Discussion Two | Power of Perception and Implicit Bias
Purpose
Examine how implicit bias and stereotypes influence our perception of others and reflect on how to become more aware of those biases. It is through awareness that we can make a change and become more interculturally flexible.
Completing this assignment will provide you an opportunity to:
- Reflect on our own biases and situations where we were judged or judged others through the use of a single story.
- Become more aware of implicit bias so we are able to thoughtfully assess the situation and reduce the use of stereotypes.
- Reflect on our knowledge of, and assumptions of, health disparities and how they impact the lives of us, our co-workers, and the patients we serve.
Tasks
Be sure to complete all parts of the assignment to earn full credit. Your initial post is due Sunday and your 2 responses to classmates are due Tuesday.
- Include concepts from our reading or lectures in boldfont and include page or lecture references i.e. (p. 9).
(1) Complete the following four Georgetown Bias Modules (will take approximately 2-3 hours). After completing them, write a 10-12 sentence reflection on what stood out to you from these modules in regard to bias in the health care setting and in relation to the disparities that exist in healthcare.
. Module Two: The Impact of Bias
. Module Three: Bias and Well-Meaning People
. Module Four: Addressing Bias
(2) Next, watch the following TedTalk by Chimamanda Ngozi-Adichie, The Danger of a Single Story, and answer the questions below the video in an 8-12 sentence post:
. We all have stereotypes, biases, and prejudices. Think about yours and how they impact your intercultural communication effectiveness. How can awareness of these biases, or single stories, begin to help you change them?
. Describe an incident where your ethnocentrism or single-story attitude caused an intercultural misunderstanding in the healthcare setting or in another setting in your life. What did you learn from that experience? How did it help you grow in regard to open-mindedness and empathy for others?
(3) Respond to at least 2 classmates in regard to their responses.
- Responses should each be at least 75 words in length and add to the conversation – reflect on their experience, add your own examples, ask questions, respectfully debate what is said, etc.
Write a 10-12 sentence reflection on what stood out to you from these modules in regard to bias in the healthcare setting and in relation to the disparities that exist in healthcare.
The modules were a reminder of the discrimination (module 1) that continues in healthcare among providers towards patient care. There are biases around us, but we need to be more aware of how to make changes to provide the best care possible. I know that culture determines the care a patient will receive because as mentioned by Dr. Elena Rios (Module 2: The Impact of Bias), biases interfere with communication between Latino patients and their healthcare professionals. This is critical as the patient may have been reluctant to go see a provider because of cultural norms. Then adding the stress of being mistreated because they are not fluent in English is detrimental to their health. In order to provide the utmost care it is important for healthcare providers to unify and work on being aware of their own biases. Unfortunately, it takes time to learn new habits, and as mentioned (Module 4: Addressing Bias) “there is evidence that many physicians do not fully accept that health and healthcare disparities exist”. By not accepting the issue at hand it is hard to promote change. According to the module Defining Bias, unconscious or implicit bias (Module 2), results in an automatic and unconscious reaction and/or behavior. Therefore the learned/ expected behavior resurfaces without a person being aware. We are constantly surrounded by many different cultures which gives us the opportunity to learn and grow, but also to limit our knowledge and create stereotypes about a culture.
We all have stereotypes, biases, and prejudices. Think about yours and how they impact your intercultural communication effectiveness. How can awareness of these biases, or single stories, begin to help you change them?
My intercultural communication effectiveness highly relies on being aware of my biases. Understanding that no single group is the same, is a start to change biases. In order to change my biases I need to continue to learn about different cultures and social standards. I like that our module addressed that there is conscious access to explicit biases and that we are able to monitor and control them to mitigate their impact on their behavior. This reminds me that to change my biases I need to be aware of my behavior as well. Having an open mind should help against my biases because it gives me the opportunity to learn more about that person before making my own conclusion. Also, being cognizant of my stress helps to take time to process the information being shared and change my biases. The Bias and Well-Meaning People module states that “Another dynamic in how can well-meaning people have bias comes from our understanding of the role of stress, cognitive load in particular, and the activation of stereotypes”. Working in an environment with stressful situations I need to take a step back and not fall into my own stereotypes, which is easier than learning a new perspective. To change, work has to be done, learning how to ask questions, by that it means choosing words wisely during communication. Taking the time to listen to what is being. I have learned to use the words “always” “never”, and “all” sparingly when communicating because it’s a big assumption to encompass a group of people under the same umbrella.
