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With input from national experts, this publication was developed by the AAMC and The Kirwan Institute for the Study of Race and Ethnicity at The Ohio State University. The report details the impact of unconscious bias on seven areas of academic medicine-patient care, medical school admissions, undergraduate medical education, resident and faculty recruitment, faculty mentoring, and faculty advancement, promotion and tenure. The publication also summarizes interventions that are being used to remediate these biases. Key insights include: Admissions committee members may sometimes unconsciously create different sets of criteria for students based on their experiences. The unconscious biases of peers and teachers can produce lasting effects on students' academic experiences. Unconscious bias can affect the faculty recruitment process even before positions are advertised. Patient care can improve when physicians explore their own biases and how these tendencies affect the care they provide. There is ample evidence that interventions can attenuate and even reverse unconscious bias. Testimony for this publication was collected from the Diversity and Inclusion Innovation Forum, jointly sponsored by the Association of American Medical Colleges and The Kirwan Institute for the Study of Race and Ethnicity at The Ohio State University.
"A powerful and extraordinarily important book." --James P. Comer, MD "A marvelous personal journey that illuminates what it means to care for people of all races, religions, and cultures. The story of this man becomes the aspiration of all those who seek to minister not only to the body but also to the soul." --Jerome Groopman, MD, author of How Doctors Think Growing up in Jim Crow-era Tennessee and training and teaching in overwhelmingly white medical institutions, Gus White witnessed firsthand how prejudice works in the world of medicine. While race relations have changed dramatically since then, old ways of thinking die hard. In this blend of memoir and manifesto, Dr. White draws on his experience as a resident at Stanford Medical School, a combat surgeon in Vietnam, and head orthopedic surgeon at one of Harvard's top teaching hospitals to make sense of the unconscious bias that riddles medical care, and to explore how we can do better in a diverse twenty-first-century America. "Gus White is many things--trailblazing physician, gifted surgeon, and freedom fighter. Seeing Patients demonstrates to the world what many of us already knew--that he is also a compelling storyteller. This powerful memoir weaves personal experience and scientific research to reveal how the enduring legacy of social inequality shapes America's medical field. For medical practitioners and patients alike, Dr. White offers both diagnosis and prescription." --Jonathan L. Walton, Plummer Professor of Christian Morals, Harvard University "A tour de force--a compelling story about race, health, and conquering inequality in medical care...Dr. White has a uniquely perceptive lens with which to see and understand unconscious bias in health care...His journey is so absorbing that you will not be able to put this book down." --Charles J. Ogletree, Jr., author of All Deliberate Speed
Offers an innovative plan to eliminate inequalities in American health care and save the lives they endanger Over 84,000 black and brown lives are needlessly lost each year due to health disparities: the unfair, unjust, and avoidable differences between the quality and quantity of health care provided to Americans who are members of racial and ethnic minorities and care provided to whites. Health disparities have remained stubbornly entrenched in the American health care system—and in Just Medicine Dayna Bowen Matthew finds that they principally arise from unconscious racial and ethnic biases held by physicians, institutional providers, and their patients. Implicit bias is the single most important determinant of health and health care disparities. Because we have missed this fact, the money we spend on training providers to become culturally competent, expanding wellness education programs and community health centers, and even expanding access to health insurance will have only a modest effect on reducing health disparities. We will continue to utterly fail in the effort to eradicate health disparities unless we enact strong, evidence-based legal remedies that accurately address implicit and unintentional forms of discrimination, to replace the weak, tepid, and largely irrelevant legal remedies currently available. Our continued failure to fashion an effective response that purges the effects of implicit bias from American health care, Matthew argues, is unjust and morally untenable. In this book, she unites medical, neuroscience, psychology, and sociology research on implicit bias and health disparities with her own expertise in civil rights and constitutional law. In a time when the health of the entire nation is at risk, it is essential to confront the issues keeping the health care system from providing equal treatment to all.
