Changes in medical student implicit attitudes following a health equity curricular intervention

Med Teach. 2018 Apr;40(4):372-378. doi: 10.1080/0142159X.2017.1403014. Epub 2017 Nov 24.

Abstract

Purpose: This study assessed the: (1) effect of an LGBTQI + health equity curriculum (eQuality) on implicit attitudes among first (M1) and second year (M2) medical students and (2) utility of dedicated time to explore implicit bias.

Method: Implicit biases were assessed at baseline using implicit association tests (IAT) for all M2s and a random sample of first years (M1A). These students were then debriefed on strategies to mitigate bias. Following eQuality, all M1 and M2s completed post-intervention IATs. The remaining first years (M1B) were then debriefed. Paired sample t-tests assessed differences between pre/post. Independent sample t-tests assessed differences in post-IATs between M1 groups.

Results: IATs indicated preferences for "Straight," "White," and "Thin" at both pre and post. M2s demonstrated statistically significant improvements pre to post for sexuality (p = 0.01) and race (p = 0.03). There were significant differences in post-intervention IAT scores between M1As who received the IAT and debriefing prior to eQuality and M1Bs for sexuality (p = 0.002) and race (p = 0.046). There were no significant changes for weight.

Conclusion: eQuality reduced implicit preference for "Straight" and "White." Differences in M1 post-intervention IAT scores between groups suggest dedicating time to debrief implicit attitudes enhances bias mitigation.

MeSH terms

  • Attitude of Health Personnel*
  • Body Weight
  • Cultural Competency
  • Curriculum
  • Female
  • Health Equity*
  • Humans
  • Male
  • Prejudice / prevention & control*
  • Racial Groups
  • Sexual and Gender Minorities*
  • Students, Medical / psychology*