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

Professor Jeff Stone, of the Department of Psychology at University of Arizona is using an MRI grant to supplement an NIH grant to study how physicians communicate implicit bias when interacting with Hispanic patients during clinical visits.

Earlier studies by Dr. Stone and colleagues as well as other researchers, have found that healthcare providers hold negative stereotypes and prejudices toward various patient groups. Studies suggest that in a clinical context these implicit attitudes and beliefs manifest through verbal, nonverbal and paraverbal communication patterns. If negative attitudes and stereotypes are automatically activated when a provider encounters a patient, they can affect nonverbal forms of bias like how much time the provider spends with the patient, the extent to which the provider dominates the conversation, and expresses positive affect. Importantly, patients may detect the nonverbal bias, which can discourage their engagement if the biases make them feel less confidence and trust in the provider and less desire to see the provider again.  Thus, the implicit activation of bias may negatively impact provider-patient communication, which in turn reduces patient satisfaction and adherence with treatment recommendations.

The MRI grant is allowing Dr. Stone to analyze audio recordings of interactions between 110 medical residents and 700 Hispanic patients. The research questions are: 1. Does implicit bias predict physician verbal, nonverbal and paraverbal communication patterns? And 2. Do these communication behaviors mediate the relationship between physician implicit bias and patient satisfaction with the clinical care they receive?

This research will provide evidence of how these processes operate in a larger sample of providers, and especially with Hispanic patients who are the fastest growing group of ethnic minorities in the US. Additionally, the results of this research will inform new training and education in medicine.