It’s implicit

I recently found myself involved in an interesting (and insightful) conversation with one of my residents and one of my practice partners about sexism and racism.  The short version of how we got there is that the resident noticed that a discussion of two trainees with identical professional development issues but of different (race/ethnicity/ I’m not going to tell you distinguishing characteristic so we’ll go with “blue” and “orange”) appeared to be VERY different in content and tone, particularly from one person.  Our discussion quickly moved from the particulars of this situation to the bigger picture- bias and prejudice, and the impact that they have on us and our trainees.  Specifically, our discussion moved to our perceptions that most prejudice that we experience, particularly as women, is no longer overt.  More importantly, most of the people we tend to identify as the biggest offenders don’t even realize their own bias.  In other words, the faculty member described apparently has no knowledge of that tendency to describe blue people and orange people in a dramatically different manner.

For those not familiar with this concept, it’s described widely in the social psychology literature as “implicit bias.”  Project Implicit, originally based at Harvard and now with an international infrastructure, is the most robust general research for information on implicit bias.  Housed within their website is the Implicit Association Test (IAT), which now addresses myriad potential angles of bias.  I first took a version of the IAT probably 8 years ago and I’ll admit- for someone who tends to think of themselves as a modern, liberal, open-minded, generally unprejudiced person it was eye-opening.  In spite of being a woman in a very male-dominated field, I found that I still had some biases about women and science (is THAT why I was a liberal arts major?!?), as well as women and command leadership.  Who knew?

What we know is that implicit bias is real.  We also know that it has a very real basis in both family and social experience imprinting; our biases are formed at a very early age. We know that those biases have a tremendous impact, and can certainly have an impact on women in academic medicine for a variety of reasons.  We know that even though those biases are imprinted early that they can be “managed”; simply being aware of our biases makes us more likely to be able to limit their influence on our behaviors and actions.  Many institutions now have in place implicit bias training as part of faculty recruitment as a starting place to address this issue.  I would be curious to hear from colleagues (yes, dear reader, that’s you) what, if anything, your institution is doing on this front.  And, of course, I would encourage you to take the IAT.  It’s eye-opening about those biases you might have about blue people versus orange people.