The Open Access version of this book, available at http://www.tandfebooks.com/, has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 3.0 license. There has been an enormous increase in interest in the use of evidence for public policymaking, but the vast majority of work on the subject has failed to engage with the political nature of decision making and how this influences the ways in which evidence will be used (or misused) within political areas. This book provides new insights into the nature of political bias with regards to evidence and critically considers what an ‘improved’ use of evidence would look like from a policymaking perspective. Part I describes the great potential for evidence to help achieve social goals, as well as the challenges raised by the political nature of policymaking. It explores the concern of evidence advocates that political interests drive the misuse or manipulation of evidence, as well as counter-concerns of critical policy scholars about how appeals to ‘evidence-based policy’ can depoliticise political debates. Both concerns reflect forms of bias – the first representing technical bias, whereby evidence use violates principles of scientific best practice, and the second representing issue bias in how appeals to evidence can shift political debates to particular questions or marginalise policy-relevant social concerns. Part II then draws on the fields of policy studies and cognitive psychology to understand the origins and mechanisms of both forms of bias in relation to political interests and values. It illustrates how such biases are not only common, but can be much more predictable once we recognise their origins and manifestations in policy arenas. Finally, Part III discusses ways to move forward for those seeking to improve the use of evidence in public policymaking. It explores what constitutes ‘good evidence for policy’, as well as the ‘good use of evidence’ within policy processes, and considers how to build evidence-advisory institutions that embed key principles of both scientific good practice and democratic representation. Taken as a whole, the approach promoted is termed the ‘good governance of evidence’ – a concept that represents the use of rigorous, systematic and technically valid pieces of evidence within decision-making processes that are representative of, and accountable to, populations served.
Attaining professional success and finding personal happiness in academic medicine is not an easy path, yet both are critical if the future is to be brighter through better science, better clinical care, better training, better responsiveness to communities, and better stewardship and leadership in the health professions. This concise, easy to read title consists of “mini” chapters intended as a resource to assist early- and middle-career physicians, clinicians, and scientists in understanding the unique mission of academic medicine and building creative, effective, and inspiring careers in academic health organizations. Organized in eight sections, the Guide covers such areas as finding your path in academic medicine, getting established at an institution, approaching work with colleagues, writing and reviewing manuscripts, conducting empirical research, developing administrative skills, advancing your academic career, and balancing your professional and personal life. Each chapter includes pointers and valuable career and “best practices” strategies in relation to the topic area. An exciting addition to the professional development literature, Achievement and Fulfillment in Academic Medicine: A Comprehensive Guide is an indispensable resource for anyone seeking to achieve a fulfilling career in academic medicine.
“Accessible and authoritative . . . While we may not have much power to eradicate our own prejudices, we can counteract them. The first step is to turn a hidden bias into a visible one. . . . What if we’re not the magnanimous people we think we are?”—The Washington Post I know my own mind. I am able to assess others in a fair and accurate way. These self-perceptions are challenged by leading psychologists Mahzarin R. Banaji and Anthony G. Greenwald as they explore the hidden biases we all carry from a lifetime of exposure to cultural attitudes about age, gender, race, ethnicity, religion, social class, sexuality, disability status, and nationality. “Blindspot” is the authors’ metaphor for the portion of the mind that houses hidden biases. Writing with simplicity and verve, Banaji and Greenwald question the extent to which our perceptions of social groups—without our awareness or conscious control—shape our likes and dislikes and our judgments about people’s character, abilities, and potential. In Blindspot, the authors reveal hidden biases based on their experience with the Implicit Association Test, a method that has revolutionized the way scientists learn about the human mind and that gives us a glimpse into what lies within the metaphoric blindspot. The title’s “good people” are those of us who strive to align our behavior with our intentions. The aim of Blindspot is to explain the science in plain enough language to help well-intentioned people achieve that alignment. By gaining awareness, we can adapt beliefs and behavior and “outsmart the machine” in our heads so we can be fairer to those around us. Venturing into this book is an invitation to understand our own minds. Brilliant, authoritative, and utterly accessible, Blindspot is a book that will challenge and change readers for years to come. Praise for Blindspot “Conversational . . . easy to read, and best of all, it has the potential, at least, to change the way you think about yourself.”