Mindfulness practice: A promising approach to reducing the effects of clinician implicit bias on patients
Abstract
Like the population at large, health care providers hold implicit racial and ethnic biases that may contribute to health care disparities. Little progress has been made in identifying and implementing effective strategies to address these normal but potentially harmful unconscious cognitive processes. We propose that meditation training designed to increase healthcare providers' mindfulness skills is a promising and potentially sustainable way to address this problem. Emerging evidence suggests that mindfulness practice can reduce the provider contribution to healthcare disparities through several mechanisms including: reducing the likelihood that implicit biases will be activated in the mind, increasing providers' awareness of and ability to control responses to implicit biases once activated, increasing self-compassion and compassion toward patients, and reducing internal sources of cognitive load (e.g., stress, burnout, and compassion fatigue). Mindfulness training may also have advantages over current approaches to addressing implicit bias because it focuses on the development of skills through practice, promotes a nonjudgmental approach, can circumvent resistance some providers feel when directly confronted with evidence of racism, and constitutes a holistic approach to promoting providers' well-being. We close with suggestions for how a mindfulness approach can be practically implemented and identify potential challenges and research gaps to be addressed.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Mindfulness may improve patient care and patient safety.
“Several theory papers and a recent review have been published discussing the potential for mindfulness and mindfulness-based interventions to improve HCP burnout and work, including findings that mindfulness may improve patient care and patient safety.22–27”
From Being Mindful: A Long-term Investigation of an Interdisciplinary Course in Mindfulness (2019) · cites this paper as [22]
Cites
Mindfulness: A proposed operational definition.
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., Segal, Z. V., Abbey, S., Speca, M., Velting, D., et al. (2004) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.bph077 · Cited by 7,234 · see citing works
Understanding and using the Implicit Association Test: III. Meta-analysis of predictive validity.
Greenwald, A. G., Poehlman, T. A., Uhlmann, E. L., & Banaji, M. R. (2009) · Journal of Personality and Social Psychology · doi:10.1037/a0015575 · Cited by 3,257 · see citing works
The Neuroscience of Mindfulness Meditation
Tang, Y.-Y., Hölzel, B. K., & Posner, M. I. (2015) · Nature reviews. Neuroscience · doi:10.1038/nrn3916 · Cited by 2,889 · see citing works
Hall, W. J., Chapman, M. V., Lee, K. M., Merino, Y. M., Thomas, T. W., Payne, B. K., Eng, E., Day, S. H., & Coyne-Beasley, T. (2015) · American Journal of Public Health · doi:10.2105/ajph.2015.302903 · Cited by 2,176 · see citing works
Anderson, J. R. (1976) · Psychology Press eBooks · doi:10.4324/9780203780954 · Cited by 2,017 · see citing works
Carmody, J., & Baer, R. A. (2008) · Journal of Behavioral Medicine · doi:10.1007/s10865-007-9130-7 · Cited by 1,823 · see citing works
Galinsky, A. D., & Moskowitz, G. B. (2000) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.78.4.708 · Cited by 1,725 · see citing works
Creswell, J. D. (2017) · Annual Review of Psychology · doi:10.1146/annurev-psych-042716-051139 · Cited by 1,702 · see citing works
Krasner, M. S. (2009) · JAMA · doi:10.1001/jama.2009.1384 · Cited by 1,650 · see citing works
Effects of mindfulness-based stress reduction on medical and premedical students
Shapiro, S. L., Schwartz, G. E., & Bonner, G. (1998) · Journal of Behavioral Medicine · doi:10.1023/a:1018700829825 · Cited by 1,493 · see citing works
Mindfulness-based stress reduction for health care professionals: results from a randomized trial
Shapiro, S. L., Astin, J. A., Bishop, S. R., & Cordova, M. (2005) · International Journal of Stress Management · doi:10.1037/1072-5245.12.2.164 · Cited by 1,323 · see citing works
Long-term reduction in implicit race bias: A prejudice habit-breaking intervention
Devine, P. G., Forscher, P. S., Austin, A. J., & Cox, W. T. L. (2012) · Journal of Experimental Social Psychology · doi:10.1016/j.jesp.2012.06.003 · Cited by 1,259 · see citing works
Trends in the Use of Complementary Health Approaches Among Adults in the United States
Jackson, C. (2015) · Holistic Nursing Practice · doi:10.1097/hnp.0000000000000088 · Cited by 1,174 · see citing works
Performance on Indirect Measures of Race Evaluation Predicts Amygdala Activation
Phelps, E. A., O'Connor, K. J., Cunningham, W. A., Funayama, E. S., Gatenby, J. C., Gore, J. C., & Banaji, M. R. (2000) · Journal of Cognitive Neuroscience · doi:10.1162/089892900562552 · Cited by 1,001 · see citing works
Loving-kindness meditation increases social connectedness.
Hutcherson, C. A., Seppala, E. M., & Gross, J. J. (2008) · Emotion · doi:10.1037/a0013237 · Cited by 758 · see citing works
Dovidio, J. F., & Gaertner, S. L. (2004) · Advances in Experimental Social Psychology · doi:10.1016/s0065-2601(04)36001-6 · Cited by 650 · see citing works
Compassion training alters altruism and neural responses to suffering.
