The DOI matches its Crossref record; 31 of the 32 references it cites were found in a registry or an index.
Unconscious race and class bias: Its association with decision making by trauma and acute care surgeons
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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“Three of these studies reported that 90.7% of doctors (n=215)28, 93% of nurses (n=245)29 and 86% of medical students (n=211)27 demonstrated an implicit preference towards people with High SES.”
From Health professionals implicit bias of patients with low socioeconomic status (SES) and its effects on clinical decision-making: a scoping review (2024) · cites this paper as [28]
In the citing paper
“However, in these studies,27–29 the high levels of implicit SES bias were not evident in HP’s decision-making.”
From Health professionals implicit bias of patients with low socioeconomic status (SES) and its effects on clinical decision-making: a scoping review (2024) · cites this paper as [28]
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Self-citationThe unequal burden of pain: confronting racial and ethnic disparities in pain
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Maina, I. W., Belton, T. D., Ginzberg, S. P., Singh, A., & Johnson, T. J. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2017.05.009 · Cited by 828
Racism in healthcare: a scoping review
Hamed, S., Bradby, H., Ahlberg, B. M., & Thapar-Björkert, S. (2022) · BMC Public Health · doi:10.1186/s12889-022-13122-y · Cited by 444
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Arpey, N. C., Gaglioti, A. H., & Rosenbaum, M. E. (2017) · Journal of Primary Care & Community Health · doi:10.1177/2150131917697439 · Cited by 413
A systematic review of the impact of physician implicit racial bias on clinical decision making
Dehon, E., Weiss, N., Jones, J., Faulconer, W., Hinton, E., & Sterling, S. (2017) · Academic Emergency Medicine · doi:10.1111/acem.13214 · Cited by 404
The Effects of Oncologist Implicit Racial Bias in Racially Discordant Oncology Interactions
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Metadata
- 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
- Venue
- Journal of Trauma and Acute Care Surgery
- Published
- 2014-09
- Volume
- 77
- Issue
- 3
- Pages
- 409-416
- ISSN
- 2163-0755 (ISSN-L)
- 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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