Implicit Bias: Recognition, Contemplation, and Reflection in Undergraduate Nursing Students

Implicit biases in healthcare can lead to health disparities related to a patient’s race, religion, sexual identity, or mental illness (Astroth et al., 2018). Research has shown that people of minority race and ethnicity have less accurate diagnoses, treatments, and worse clinical outcomes (Chapman, Kaatz, & Carnes, 2013).

Nursing students need to explore student perspectives of implicit bias related to race. Becoming consciously aware of implicit biases and beliefs can help a person choose behaviors that are non-biased, generally attained through education or training (Astroth et al., 2018). Accelerated and traditional nursing students completed the Race Implicit Association Test (IAT). Following this activity, students were given time for contemplation and reflection, including completing standardized reflective writing from their results.

Researchers analyzed and identified common themes from the results of the de-identified reflective writing assignment. Both accelerated and traditional students expressed a common theme of surprise or shock, frustrated, or disheartened as a result of taking the IAT. A second theme was the risk for unintentional changes in patient care due to their implicit bias. Students identified becoming more aware of the need for change while reflecting. Gaining insight into the effects of implicit bias on an individual was identified by several students. Finally, a theme identified the need for an educational learning environment that promotes awareness of implicit bias.

The IAT exercise led students to recognize implicit biases and promoted reflection as a starting point for faculty to lead efforts on equity and inclusivity in healthcare.

Jacquie Hanks
DNP, APRN-NP, CPNP AC/PC
Assistant Professor
Creighton University

Biography

Jacquie Hanks is an assistant professor at Creighton University College of Nursing and a nurse practitioner with the Children’s Hospital and Medical Center (Omaha, NE), hospitalist division. She has worked as a pediatric nurse practitioner in various inpatient setting since 2005 and enjoys teaching pediatrics to graduate and undergraduate nursing students.

Phone: 402-216-7867
Email: jacquiehanks@creighton.edu

Co-Author(s):
Whitney Van De Graaff, MSN, RN, CPN
Dana Koziol, MSN, RN, Assistant Professor
Jacquie Williams, MSN, RN, Assistant Professor
Chelsea Hamzhie, DNP, APRN-NP