Effectiveness of a Simulated Interprofessional Education Experiences on Reducing Implicit Racial Bias in Health Care Students

INTRODUCTION: Emerging research indicates that implicit biases impact clinical decision making. The aims of this mixed-methods study were to determine if implicit racial bias exists in physician assistant (PA) and physical therapy (PT) students and, if so, is interprofessional education (IPE) using a clinical simulation (CS) model with standardized patients (SPs) an effective mitigator. METHODS: Parallel cases were developed for a simulated critical-care arena. Cases were identical related to medical and social history, medications, demographics, and hospital courses. The only variable was race. Outcome measures included pre/post Harvard Implicit Test-Racism (HIAT-R), discharge location and rationale for the location, and qualitative data obtained from debriefings. RESULTS: The preintervention HIAT-R indicated that 80% of students in the PA and PT programs scored as having some level of implicit racial bias favoring people White people over Black people. The intervention appeared effective in altering student bias as measured by the postintervention HIAT-R (P < .001), discharge recommendation, and rationale for discharge recommendation. The qualitative analysis from the debriefing of the SPs revealed a greater sensitivity to perceived microaggressions in the Black SPs than White SPs. Student debriefing revealed several themes centering on guilt, lack sensitivity to persons of color, and the need to obtain additional educational content related to implicit bias. The multimodal intervention using the HIAT-R, IPE, CS, and SPs has an effect on implicit bias. DISCUSSION: Implicit racial bias is common in health care students and impacts clinical decision making associated with discharge planning. An intervention using IPE, CS, and SPs appears to mitigate the implicit bias.