Weng, H. Y., Fox, A. S., Shackman, A. J., Stodola, D. E., Caldwell, J. Z. K., Olson, M. C., Rogers, G. M., & Davidson, R. J. (2013) · Psychological Science · doi:10.1177/0956797612469537 · Cited by 602 · see citing works
Prejudice with and without compunction
Devine, P. G., Monteith, M. J., Zuwerink, J. R., & Elliot, A. J. (1991) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.60.6.817 · Cited by 572 · see citing works
The neuroscience of prejudice and stereotyping
Amodio, D. M. (2014) · Nature reviews. Neuroscience · doi:10.1038/nrn3800 · Cited by 569 · see citing works
Teper, R., Segal, Z. V., & Inzlicht, M. (2013) · Current Directions in Psychological Science · doi:10.1177/0963721413495869 · Cited by 554 · see citing works
Reducing Racial Bias Among Health Care Providers: Lessons from Social-Cognitive Psychology
Burgess, D., van Ryn, M., Dovidio, J., & Saha, S. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-007-0160-1 · Cited by 495 · see citing works
Self-citationPerspective taking combats automatic expressions of racial bias.
Todd, A. R., Bodenhausen, G. V., Richeson, J. A., & Galinsky, A. D. (2011) · Journal of Personality and Social Psychology · doi:10.1037/a0022308 · Cited by 462 · see citing works
Meditation increases compassionate responses to suffering.
Condon, P., Desbordes, G., Miller, W. B., & DeSteno, D. (2013) · Psychological Science · doi:10.1177/0956797613485603 · Cited by 451 · see citing works
A brief mindfulness-based stress reduction intervention for nurses and nurse aides
Mackenzie, C. S., Poulin, P. A., & Seidman-Carlson, R. (2006) · Applied Nursing Research · doi:10.1016/j.apnr.2005.08.002 · Cited by 448 · see citing works
Fortney, L., Luchterhand, C., Zakletskaia, L., Zgierska, A., & Rakel, D. (2013) · The Annals of Family Medicine · doi:10.1370/afm.1511 · Cited by 431 · see citing works
Health Care Providers' Implicit and Explicit Attitudes Toward Lesbian Women and Gay Men.
Sabin, J., Riskind, R. G., & Nosek, B. A. (2015) · American Journal of Public Health · doi:10.2105/ajph.2015.302631 · Cited by 400 · see citing works
Zestcott, C. A., Blair, I. V., & Stone, J. (2016) · Group Processes & Intergroup Relations · doi:10.1177/1368430216642029 · Cited by 381 · see citing works
Dovidio, J. F., & Fiske, S. T. (2012) · American Journal of Public Health · doi:10.2105/ajph.2011.300601 · Cited by 352 · see citing works
Jazaieri, H., McGonigal, K. M., Jinpa, T., Doty, J. R., Gross, J. J., & Goldin, P. R. (2013) · Motivation and Emotion · doi:10.1007/s11031-013-9368-z · Cited by 343 · see citing works
Todd, A. R., & Galinsky, A. D. (2014) · Social and Personality Psychology Compass · doi:10.1111/spc3.12116 · Cited by 335 · see citing works
(2017) · Annual Review of Psychology · doi:10.1146/psych.716 · Cited by 331 · see citing works
Interventions to Reduce the Consequences of Stress in Physicians: A Review and Meta-Analysis
Regehr, C., Glancy, D., Pitts, A., & LeBlanc, V. R. (2014) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0000000000000130 · Cited by 310 · see citing works
The impact of racism on clinician cognition, behavior, and clinical decision making
van Ryn, M., Burgess, D. J., Dovidio, J. F., Phelan, S. M., Saha, S., Malat, J., Griffin, J. M., Fu, S. S., & Perry, S. (2011) · Du Bois Review: Social Science Research on Race · doi:10.1017/s1742058x11000191 · Cited by 303 · see citing works
Self-citationMindfulness and compassion: an examination of mechanism and scalability
Lim, D., Condon, P., & DeSteno, D. (2015) · PLOS ONE · doi:10.1371/journal.pone.0118221 · Cited by 291 · see citing works
Mindfulness and De-Automatization
Kang, Y., Gruber, J., & Gray, J. R. (2013) · Emotion Review · doi:10.1177/1754073912451629 · Cited by 286 · see citing works
Lueke, A., & Gibson, B. (2015) · Social Psychological and Personality Science · doi:10.1177/1948550614559651 · Cited by 265 · see citing works
The Impact of a Program in Mindful Communication on Primary Care Physicians
Beckman, H., Wendland, M., Mooney, C. J., Krasner, M. S., Quill, T. E., Suchman, A. L., & Epstein, R. M. (2012) · Academic Medicine · doi:10.1097/acm.0b013e318253d3b2 · Cited by 261 · see citing works
Boellinghaus, I., Jones, F. W., & Hutton, J. (2014) · Mindfulness · doi:10.1007/s12671-012-0158-6 · Cited by 250 · see citing works
Non‐conscious bias in medical decision making: what can be done to reduce it?