On (Moduled 4 Addressing Bias) has six interventions acknowledge, assume individual responsibility, engage in self-reflection, combat “hard wiring”, perform self-monitoring, and incorporate cultural and linguistic competence in your practice. By applying these steps not only in out work environment but also in our daily lives we can begin change.
Describe an incident where your ethnocentrism or single-story attitude caused an intercultural misunderstanding in the healthcare setting or in another setting in your life. What did you learn from that experience? How did it help you grow in regard to open-mindedness and empathy for others?
In my culture is it very common for grandparents to be taken care of by families. I had an incident where I had an 85-year-old patient being discharged home on antibiotics. Her daughter was involved in her care. She would visit daily and know her mother’s medical diagnosis. I thought my patient was living with their family instead of living alone. At the time of giving discharge instructions, I mentioned how nice it was for her to be with family to help with ADLs. I assumed she lived with her daughter because that is common for me. From this experience, I learned to be cautious and ask questions instead of assuming. It helped me to be open-minded that some older people like living alone. Just because the elderly lives alone it doesn’t mean that they don’t have a relationship with their families. Also, it gave me an understanding of how other people’s living situations.
Meeral
(1) Biases in healthcare perpetuate the disparities that exist in healthcare. As described in the module, biases can be conscious or unconscious (Perception PPT, slide 4), or implicit, yet their impact on the healthcare of those that they affect are profound. It was surprising that it was noted that “less than a third of physicians surveyed believed that the healthcare systems sometimes treat people unfairly because of their race or ethnicity” (Module 2).
To me, it seems pretty obvious that biases and stereotypes (Perception PPT, slide 4) can and do negatively impact the quality of care a person receives. Early on in nursing clinicals, it was apparent that biases regarding race, language, gender, education, living condition, and substance use affected the communication and type of care given by the provider. It was not surprising to me to read how “Latinos responded that people were treated unfairly “very often” and “somewhat often” based on how well a person speaks English” (Module 2). As a nursing student, I had a patient that did not speak English and required education on pain and diabetes management, yet the nurse found it cumbersome to use the interpreter services that was on their phone provided by the hospital.
There was this notion that English should have been learned by now, given the patient’s age and length of stay in the US and consequently this patient had unmet needs. I also had a homeless patient that was admitted for substance use and ignored for several hours due to the perception (Perception PPT, slide 2) that they were being dramatic in their complaints.
A delayed code stroke revealed that the patient had a real medical issue evolving which was dismissed. In nursing courses, I learned about several studies that show how women suffer from biases and are undertreated for pain, and in obstetrics have higher mortality rates than their white counterparts. These are all examples of how biases contribute to poor health outcomes, inequality, and disparity. Granted, everyone has biases, but as the modules present, awareness and active confrontation is necessary to address the unequal care that can result from unconscious biases.
(2) Awareness of biases is a necessary catalyst for change. It is the first step to helping to change them as we cannot begin to change something that we refuse to recognize. Recognizing biases and the automatic, unconscious thought patterns that may be perpetuating health disparities is important to understand as these influence behavior and care.
As a nursing student, my preceptor and I had a patient that was homeless and admitted for substance overdose. When this patient started complaining of pain, the single-story attitude (TedTalk) for this patient was just that this was another homeless patient seeking drugs. In actuality this patient was experiencing a real medical issue and their care was delayed due to provider bias.
It was not even considered that this patient is someone’s child or sibling, what their background is, or why this patient is homeless and in this particular situation. This experience taught me that biases can profoundly impact the quality of care a patient receives. It felt inappropriate and discriminatory (Perception PPT, slide 5) how dismissive the provider was of this patient’s complaints.
This experience showed me how important it is to challenge the automatic stereotypes or biases (Perception PPT, slide 4) that can come up with patients. Had there been more open-mindedness and empathy, as I’m sure there would have been were it a different type of patient, the basic standard of care would have been provided.