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Does Implicit Bias Influence Medical Decision-Making? Developing and Validating Novel Models and Outcome Metrics

隐性偏见会影响医疗决策吗？

基本信息

批准号：
10619642
负责人：
CRISTINA M GONZALEZ
金额：
$ 17.06万
依托单位：
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-08-27 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10619642
关键词：
Address Behavior Black race Calibration Caring Chest Pain Clinical Clinical Research Cognitive Collaborations Communication Communities Consultations Decision Making Development Disparate Disparity Educational Intervention Effectiveness Evaluation Exercise Foundations Future Health Occupations Implicit Association Test Individual Institution Intervention Intervention Studies Intervention Trial K-Series Research Career Programs Knowledge Link Measurement Measures Medical Mentors Methods Modeling Outcome Outcome Measure Pain management Patient Care Patient Simulation Patient-Focused Outcomes Patients Pattern Perception Physicians Process Provider Psychometrics Publishing Race Reporting Reproducibility Research Research Design Research Personnel Standardization Statistical Data Interpretation Testing Training Unconscious State Work acute coronary syndrome black patient clinical care clinical practice communication behavior computerized design effective intervention experience health disparity implicit bias improved medical specialties member negative affect novel primary outcome programs provider behavior racial disparity response secondary outcome simulation skills stressor virtual volunteer

项目摘要

Abstract Implicit, or unconscious, bias may contribute to health disparities via two facets of clinical practice behaviors: communication patterns and medical decision-making. The evidence for a correlation between physician racial implicit bias and disparities in communication by physicians with Black and White patients is strong. In contrast, research investigating the relationship between physician racial implicit bias and medical decision-making, has led to conflicting results. Moreover, investigators seeking to design skills-based interventions to enable physicians to recognize their biases and mitigate their influence on their clinical practice behaviors are limited by the lack of validated outcome metrics, such as checklists and global rating scales. In this proposal Dr. Cristina Gonzalez seeks to build on her expertise as a medical educator and qualitative researcher with new skills in standardized patient case development, psychometric measurement, validity evidence, statistical analysis, and clinical study design. The objectives of the proposal are to develop novel outcome metrics to assess both physician communication and medical decision-making and correlate them with implicit bias. Dr. Gonzalez will design high-fidelity standardized patient cases. Through a mixed-method approach, she will develop novel outcome measures in the form of validated checklists and global rating scales to assess specific clinical practice behaviors. The final aim of this proposal is a clinical study to examine any correlation between implicit bias and medical decision-making. The outcome of this final aim will address an important gap in knowledge relevant to the design future intervention studies. Dr. Gonzalez will emerge from this K award transformed from a medical educator into a clinician investigator able to conduct multi-institution intervention studies addressing physician racial implicit bias and patient outcomes.

摘要内隐或无意识的偏见可能通过临床症状的两个方面导致健康差异。实践行为：沟通模式和医疗决策。A的证据医生种族内隐偏见与沟通差异的相关性黑人和白色病人的医生是强大的。相比之下，研究医生种族内隐偏见和医疗决策之间的关系，导致矛盾的结果。此外，寻求设计基于技能的干预措施的研究人员，使医生能够认识到他们的偏见，并减轻他们对临床实践的影响由于缺乏经过验证的结果指标，如检查表和全球评分量表在这项提案中，克里斯蒂娜·冈萨雷斯博士试图建立在她的专业知识作为一个医疗教育工作者和定性研究人员，具有标准化患者病例开发方面的新技能，心理测量、效度证据、统计分析和临床研究设计。的该提案的目标是开发新的结果指标来评估两位医生沟通和医疗决策，并将其与内隐偏见相关联。博士冈萨雷斯将设计高保真标准化的病人病例。通过混合方法方法，她将开发新的成果措施的形式验证清单，全球评级量表，以评估具体的临床实践行为。本提案的最终目的是一项临床研究，旨在检查内隐偏见与医疗决策之间的任何相关性。这一最终目标的结果将解决与设计相关的知识方面的一个重要空白未来的干预研究。冈萨雷斯博士将从这个K奖中脱颖而出，医学教育者转变为能够进行多机构干预的临床研究者针对医生种族内隐偏见和患者结局的研究。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Qualitative analysis of medical student reflections on the implicit association test.

DOI：
10.1111/medu.14468
发表时间：
2021-06
期刊：
Medical education
影响因子：
6
作者：
Gonzalez CM;Noah YS;Correa N;Archer-Dyer H;Weingarten-Arams J;Sukhera J
通讯作者：
Sukhera J

Twelve tips for teaching implicit bias recognition and management.

DOI：
10.1080/0142159x.2021.1879378
发表时间：
2021-12
期刊：
Medical teacher
影响因子：
4.7
作者：
Gonzalez CM;Lypson ML;Sukhera J
通讯作者：
Sukhera J

Bricolage in medical education, an approach with potential to address complex problems.

医学教育中的拼凑是一种有可能解决复杂问题的方法。

DOI：
10.1111/medu.14714
发表时间：
2022
期刊：
Medical education
影响因子：
6
作者：
Gonzalez,CristinaM;Lypson,MonicaL
通讯作者：
Lypson,MonicaL

Heartache or Bellyache? Epigastric Pain, Communication Skills, and Implicit Bias: Can We Uncover an Association in the Simulation Lab?

DOI：
10.1097/acm.0000000000004868
发表时间：
2022-11-01
期刊：
ACADEMIC MEDICINE
影响因子：
7.4
作者：
Ark, Tavinder;Fisher, Marla;Milan, Felise;Kalet, Adina L;Marantz, Paul R;Burgess, Diana;Rodriguez, Carlos J;Burd-Orama, Lily;Samuel, Malika;Gonzalez, Cristina M
通讯作者：
Gonzalez, Cristina M

Frontline Physician Perspectives on Their Experiences Working During the First Wave of the COVID-19 Pandemic.