Cited by 147Diversity and Career in MedicineSocial and Intergroup PsychologyRacial and Ethnic Identity Research

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Unconscious race and class bias: Its association with decision making by trauma and acute care surgeons

Haider, Adil H., Schneider, Eric B., Sriram, N, Dossick, Deborah S., Scott, Valerie K., Swoboda, Sandra M., Losonczy, Lia, Haut, Elliott R., Efron, David T., Pronovost, Peter J., Freischlag, Julie A., Lipsett, Pamela A., Cornwell, Edward E., MacKenzie, Ellen J., Cooper, Lisa A.·2014·Journal of Trauma and Acute Care Surgery

DOI 10.1097/ta.0000000000000392

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Abstract

Background Recent studies have found that unconscious biases may influence physicians' clinical decision making. The objective of our study was to determine, using clinical vignettes, if unconscious race and class biases exist specifically among trauma/acute care surgeons and, if so, whether those biases impact surgeons' clinical decision making. Methods A prospective Web-based survey was administered to active members of the Eastern Association for the Surgery of Trauma. Participants completed nine clinical vignettes, each with three trauma/acute care surgery management questions. Race Implicit Association Test (IAT) and social class IAT assessments were completed by each participant. Multivariable, ordered logistic regression analysis was then used to determine whether implicit biases reflected on the IAT tests were associated with vignette responses. Results In total, 248 members of the Eastern Association for the Surgery of Trauma participated. Of these, 79% explicitly stated that they had no race preferences and 55% stated they had no social class preferences. However, 73.5% of the participants had IAT scores demonstrating an unconscious preference toward white persons; 90.7% demonstrated an implicit preference toward upper social class persons. Only 2 of 27 vignette-based clinical decisions were associated with patient race or social class on univariate analyses. Multivariable analyses revealed no relationship between IAT scores and vignette-based clinical assessments.…

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Authors: Haider, A. H., Schneider, E. B., Sriram, N., Dossick, D. S., Scott, V. K., Swoboda, S. M., Losonczy, L., Haut, E. R., Efron, D. T., Pronovost, P. J., Freischlag, J. A., Lipsett, P. A., Cornwell, E. E., MacKenzie, E. J., & Cooper, L. A.
Affiliations: Howard University (US)
ORCID: Haider, Adil H.
Schneider, Eric B.
Swoboda, Sandra M.
Losonczy, Lia
Haut, Elliott R.
Efron, David T.
Pronovost, Peter J.
Freischlag, Julie A.
Lipsett, Pamela A.
MacKenzie, Ellen J.
Cooper, Lisa A.
Venue: Journal of Trauma and Acute Care Surgery
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2014-09
Volume: 77
Issue: 3
Pages: 409-416
ISSN: 2163-0755 (ISSN-L)
DOI: 10.1097/ta.0000000000000392
OpenAlex: W2123236160
Cited by: 147
References: 32
Citations by year: 2026: 5 · 2025: 11 · 2024: 10 · 2023: 16 · 2022: 19 · 2021: 12 · 2020: 13 · 2019: 10 · 2018: 13 · 2017: 13 · 2016: 18 · 2015: 6
FWCI: 31.22
Type: journal article
Language: en
Open access: closed
Locations: The Journal of Trauma: Injury, Infection, and Critical Care (publishedVersion)
PubMed (publishedVersion)
eCommons - AKU (Aga Khan University) (submittedVersion)
Funders: National Institute of General Medical Sciences (K23GM093112)
Topics: Social Sciences › Gender Studies › Diversity and Career in Medicine
Social Sciences › Sociology and Political Science › Social and Intergroup Psychology
Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
Keywords: implicit bias, racial bias, social class bias, trauma surgeons, acute care surgeons, clinical decision-making, clinical vignettes, Implicit Association Test, racial preferences
MeSH terms: Adult, Data Collection, Decision Making, Female, Humans, Male, Prejudice, Surveys and Questionnaires, Social Class, Traumatology, United States, Racial Groups, Healthcare Disparities, Racism

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Unconscious race and class bias: Its association with decision making by trauma and acute care surgeons

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