Stone, J., & Moskowitz, G. B. (2011) · Medical Education · doi:10.1111/j.1365-2923.2011.04026.x · Cited by 247 · see citing works
A Systematic Review of the Extent and Measurement of Healthcare Provider Racism
Paradies, Y., Truong, M., & Priest, N. (2014) · Journal of general internal medicine · doi:10.1007/s11606-013-2583-1 · Cited by 234 · see citing works
Lamothe, M., Rondeau, É., Malboeuf-Hurtubise, C., Duval, M., & Sultan, S. (2016) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2015.11.001 · Cited by 228 · cited 7× · see citing works
“I f interventions prove successful, mindfulness may best be introduced during clinical training, where it can become part of the informal and formal curricula Research on mindfulness is rapidly proliferating, and there is growing enthusiasm among the general public [74] and among those seeking to reduce worrisome leve…”
BackgroundInfluentialA Multicenter Study of Physician Mindfulness and Health Care Quality
Beach, M. C., ROTER, D. L., Korthuis, P. T., Epstein, R. M., Sharp, V., Ratanawongsa, N., Cohn, J. A., Eggly, S. S., Sankar, A., Moore, R. D., et al. (2013) · The Annals of Family Medicine · doi:10.1370/afm.1507 · Cited by 225 · see citing works
Self-citationAsuero, A. M., Queraltó, J. M., Pujol-Ribera, E., Berenguera, A., Rodriguez-Blanco, T., & Epstein, R. M. (2014) · Journal of Continuing Education in the Health Professions · doi:10.1002/chp.21211 · Cited by 223 · see citing works
Framing Inequity Safely: Whites' Motivated Perceptions of Racial Privilege
Lowery, B. S., Knowles, E. D., & Unzueta, M. M. (2007) · Personality and Social Psychology Bulletin · doi:10.1177/0146167207303016 · Cited by 223 · see citing works
The nondiscriminating heart: Lovingkindness meditation training decreases implicit intergroup bias.
Kang, Y., Gray, J. R., & Dovidio, J. F. (2014) · Journal of Experimental Psychology: General · doi:10.1037/a0034150 · Cited by 219 · see citing works
Burgess, D. J. (2010) · Medical Decision Making · doi:10.1177/0272989x09341751 · Cited by 213 · see citing works
Self-citationThe Impact of Cognitive Stressors in the Emergency Department on Physician Implicit Racial Bias
Johnson, T. J., Hickey, R. W., Switzer, G. E., Miller, E. P., Winger, D. G., Nguyen, M. B., Saladino, R. A., & Hausmann, L. R. M. (2016) · Academic Emergency Medicine · doi:10.1111/acem.12901 · Cited by 205 · see citing works
An on-the-job mindfulness-based intervention for pediatric ICU nurses: a pilot
Gauthier, T., Meyer, R. M. L., Grefe, D., & Gold, J. I. (2015) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2014.10.005 · Cited by 177 · see citing works
Reducing Racial Health Care Disparities
Penner, L. A., Blair, I. V., Albrecht, T. L., & Dovidio, J. F. (2014) · Policy Insights from the Behavioral and Brain Sciences · doi:10.1177/2372732214548430 · Cited by 153 · see citing works
Duchemin, A.-M., Steinberg, B. A., Marks, D. R., Vanover, K., & Klatt, M. (2015) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0000000000000371 · Cited by 146 · see citing works
Perspective-Taking Increases Willingness to Engage in Intergroup Contact
Wang, C. S., Tai, K., Ku, G., & Galinsky, A. D. (2014) · PLoS ONE · doi:10.1371/journal.pone.0085681 · Cited by 131 · see citing works
Todd, A. R., Galinsky, A. D., & Bodenhausen, G. V. (2012) · Social Cognition · doi:10.1521/soco.2012.30.1.94 · Cited by 123 · see citing works
Brief Report: Thin Slices of Racial Bias
Richeson, J. A., & Shelton, J. N. (2005) · Journal of Nonverbal Behavior · doi:10.1007/s10919-004-0890-2 · Cited by 122 · see citing works
Gonzalez, C. M., Kim, M. Y., & Marantz, P. (2014) · Teaching and learning in medicine · doi:10.1080/10401334.2013.857341 · Cited by 120 · see citing works
Teal, C. R., Shada, R. E., Gill, A. C., Thompson, B. M., Frugé, E., Villarreal, G. B., & Haidet, P. (2010) · Journal of General Internal Medicine · doi:10.1007/s11606-009-1243-y · Cited by 114 · see citing works
Separate and Unequal: Clinics Where Minority and Nonminority Patients Receive Primary Care
Varkey, A. B. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2008.559 · Cited by 112 · see citing works
Brief mindfulness meditation reduces discrimination.
Lueke, A. K., & Gibson, B. D. (2016) · Psychology of Consciousness Theory Research and Practice · doi:10.1037/cns0000081 · Cited by 108 · see citing works
Irving, J. A., Park-Saltzman, J., Fitzpatrick, M., Dobkin, P. L., Chen, A., & Hutchinson, T. (2014) · Mindfulness · doi:10.1007/s12671-012-0147-9 · Cited by 103 · see citing works
Mimicry reduces racial prejudice
Inzlicht, M., Gutsell, J. N., & Legault, L. (2011) · Journal of Experimental Social Psychology · doi:10.1016/j.jesp.2011.06.007 · Cited by 101 · see citing works
The Impact of Mindfulness Meditation in Promoting a Culture of Safety on an Acute Psychiatric Unit
Brady, S., O'Connor, N., Burgermeister, D., & Hanson, P. (2012) · Perspectives in Psychiatric Care · doi:10.1111/j.1744-6163.2011.00315.x · Cited by 97 · see citing works
Instilling new habits: addressing implicit bias in healthcare professionals
Byrne, A., & Tanesini, A. (2015) · Advances in Health Sciences Education · doi:10.1007/s10459-015-9600-6 · Cited by 89 · see citing works
Genetic counselors’ implicit racial attitudes and their relationship to communication.
