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Table 1 Overview of conceptual framework (study constructs and domains)

From: Development and testing of study tools and methods to examine ethnic bias and clinical decision-making among medical students in New Zealand: The Bias and Decision-Making in Medicine (BDMM) study

Racial/ethnic bias

Construct

Domains of interest

Proposed study components

Beliefs [9, 25, 60]

Beliefs and stereotypes about Māori and New Zealand Europeans in general and Māori health in particular

General stereotypes - competence

Explicit: direct questions about Māori and New Zealand Europeans

Vignette: questions about competence of hypothetical patient

Health specific stereotypes - compliance

Implicit: Race and compliant patient IAT

Explicit: direct questions about Māori and New Zealand European patients

Vignette: questions about compliance of hypothetical patient

Beliefs or knowledge about causes of ethnic inequalities in health between Māori and NZ European

Explicit: direct questions about Māori health, health outcomes and healthcare disparities

Evaluations (feelings) [9, 61, 62]

Feelings, judgements and expectations of Māori and NZ Europeans in general and patients in particular

General race/ethnic preference

Implicit: General race preference IAT

Explicit: direct questions about preference for Māori relative to New Zealand European

Warmth towards ethnic groups

Explicit: direct questions about warmth for Māori and New Zealand European ethnic groups

Vignette: question about comfort with hypothetical patient

Discrimination (behaviours) [25, 60]

Behaviour towards and unfair treatment in clinical decision-making between Māori and NZ European

Diagnosis, management and treatment decision-making

Vignette: questions about decision-making for hypothetical patient

Intent/motivation to treat

Vignette: question about intention to treat hypothetical patient

Capacity to benefit

Vignette: question about perceived capacity of hypothetical patient to benefit

  1. Note: Prejudice (attitude) draws on both beliefs (cognitive component) and evaluations (affective component) and is measured under these domains [25]