NIH funded research investigates how physicians communicate implicit bias when they interact with Hispanic patients during a clinical visit.

Dr. Jeff Stone,  University Distinguished Professor of Psychology and Psychiatry at the University of Arizona received support from the Mental Research Institute to conduct research and investigate how physicians communicate implicit bias when they interact with Hispanic patients during a clinical visit.

Studies suggest that if negative attitudes and stereotypes are automatically activated when a provider encounters a stigmatized patient, they can affect nonverbal forms of bias like how long the provider spends with the patient, the extent to which the provider dominates the conversation and expresses positive affect (Hagiwara et al., 2020). However, there are significant limitations to their current understanding of how providers' implicit bias impacts provider-patient communication and patients' satisfaction. Their work directly addressed these limitations by investigating verbal and nonverbal communication markers of implicit bias that may mediate the negative reactions that Hispanic patients have to a provider who holds an implicit bias against their group. They analyzed audio recordings of interactions between 114 medical residents and 570 Hispanic patients from two clinical trials.

The MRI support allowed them to hire and train research assistants to code the audio recordings for the residents’ verbal, nonverbal and paraverbal behaviors to…

(1) determine the verbal, nonverbal and paraverbal channels by which residents communicated their implicit bias during the clinical meeting with the Hispanic patients, and

(2) if the independent ratings of the residents verbal, nonverbal and paraverbal behavior mediate the relationship between resident implicit and explicit bias and their Hispanic patient’s satisfaction.

The coders were trained to identify and rate verbal, nonverbal and paraverbal behaviors that may correspond with provider bias (Hagiwara & Dent, 2016). The verbal behaviors included the residents' use of medical jargon and their "investment" in the greeting and closing with the patient. The nonverbal behaviors were perceptions of the residents’ warmth and competence when speaking to the patients, and the coders' personal perceptions of how much they believe the resident liked, respected, and could be trusted to care for the patient.

Once they complete the final coding, Dr Stone and his team will analyze the data and when the data analyses are complete and the results are available, they plan to publish their findings in academic journals, and to write commentaries, book chapters, and technical reports as these opportunities arise. They also plan to share the results through presentations in webinars, at healthcare conferences and meetings, and for faculty, residents, students, and staff in medical education training centers.

Stay tuned for more on this very important topic.