Schaa, K. L., ROTER, D. L., Biesecker, B. B., Cooper, L. A., & Erby, L. H. (2015) · Health Psychology · doi:10.1037/hea0000155 · Cited by 83 · see citing works
Brief loving-kindness meditation reduces racial bias, mediated by positive other-regarding emotions
Stell, A. J., & Farsides, T. (2015) · Motivation and Emotion · doi:10.1007/s11031-015-9514-x · Cited by 78 · see citing works
“Fair Play”: A Videogame Designed to Address Implicit Race Bias Through Active Perspective Taking
Gutierrez, B., Kaatz, A., Chu, S., Ramirez, D., Samson-Samuel, C., & Carnes, M. (2014) · Games for Health Journal · doi:10.1089/g4h.2013.0071 · Cited by 74 · see citing works
Can Patient-Centered Attitudes Reduce Racial and Ethnic Disparities in Care?
Beach, M. C., Rosner, M., Cooper, L. A., Duggan, P. S., & Shatzer, J. H. (2007) · Academic Medicine · doi:10.1097/acm.0b013e31802d94b2 · Cited by 73 · see citing works
Self-citationIntensive meditation training influences emotional responses to suffering
Rosenberg, E. L., Zanesco, A. P., King, B. G., Aichele, S. R., Jacobs, T. L., Bridwell, D. A., MacLean, K. A., Shaver, P. R., Ferrer, E., Sahdra, B. K., et al. (2015) · Emotion · doi:10.1037/emo0000080 · Cited by 70 · see citing works
On the Control Over Stereotype Activation and Stereotype Inhibition
Moskowitz, G. B. (2010) · Social and Personality Psychology Compass · doi:10.1111/j.1751-9004.2009.00251.x · Cited by 69 · see citing works
Enhancing Clinicians' Well-Being and Patient-Centered Care Through Mindfulness
Dobkin, P. L., Bernardi, N. F., & Bagnis, C. I. (2016) · Journal of Continuing Education in the Health Professions · doi:10.1097/ceh.0000000000000021 · Cited by 66 · see citing works
Hernandez, R. A., Haidet, P., Gill, A. C., & Teal, C. R. (2012) · Medical Teacher · doi:10.3109/0142159x.2012.733453 · Cited by 60 · see citing works
The neural mediators of kindness-based meditation: a theoretical model
Mascaro, J. S., Darcher, A., Negi, L. T., & Raison, C. L. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00109 · Cited by 58 · see citing works
Evidence That a Brief Meditation Exercise Can Reduce Prejudice Toward Homeless People
Parks, S., Birtel, M. D., & Crisp, R. J. (2014) · Social Psychology · doi:10.1027/1864-9335/a000212 · Cited by 56 · see citing works
Malat, J., Clark-Hitt, R., Burgess, D. J., Friedemann‐Sánchez, G., & van Ryn, M. (2010) · Ethnic and Racial Studies · doi:10.1080/01419870903501970 · Cited by 39 · see citing works
Self-citationGroup Online Mindfulness Training
Kemper, K. J., & Yun, J. (2014) · Journal of Evidence-Based Complementary & Alternative Medicine · doi:10.1177/2156587214553306 · Cited by 34 · see citing works
Mindful Medical Practitioners: A Guide for Clinicians and Educators
Dobkin, P. L., & Hassed, C. S. (2016) · Thammasat University Digital Collections · doi:10.1007/978-3-319-31066-4 · Cited by 14 · see citing works
Flagged first, then by citations
2 of the 76 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Maina, I., Belton, T. D., Ginzberg, S. P., Singh, A., & Johnson, T. J. (2017) · Social Science & Medicine (1967) · doi:10.1016/j.socscimed.2017.05.009 · Cited by 716 · see citing works
Altman, M. R., Oseguera, T. W., McLemore, M. R., Kantrowitz‐Gordon, I., Franck, L. S., & Lyndon, A. (2019) · Social Science & Medicine · doi:10.1016/j.socscimed.2019.112491 · Cited by 279 · see citing works
Scheepers, R. A., Emke, H., Epstein, R. M., & Lombarts, K. M. J. M. H. (2019) · Medical Education · doi:10.1111/medu.14020 · Cited by 178 · see citing works
Reduction of Peripartum Racial and Ethnic Disparities
Howell, E. A., Brown, H. L., Brumley, J., Bryant, A., Caughey, A. B., Cornell, A., Grant, J., Gregory, K. D., Gullo, S. M., Kozhimannil, K. B., et al. (2018) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000002475 · Cited by 167 · see citing works
CE: Addressing Implicit Bias in Nursing: A Review
Narayan, M. C. (2019) · AJN American Journal of Nursing · doi:10.1097/01.naj.0000569340.27659.5a · Cited by 106 · see citing works
Howell, E. A., Brown, H. L., Brumley, J., Bryant, A., Caughey, A. B., Cornell, A., Grant, J. H., Gregory, K. D., Gullo, S. M., Kozhimannil, K. B., et al. (2018) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1016/j.jogn.2018.03.004 · Cited by 100 · see citing works
Amutio, A., García‐Campayo, J., Delgado, L., Hermosilla, D., & Martínez-Taboada, C. (2017) · Journal of Clinical Medicine · doi:10.3390/jcm6030033 · Cited by 90 · see citing works
Kanter, J. W., Rosen, D. C., Manbeck, K. E., Branstetter, H. M. L., Kuczynski, A. M., Corey, M. D., Maitland, D. W. M., & Williams, M. T. (2020) · BMC Medical Education · doi:10.1186/s12909-020-02004-9 · Cited by 88 · see citing works