—Leonard Mlodinow, The New York Review of Books “Banaji and Greenwald deserve a major award for writing such a lively and engaging book that conveys an important message: Mental processes that we are not aware of can affect what we think and what we do. Blindspot is one of the most illuminating books ever written on this topic.”—Elizabeth F. Loftus, Ph.D., distinguished professor, University of California, Irvine; past president, Association for Psychological Science; author of Eyewitness Testimony
This authoritative, updated and expanded title serves as the gold-standard resource to assist physicians, clinicians, and scientists in developing effective and satisfactory careers in academic medicine. Covering such critical topics as finding one's path in academic medicine, getting established at an institution, approaching work with colleagues, writing and reviewing manuscripts, conducting empirical research, developing administrative skills, advancing one's academic career, and balancing one's professional and personal life, each chapter includes valuable career pointers and best practice strategies, as well as pithy words to the wise and questions to ask a mentor or colleague. Building on the success of the first edition, the Roberts Academic Medicine Handbook: A Guide to Achievement and Fulfillment for Academic Faculty, 2nd Edition includes new case examples and updated references, as well as many new and timely chapters on topics such as public speaking, working with the media, working with community-based organizations, philanthropy, and finding meaning and a sense of belonging in one's work. The Roberts Academic Medicine Handbook, 2nd Edition is an indispensable resource for all professionals entering or already established in academic medicine who wish to achieve a fulfilling career.
The United States is rapidly transforming into one of the most racially and ethnically diverse nations in the world. Groups commonly referred to as minorities-including Asian Americans, Pacific Islanders, African Americans, Hispanics, American Indians, and Alaska Natives-are the fastest growing segments of the population and emerging as the nation's majority. Despite the rapid growth of racial and ethnic minority groups, their representation among the nation's health professionals has grown only modestly in the past 25 years. This alarming disparity has prompted the recent creation of initiatives to increase diversity in health professions. In the Nation's Compelling Interest considers the benefits of greater racial and ethnic diversity, and identifies institutional and policy-level mechanisms to garner broad support among health professions leaders, community members, and other key stakeholders to implement these strategies. Assessing the potential benefits of greater racial and ethnic diversity among health professionals will improve the access to and quality of healthcare for all Americans.
Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
Get to know the sociopolitical context behind microaggressions Microaggressions are brief, everyday exchanges that send denigrating messages to certain individuals because of their group membership (e.g., race, gender, culture, religion, social class, sexual orientation, etc.). These daily, common manifestations of aggression leave many people feeling vulnerable, targeted, angry, and afraid. How has this become such a pervasive part of our social and political rhetoric, and what is the psychology behind it? In Microaggression Theory, the original research team that created the microaggressions taxonomy, Gina Torino, David Rivera, Christina Capodilupo, Kevin Nadal, and Derald Wing Sue, address these issues head-on in a fascinating work that explores the newest findings of microaggressions in their sociopolitical context. It delves into how the often invisible nature of this phenomenon prevents perpetrators from realizing and confronting their own complicity in creating psychological dilemmas for marginalized groups, and discusses how prejudice, privilege, safe spaces, and cultural appropriation have become themes in our contentious social and political discourse. Details the psychological effects of microaggressions in separate chapters covering clinical impact, trauma, related stress syndromes, and the effect on perpetrators Examines how microaggressions affect education, employment, health care, and the media Explores how social policies and practices can minimize the occurrence and impact of microaggressions in a range of environments Investigates how microaggressions relate to larger social movements If you come across the topic of microaggressions in your day-to-day life, you can keep the conversation going in a productive manner—with research to back it up!