N Engl J Med 1999;340:618-26.
7. Nelson T. The Handbook of Prejudice, Stereotyping, and Discrimination. Psychology Press: London 2009.
8. van Ryn M, Burke J. The effect of patient race and socio-economic status on physicians' perceptions of patients. Soc Sci Med 2000;50 (6):813-28.
9. Green AR, Carney DR, Pallin DJ, Ngo LH, Raymond KL, Lezzoni LI, Banaji MR. Implicit bias among physicians and its prediction of thrombolysis decisions for black and white patients. J Gen Intern Med 2007;22:1231-8.
10. Brach C, Fraser I. Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Med Care Res Rev 2000;57:181-217.
11. Castro A, Ruiz E. The effects of nurse practitioner cultural competence on Latina patient satisfaction. J Am Acad Nurse Pract 2009;21:278-86.
12. Groman R, Ginsburg J. Racial and ethnic disparities in health care. A position paper of the American College of Physicians. Ann Intern Med 2004;141:226-32.
13. Devine PG. Stereotypes and prejudice: their automatic and controlled components. J Pers Soc Psychol 1989;56:5-18.
14. Burgess D, van Ryn M, Dovidio J, Saha S. Reducing racial bias among health care providers: lessons from social-cognitive psychology. J Gen Intern Med 2007;22:882-7.
15. Blair IV. The malleability of automatic stereotypes and prejudice. Pers Soc Psychol Rev 2002;6 (3):242-61.
16. Monteith MJ, Lybarger JE, Woodcock A. Schooling the cognitive monster: the role of motivation in the regulation and control of prejudice. Soc Personal Psychol Compass 2009;3:211-26.
17. Moskowitz GB. On the control over stereotype activation and stereotype inhibition. Soc Personal Psychol Compass 2010;4(2):140-58.
18. Hamilton DL, Trolier TK. Stereotypes and stereotyping: an overview of the cognitive approach. In: Dovidio JF, Gaertner SL, eds. Prejudice, Discrimination, and Racism. Orlando, FL: Academic Press 1986;127-63.
19. Moskowitz GB. Social Cognition: Understanding Self and Others. New York, NY: Guilford Press 2005;438-79.
20. Kunda Z, Spencer SJ. When do stereotypes come to mind and when do they colour judgement? A goal-based theory of stereotype activation and application. Psychol Bull 2003;129:522-44.
21. Dovidio JF, Kawakami K, Gaertner SL. Implicit and explicit prejudice and interracial interaction. J Pers Soc Psychol 2002;82:62-8.
22. Hebl MR, Foster JB, Mannix LM, Dovidio JF. Formal and interpersonal discrimination: a field study of bias toward homosexual applicants. Personal Soc Psychol Bull 2002;28:815-25.
23. Cross TL, Bazron BJ, Dennis KW, Isaacs MR. Towards a Culturally Competent System of Care: A Monograph on Effective Services for Minority Children who are Severely Emotionally Disturbed. Washington, DC: CASSP Technical Assistance Center, Georgetown University Child Development Center 1989;1-75.
24. U.S. Department of Health and Human Services, Office of Minority Health. National Standards for Culturally and Linguistically Appropriate Services in Health Care, Final Report. Washington DC: U.S. DHHS, OMH, March 2001.
25. Betancourt J, Green A, Carrillo E. Cultural Competence in Health Care: Emerging Frameworks and Practical Approaches. New York, NY: Commonwealth Fund 2002;1-30.
26. Smith AK, Sudor RL, Pérez-Stable EJ. Palliative care for Latino patients and their families: 'Whenever We Prayed, She Wept'. JAMA 2009;301 (10):1047-67.
27. Macrae CN, Bodenhausen GV, Milne AB, Jetten J. Out of mind but back in sight: stereotypes on the rebound. J Pers Soc Psychol 1994;67:808-17.
28. Galinsky AD, Moskowitz GB. Further ironies of suppression: stereotype and counterstereotype accessibility following suppression. J Exp Soc Psychol 2007;43:833-41.
29. Gawronski B, Bodenhausen GV. Associative and propositional processes in evaluation: an integrative review of implicit and explicit attitude change. Psychol Bull 2006;132:692-731.
30. Czopp AM, Monteith MJ, Mark AY. Standing up for a change: reducing bias through interpersonal confrontation. J Pers Soc Psychol 2006;90:784-803.
31. Vorauer JD, Sasaki SJ. Helpful only in the abstract? Psychol Sci 2009;20 (2):191-7.
32. Stone J, Whitehead J, Schmader T, Focella E. Thanks for asking: self-affirming questions reduce backlash when stigmatized targets confront prejudice. J Exp Soc Psychol 2011;47:589-98.
33. Greenwald AG, McGhee DE, Schwartz JKL. Measuring individual differences in implicit cognition: the Implicit Association Test. J Pers Soc Psychol 1998;74:1464-80.
34. Greenwald AG, Poehlman TA, Uhlmann E, Banaji MR. Understanding and using the implicit association test: III. Meta-analysis of predictive validity. J Pers Soc Psychol 2009;97:17-41.
35. Kawakami K, Dovidio J, Moll J, Hermsen S, Russin A. Just say no (to stereotyping): effects of training in the negation of stereotype associations on stereotype activation. J Pers Soc Psychol 2000;78:871-88.
36. Blair IV, Banaji MR. Automatic and controlled processes in stereotype priming. J Pers Soc Psychol 1996;70:1142-63.
37. Moskowitz GB, Salomon AR, Taylor CM. Implicit control of stereotype activation through the preconscious operation of egalitarian goals. Soc Cogn 2000;18:151-77.
38. Moskowitz GB, Gollwitzer P, Wasel W, Schaal B. Preconscious control of stereotype activation through chronic egalitarian goals. J Pers Soc Psychol 1999;77:167-84.
39. Moskowitz GB, Li P, Ignarri C, Stone J. Compensatory cognition associated with egalitarian goals. J Exp Soc Psychol 2011;47:365-70.
40. Monteith MJ, Ashburn-Nardo L, Voils CI, Czopp AM. Putting the brakes on prejudice: on the development and operation of cues for control. J Pers Soc Psychol 2002;83:1029-50.
41. Gaertner SL, Dovidio JF. Addressing contemporary racism: the common ingroup identity model. In: Willis-Esqueda C, ed. Motivational Aspects of Prejudice and Racism: Nebraska Symposium on Motivation. New York, NY: Springer 2008;111-33.
42. Galinsky AD, Moskowitz GB. Perspective taking: decreasing stereotype expression, stereotype accessibility and in-group favouritism. J Pers Soc Psychol 2000;78:708-24.
43. Vescio TK, Sechrist GB, Paolucci MP. Perspective taking and prejudice reduction: the mediational role of empathy arousal and situational attributions. Eur J Soc Psychol 2003;33:455-72.
44. Dovidio JF, ten Verget M, Stewart TL, Gaertner SL, Johnson JD, Esses VM, Riek BM, Pearson AR. Perspective and prejudice: antecedents and mediating mechanisms. Pers Soc Psychol Bull 2004;12:1537-49.