Harrison-Bernard, L., Augustus-Wallace, A. C., Souza-Smith, F. M., Tsien, F., Casey, G. P., & Gunaldo, T. (2020) · Advances in Physiology Education · doi:10.1152/advan.00164.2019 · Cited by 68 · see citing works
Ackerman-Barger, K. W., & Jacobs, N. (2020) · Academic Medicine · doi:10.1097/acm.0000000000003692 · Cited by 79 · see citing works
Fisher, E. S. (2019) · School Psychology International · doi:10.1177/0143034319893097 · Cited by 77 · see citing works
Vora, S., Dahlen, B., Adler, M., Kessler, D. O., Jones, V. F., Kimble, S., & Calhoun, A. W. (2021) · Simulation in Healthcare The Journal of the Society for Simulation in Healthcare · doi:10.1097/sih.0000000000000591 · Cited by 71 · see citing works
Diversity Is Not Enough: Advancing a Framework for Antiracism in Medical Education
Solomon, S. R., Atalay, A. J., & Osman, N. Y. (2021) · Academic Medicine · doi:10.1097/acm.0000000000004251 · Cited by 69 · see citing works
Ricks, T. N., Abbyad, C. W., & Polinard, E. L. (2021) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-021-01137-x · Cited by 67 · see citing works
Cultural conceptions of Women's labor pain and labor pain management: A mixed-method analysis
Mathur, V. A., Morris, T., & McNamara, K. (2020) · Social Science & Medicine · doi:10.1016/j.socscimed.2020.113240 · Cited by 66 · see citing works
Bhushan, D., Kotz, K. J., McCall, J., Wirtz, S., Gilgoff, R., Dube, S. R., Powers, C., Olson-Morgan, J., Galeste, M., Patterson, K., et al. (2020) · doi:10.48019/peam8812 · Cited by 71 · see citing works
Addressing Microaggressions in Academic Health: A Workshop for Inclusive Excellence
Ackerman-Barger, K. W., Jacobs, N., Orozco, R., & London, M. R. (2021) · MedEdPORTAL · doi:10.15766/mep_2374-8265.11103 · Cited by 63 · see citing works
Braun, S. E., Kinser, P. A., & Rybarczyk, B. (2019) · Translational Behavioral Medicine · doi:10.1093/tbm/iby059 · Cited by 56 · see citing works
Fiscella, K. A., Epstein, R. M., Griggs, J. J., Marshall, M., & Shields, C. G. (2021) · PLoS ONE · doi:10.1371/journal.pone.0257794 · Cited by 56 · see citing works
First Nations members’ emergency department experiences in Alberta: A qualitative study.
McLane, P., Bill, L., & Barnabe, C. (2021) · Canadian Journal of Emergency Medicine · doi:10.1007/s43678-020-00009-3 · Cited by 55 · see citing works
Strategies to Mitigate Clinician Implicit Bias Against Sexual and Gender Minority Patients.
McDowell, M., Goldhammer, H., Potter, J., & Keuroghlian, A. (2020) · Psychosomatics · doi:10.1016/j.psym.2020.04.021 · Cited by 34 · see citing works
Persaud, S. (2019) · Nursing Administration Quarterly · doi:10.1097/naq.0000000000000348 · Cited by 53 · see citing works
Davis, D. L. F., Tran-Taylor, D., Imbert, E., Wong, J. O., & Chou, C. L. (2021) · Journal of Medical Education and Curricular Development · doi:10.1177/23821205211000352 · Cited by 48 · see citing works
Ni, Y., Ma, L., & Li, J. (2020) · Journal of Nursing Scholarship · doi:10.1111/jnu.12560 · Cited by 46 · see citing works
General Medical Clinicians’ Attitudes Toward People with Serious Mental Illness: A Scoping Review
Stone, E. M., Chen, L. N., Daumit, G. L., Linden, S., & McGinty, E. E. (2019) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-019-09652-w · Cited by 46 · see citing works
Centola, D. M., Guilbeault, D., Sarkar, U., Khoong, E. C., & Zhang, J. (2021) · Nature Communications · doi:10.1038/s41467-021-26905-5 · Cited by 43 · see citing works
Callahan, K., Christman, G. P., & Maltby, L. E. (2018) · Advances in Pediatrics · doi:10.1016/j.yapd.2018.03.001 · Cited by 40 · see citing works
Identifying stigmatizing language in clinical documentation: A scoping review of emerging literature
Barcelona, V., Scharp, D., Idnay, B., Moen, H., Cato, K., & Topaz, M. (2024) · PLoS ONE · doi:10.1371/journal.pone.0303653 · Cited by 38 · see citing works
Sukhera, J., Wodzinski, M., Teunissen, P., Lingard, L. A., & Watling, C. (2018) · Academic medicine : journal of the Association of American Medical Colleges · doi:10.1097/acm.0000000000002382 · Cited by 31 · see citing works
A Review of Latino/Latinx Participants in Mindfulness-Based Intervention Research
Cotter, E. W., & Jones, N. (2019) · Mindfulness · doi:10.1007/s12671-019-01266-9 · Cited by 35 · see citing works
Chang, D. F., Donald, J. N., Whitney, J. M., Miao, I. Y., & Sahdra, B. K. (2023) · Personality and Social Psychology Bulletin · doi:10.1177/01461672231178518 · Cited by 33 · see citing works
The Significance of Cultural Intelligence in Nurse Leadership
Richard‐Eaglin, A. (2020) · Nurse Leader · doi:10.1016/j.mnl.2020.07.009 · Cited by 32 · see citing works
Tao, S., Geng, Y., Li, M., Ye, J., & Liu, Z. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.111071 · Cited by 34 · see citing works
Salvati, M., Chiorri, C., & Baiocco, R. (2019) · Mindfulness · doi:10.1007/s12671-019-01215-6 · Cited by 29 · see citing works
