Table 1 Aggregated data from 90 studies included in scoping review on post-graduate physician implicit bias curricula
From: Confronting implicit bias toward patients: a scoping review of post-graduate physician curricula
Type of bias addressed | n (%)Total reported: 90 |
 General implicit bias | 41 (46%) |
 Race, ethnicity, and diverse cultures | 21 (23%) |
 LGBQ Patients | 7 (8%) |
 Mental Illness | 6 (7%) |
 Socioeconomic Status | 6 (7%) |
 Other   Including bias related to HIV/AIDS, weight/obesity, gender, substance use disorders, disability, age, gender non-conforming/intersex, and incarcerated populations | 20 (22%) |
Learners' professional position | n (%) Total reported: 82 |
 Residents/fellows | 53 (65%) |
 Attendings | 26 (32%) |
 Physicians: unspecified | 20 (24%) |
 Mixed health professionals   Nurses, social workers, and other members of the health care system | 18 (22%) |
 Medical students | 13 (16%) |
Learners' specialty | n (%) Total reported: 49 |
 Internal medicine   Including general internal medicine, hematology-oncology, endocrinology, and primary care | 17 (35%) |
 Family medicine | 9 (18%) |
 Emergency medicine | 8 (16%) |
 Pediatrics | 8 (16%) |
 Open to multiple specialties | 4 (8%) |
 Psychiatry | 4 (8%) |
 Other   Including OB/GYN, physical medicine and rehabilitation, surgery, and palliative care | 5 (10%) |
Curriculum schedule | n (%) Total reported: 52 |
 Single session | 28 (54%) |
 6 months or more | 11 (21%) |
 1 month to < 6 months | 8 (15%) |
 1 week to < 4 weeks | 4 (8%) |
 2 days to < 7 days | 1 (2%) |
Mode of intervention | n (%) Total reported: 73 |
 Group discussion, exercise, or debrief | 49 (67%) |
 Lecture, didactic, or reading | 41 (56%) |
 Exposure to patient population or community members | 20 (27%) |
 Reflection exercise or writing | 16 (22%) |
 Film | 15 (21%) |
 Role play or simulation | 13 (18%) |
 IAT | 11 (15%) |
 Case-based learning | 10 (14%) |
 Asynchronous online module or e-learning | 5 (7%) |
Was facilitator background/preparation reported? | n (%) 66 implemented curriculum |
 Yes | 33 (50%) |
 No | 33 (50%) |
Methods for measuring outcomes | n (%) Total reported: 58 |
 Pre and post surveys | 36 (62%) |
 Post surveys/course evaluations | 19 (33%) |
 Interviews/focus groups | 8 (14%) |
 Observation of clinical decision-making | 3 (5%) |
 Long-term follow-up surveys | 3 (5%) |
 Other   Includes written reflections and IAT | 3 (5%) |
Outcomes reported | n (%) Total reported: 53 |
 Increased recognition of systemic disparities | 19 (36%) |
 Increased awareness of personal bias | 15 (28%) |
 Significant reduction in measured bias | 15 (28%) |
 Increased comfort in or commitment to addressing bias | 14 (26%) |
 Learners rated intervention highly | 8 (15%) |
 Self-reported reduction in discriminatory behavior | 7 (13%) |
 Increased knowledge of strategies to address bias | 7 (13%) |
 Increased understanding of patients' experiences | 4 (8%) |
 Increased insight into teaching about bias | 3 (6%) |
 Other:   Includes significant increase in measured bias and no significant change in learner behavior | 2 (4%) |
Strengths reported | n (%) Total reported: 35 |
 Group discussion/interactive | 9 (26%) |
 Self-reflection on personal bias | 7 (20%) |
 Demonstrates heterogeneity within stereotyped groups (by breaking down  ingroup/outgroup boundaries or through exposure to stereotyped groups) | 7 (20%) |
 Evidence-based   Research or guidelines formed basis for curriculum | 6 (17%) |
 Perspective-taking/fosters empathy | 5 (14%) |
 Interdisciplinary contributions to curriculum   Involving patients, community, or other fields | 5 (14%) |
 Learning environment conducive to honest discussion | 5 (14%) |
 Cultural humility/cross-cultural care | 5 (14%) |
 Feasibility | 4 (11%) |
 Actionable solutions   Provides tools for providers to use to change clinical practice | 4 (11%) |
 Simulated patient encounter | 3 (9%) |
Weaknesses | n (%) Total reported: 36 |
 Lack of time/resources   Includes scheduling challenges, brief duration of intervention, and lack of faculty/institutional investment | 19 (53%) |
 Learner defensiveness (including distrust of IAT validity) | 7(19%) |
 Lack of facilitators experienced in/comfortable with subject material | 5 (14%) |
 Learners self-selected and may not represent target audience | 4 (11%) |
 Lack of actionable solutions | 4 (11%) |
 Limited scope of course material | 3 (8%) |
 Subject undervalued by learners | 3 (8%) |
 Risk of reinforcing stereotypes | 2 (6%) |
Future directions | n (%) Total reported: 45 |
 Improve outcomes evaluation (including behavioral outcomes and long-term outcomes) | 19 (42%) |
 Extend to more sessions | 7 (16%) |
 Improve facilitator preparation | 4 (9%) |
 Encourage institutional buy-in | 3 (7%) |
 Interdisciplinary and community collaboration   Includes partnerships with community, patients, and other disciplines | 3 (7%) |
 Reevaluate competency model   Examine alternatives to the cultural competency model for teaching implicit bias | 3 (7%) |
More clinical immersion | 3 (7%) |