The Association Between Implicit Racial Bias and Mindfulness in Mental Health Practitioners
Ivers, N. N., Johnson, D. A., & Rogers, J. L. (2020) · Journal of Counseling & Development · doi:10.1002/jcad.12350 · Cited by 30 · see citing works
Chang, D. F., Dunn, J. J., & Omidi, M. (2020) · Journal of Clinical Psychology · doi:10.1002/jclp.23080 · Cited by 28 · see citing works
Gaps in Measuring and Mitigating Implicit Bias in Healthcare
Arif, S. A., & Schlotfeldt, J. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.633565 · Cited by 28 · see citing works
Effects of Mindfulness Meditation on Conscious and Non-Conscious Components of the Mind
Fabbro, A., Crescentini, C., Matiz, A., Clarici, A., & Fabbro, F. (2017) · Applied Sciences · doi:10.3390/app7040349 · Cited by 27 · see citing works
Gullo, G. L., & Beachum, F. D. (2020) · Teachers College Record The Voice of Scholarship in Education · doi:10.1177/016146812012200309 · Cited by 27 · see citing works
Tejeda, S., Stolley, M. R., Vijayasiri, G., Campbell, R. T., Ferrans, C. E., Warnecke, R. B., & Rauscher, G. H. (2017) · Psycho-Oncology · doi:10.1002/pon.4456 · Cited by 26 · see citing works
Being Mindful: A Long-term Investigation of an Interdisciplinary Course in Mindfulness
Braun, S. E., Kinser, P., Carrico, C. K., & Dow, A. (2019) · Global Advances In Health and Medicine · doi:10.1177/2164956118820064 · Cited by 25 · see citing works
Rojas-Torres, L. P., Alonso-Esteban, Y., López-Ramón, M. F., & Alcantud-Marín, F. (2021) · Children · doi:10.3390/children8050316 · Cited by 25 · see citing works
Howell, E. A., Brown, H. L., Brumley, J., Bryant, A., Caughey, A. B., Cornell, A., Grant, J. H., Gregory, K. D., Gullo, S. M., Kozhimannil, K. B., et al. (2018) · Journal of Midwifery & Women s Health · doi:10.1111/jmwh.12756 · Cited by 26 · see citing works
Pandit, A. S., de Gouveia, M., Horsfall, H. L., Reka, A., & Marcus, H. J. (2022) · Frontiers in Surgery · doi:10.3389/fsurg.2022.916228 · Cited by 24 · see citing works
Epstein, R. M., Marshall, F., Sanders, M., & Krasner, M. S. (2021) · Journal of Continuing Education in the Health Professions · doi:10.1097/ceh.0000000000000379 · Cited by 24 · see citing works
Yuguero, O., Melnick, E. R., Marsal, J. R., Esquerda, M., & Soler-González, J. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-020949 · Cited by 25 · see citing works
Makdessi, C. J., Day, C., & Chaar, B. B. (2019) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2019.01.017 · Cited by 28 · see citing works
Wong, Y. R., & Vinsky, J. (2021) · Australian Social Work · doi:10.1080/0312407x.2020.1850816 · Cited by 23 · see citing works
‘I'm still here, I'm alive and breathing’: The experience of Black Americans with long COVID
Bergmans, R. S., Chambers‐Peeple, K., Yu, C., Xiao, L. Z., Wegryn‐Jones, R., Martin, A., Dell’Imperio, S., Aboul‐Hassan, D., Williams, D. A., Clauw, D. J., et al. (2023) · Journal of Clinical Nursing · doi:10.1111/jocn.16733 · Cited by 24 · see citing works
Wei, J., Yun, Z., Zhang, Y., Liang, Y., Hu, Z., Gao, C., Tang, X., & Liu, H. (2025) · Journal of Nursing Management · doi:10.1155/jonm/8572654 · Cited by 22 · see citing works
Implicit Bias Recognition and Management: Tailored Instruction for Faculty
Rodriguez, N., Kintzer, E., List, J., Lypson, M. L., Grochowalski, J. H., Marantz, P. R., & González, C. M. (2021) · Journal of the National Medical Association · doi:10.1016/j.jnma.2021.05.003 · Cited by 24 · see citing works
Nursing Leadership Must Confront Implicit Bias as a Barrier to Diversity in Health Care Today
Stamps, D. C. (2021) · Nurse Leader · doi:10.1016/j.mnl.2021.02.004 · Cited by 20 · see citing works
Sardessai‐Nadkarni, A. A., & Street, R. L. (2022) · Journal of Cancer Survivorship · doi:10.1007/s11764-022-01170-7 · Cited by 21 · see citing works
Caring for providers to improve patient experience (CPIPE): intervention development process
Afulani, P., Oboke, E. N., Ogolla, B. A., Getahun, M., Kinyua, J., Oluoch, I., Odour, J., & Ongeri, L. (2022) · Global Health Action · doi:10.1080/16549716.2022.2147289 · Cited by 18 · see citing works
The impact of racism on emergency health care workers
Kaltiso, S. O., Seitz, R. M., Zdradzinski, M. J., Moran, T. P., Heron, S., Robertson, J., & Lall, M. D. (2021) · Academic Emergency Medicine · doi:10.1111/acem.14347 · Cited by 19 · see citing works
Raskin, S. E., Thakkar‐Samtani, M., Santoro, M., Fleming, E., Heaton, L. J., & Tranby, E. P. (2023) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-023-01821-0 · Cited by 21 · see citing works
Kafka, J. M., Moracco, K. E., Barrington, C., & Mortazavi, A. L. (2019) · Qualitative Health Research · doi:10.1177/1049732318821691 · Cited by 21 · see citing works
Logan, A. C., Berman, S. H., Berman, B., & Prescott, S. L. (2021) · Challenges · doi:10.3390/challe12010001 · Cited by 20 · see citing works
Minimizing Unconscious Bias in Nursing School Admission
Noone, J., & Najjar, R. H. (2021) · Journal of Nursing Education · doi:10.3928/01484834-20210520-03 · Cited by 17 · see citing works
School Leadership: Implicit Bias and Social Justice
Beachum, F. D., & Gullo, G. L. (2020) · Springer eBooks · doi:10.1007/978-3-030-14625-2_66 · Cited by 18 · see citing works
Thominet, L., Hamel, L. M., Baidoun, F., Moore, T. F., Barton, E. E., Heath, E. I., Carducci, M. A., Lansey, D. G., & Eggly, S. S. (2022) · Patient Education and Counseling · doi:10.1016/j.pec.2022.09.002 · Cited by 16 · see citing works
Hente, E. A., Sears, R. W., Cotton, S., Pallerla, H., Siracusa, C. M., Filigno, S. S., & Boat, T. F. (2020) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2020.02.081 · Cited by 19 · see citing works
Confronting Racism with Mindfulness
Anālayo, B. (2020) · Mindfulness · doi:10.1007/s12671-020-01432-4 · Cited by 17 · see citing works
Addressing Racial Biases in Medicine: A Review of the Literature, Critique, and Recommendations
Parsons, S. (2020) · International Journal of Health Services · doi:10.1177/0020731420940961 · Cited by 15 · see citing works
Richards, R., & Wohlauer, M. V. (2021) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2021.04.021 · Cited by 14 · see citing works
The Mindful Brain at Rest: Neural Oscillations and Aperiodic Activity in Experienced Meditators
McQueen, B., Murphy, O. W., Fitzgerald, P. B., & Bailey, N. W. (2024) · Mindfulness · doi:10.1007/s12671-024-02461-z · Cited by 14 · see citing works
Pinnock, R., Ritchie, D., Gallagher, S., Henning, M. A., & Webster, C. S. (2021) · Advances in Health Sciences Education · doi:10.1007/s10459-020-10022-x · Cited by 14 · see citing works
Smith, S. M., Kheri, A., Ariyo, K., Gilbert, S., Salla, A., Lingiah, T., Taylor, C. J., & Edge, D. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1053502 · Cited by 12 · see citing works
Mladen, S. N., Loughan, A. R., Kinser, P. A., Crawford, M., Jones, A., Edwards, S., Rybarczyk, B. D., & Braun, S. E. (2019) · Global Advances in Health and Medicine · doi:10.1177/2164956119879872 · Cited by 14 · see citing works
Acting Wisely: Eliminating Negative Bias in Medical Education—Part 1: The Fundamentals
Plews-Ogan, M. L., Bell, T. D., Townsend, G., Canterbury, R. J., & Wilkes, D. S. (2020) · Academic Medicine · doi:10.1097/acm.0000000000003699 · Cited by 13 · see citing works
Twelve tips for mindful teaching and learning in medical education
Ryznar, E., & Levine, R. B. (2021) · Medical Teacher · doi:10.1080/0142159x.2021.1901869 · Cited by 13 · see citing works
Advancing Equity and Justice in Academic Nursing Through Trauma-Informed Education Practice.
Najjar, R. H., & Ackerman-Barger, K. (2024) · The Journal of Nursery Education · doi:10.3928/01484834-20240502-01 · Cited by 10 · see citing works
Contemplative Pedagogy: Creating Mindful Educators and Classrooms
Chapman, L. R. (2021) · Perspectives of the ASHA Special Interest Groups · doi:10.1044/2021_persp-21-00065 · Cited by 11 · see citing works
Diversifying academic medicine: One search committee at a time
Jacobs, N., Esquierdo-Leal, J. L., Smith, G. S., Piasecki, M. M., & Houmanfar, R. A. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.854450 · Cited by 11 · see citing works
The State of the Science of Nurses' Implicit Bias
Wei, H., Price, Z., Evans, K., Haberstroh, A. L., Hines-Martin, V. P., & Harrington, C. C. (2023) · Advances in Nursing Science · doi:10.1097/ans.0000000000000470 · Cited by 11 · see citing works
Meyer, M. L., & Young, E. (2021) · Professional Psychology Research and Practice · doi:10.1037/pro0000409 · Cited by 12 · see citing works
Azman, N. B. N., Zhou, T. W., & Shorey, S. (2023) · Nurse Education in Practice · doi:10.1016/j.nepr.2023.103820 · Cited by 11 · see citing works
Unconscious Bias and the Impacts on Caring: The Role of the Clinical Nursing Instructor
Crandlemire, L. A. (2020) · International journal for human caring · doi:10.20467/humancaring-d-19-00048 · Cited by 4 · see citing works
Givron, H., & Desseilles, M. (2021) · Patient Education and Counseling · doi:10.1016/j.pec.2021.03.015 · Cited by 10 · see citing works
Vamos, C. A., Foti, T. R., Martinez, E. R., Pointer, Z., Detman, L. A., & Sappenfield, W. M. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20116003 · Cited by 9 · see citing works
Nguyen-Truong, C. K. Y., Rakha, S., Eti, D. U., & Angelesco, L. (2021) · Asian/Pacific Island Nursing Journal · doi:10.31372/20200504.1109 · Cited by 9 · see citing works
[Mindfulness and the clinical relationship: steps to a resilience in medicine].
Krogh, E., Medeiros, S., Bitrán, M., & Langer, Á. I. (2019) · Revista médica de Chile (Impresa) · doi:10.4067/s0034-98872019000500618 · Cited by 9 · see citing works
McKnight, K., Venkateswaran, N., Laird, J., Dilig, R., Robles, J., & Shalev, T. (2022) · doi:10.3768/rtipress.2022.op.0077.2209 · Cited by 9 · see citing works
Prescott, S. L., Greeson, J. M., & El‐Sherbini, M. S. (2022) · Challenges · doi:10.3390/challe13020037 · Cited by 8 · see citing works
Sereno, M., Catagnus, R. M., Griffith, A. K., & Eilers, H. J. (2023) · Trauma Violence & Abuse · doi:10.1177/15248380231171186 · Cited by 9 · see citing works
Empathy and Implicit Bias: Can Empathy Training Improve Equity?
Sukhera, J. (2019) · Teaching Empathy in Healthcare · doi:10.1007/978-3-030-29876-0_14 · Cited by 8 · see citing works
Developing a measure of blind patients’ interactions with their healthcare providers
Heydarian, N. M., Morera, O. F., & Frankowski, S. (2020) · Disability and health journal · doi:10.1016/j.dhjo.2020.100906 · Cited by 8 · see citing works
Health Disparities in Pulmonary Arterial Hypertension and the Impact of the COVID-19 Pandemic
Ryan, J. T., Pérez, V. D. J., & Ryan, J. J. (2021) · Advances in Pulmonary Hypertension · doi:10.21693/1933-088x-20.1.6 · Cited by 8 · see citing works
Potential Influence of Nurses’ Implicit Racial Bias on Maternal Mortality
Rattan, J., & Bartlett, T. (2023) · Public Health Nursing · doi:10.1111/phn.13201 · Cited by 7 · see citing works
Derbyshire, D. W., & Keay, T. (2024) · Journal of Clinical Nursing · doi:10.1111/jocn.17097 · Cited by 7 · see citing works
Understanding Bias in Surgery: Perceived Cultural Similarity Between Surgeons and Patient Families
Leu, G. R., Links, A. R., Tunkel, D., Walsh, J., Ryan, M. A., DiCarlo, H., Jelin, E., Beach, M., & Boss, E. (2021) · Otolaryngology Head & Neck Surgery · doi:10.1177/0194599820982639 · Cited by 7 · see citing works
Self-citationA content analysis: Consider mindfulness in response to colorist biases
Ransom, N., Williams, M. A., Keyes, L., & Hall, R. E. (2021) · Journal of Human Behavior in the Social Environment · doi:10.1080/10911359.2021.1968559 · Cited by 7 · see citing works
Using Everyday Ethics to Address Bias and Racism in Clinical Care
Kalevor, S., Uveges, M. K., & Meyer, E. C. (2022) · AACN Advanced Critical Care · doi:10.4037/aacnacc2022566 · Cited by 7 · see citing works
A constructivist grounded theory exploration of Mindfulness for Healthcare Professional students
Braun, S. E., Mladen, S. N., Crawford, M., Edwards, S., & Kinser, P. A. (2022) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2022.101689 · Cited by 7 · see citing works
Pintado, S. (2018) · Terapia psicológica · doi:10.4067/s0718-48082018000200071 · Cited by 7 · see citing works
Cordero, D. M., & Davis, D. L. F. (2020) · Journal of Patient Experience · doi:10.1177/2374373520933110 · Cited by 7 · see citing works
CORE: Compassion Oriented Reflection and Engagement to Guide Academic-Community Partnership
Chou, T., & Frazier, S. L. (2020) · Journal of Participatory Research Methods · doi:10.35844/001c.13314 · Cited by 7 · see citing works
Sociocultural Environments and Health Disparities Research
Amaro, H. D. L. A., García, S., Arnaudova, I., & Jolles, M. P. (2021) · Wiley eBooks · doi:10.1002/9781119374855.ch5 · Cited by 7 · see citing works
Newton, C. S. (2025) · Reflective Practice · doi:10.1080/14623943.2025.2494328 · Cited by 6 · see citing works
Li, C., Wong, N. K., Liu, D., & Kee, Y. H. (2020) · International Journal of Disability Development and Education · doi:10.1080/1034912x.2020.1830950 · Cited by 6 · see citing works
- Authors
- Burgess, D. J., Beach, M. C., & Saha, S.
- Affiliations
- University of Minnesota (US)
- Johns Hopkins University (US)
- Oregon Health & Science University (US)
- Corresponding author
- Burgess, Diana J.
- Venue
- Patient Education and Counseling
- Publisher
- Elsevier BV
- Published
- 2017-02
- Volume
- 100
- Issue
- 2
- Pages
- 372-376
- ISSN
- 0738-3991 (ISSN-L)
- OpenAlex
- W2518908671
- Cited by
- 182
- References
- 76
- Citations by year
- 2026: 4 · 2025: 19 · 2024: 15 · 2023: 21 · 2022: 22 · 2021: 37 · 2020: 27 · 2019: 17 · 2018: 13 · 2017: 6 · 2012: 1
- FWCI
- 16.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Patient Education and Counseling (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Keywords
- mindfulness training, implicit bias, racial and ethnic bias, health care disparities, clinician bias, meditation, self-compassion, compassion fatigue, burnout, cognitive load, provider well-being, racism in healthcare
- MeSH terms
- Compassion Fatigue, Attitude of Health Personnel, Burnout, Professional, Emotions, Empathy, Health Personnel, Humans, Prejudice, Bias, Meditation, Healthcare Disparities, Racism, Mindfulness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
