The Washington Post

Implicit bias training at work

- Alisa Harvey, Manassas

Marilyn Singleton’s Feb. 24 Friday Opinion commentary, “I’m a Black physician, and I’m appalled by mandated implicit bias training,” disregarde­d well-establishe­d evidence of disparate medical treatment and outcomes for Black patients. However, though peripheral to Dr. Singleton’s argument, the piece referenced one well-founded problem with mandatory implicit bias training: the absence of robust evidence demonstrat­ing that such training makes a meaningful difference in the practice of most profession­als.

This problem is well-documented in recent meta-analyses establishi­ng that individual studies claiming positive training effects are often deeply flawed. These individual studies tend to have unreliably small sample sizes, to be conducted only in academic settings, to overstate positive results, and to go unpublishe­d if the results are null or negative.

As someone who studies continuing profession­al education, I have seen proponents of mandatory diversity training gloss over these problems time and again. The profession or the legislatur­e observes a real problem, declares that something must be done and throws a continuing education requiremen­t at it — with little considerat­ion of what that requiremen­t can realistica­lly accomplish.

Does mandatory training have any place in the struggle to overcome bias? Perhaps, but providers must commit to becoming a meaningful part of the research, working with social scientists to design and study various training approaches. For example, does mandatory training have more significan­t impacts than voluntary? Does in-person or repeated training have more significan­t impacts than remote or one-time events? Can training without other organizati­onal reforms have any impact at all? The research questions are fundamenta­l; failing to engage with these questions, and to adapt the training as the research evolves, is unacceptab­le.

Rima Sirota, Chevy Chase

It appears that Marilyn Singleton might have forgotten that when she walks into a doctor’s office or hospital for care, she is a doctor, not just a Black woman. The respect she receives from physicians is most likely about her profession.

I am a Black woman without a medical degree. In 1982, I was rushed to the hospital by my parents after passing out and convulsing from a heat stroke. Hours earlier, I competed in hot and humid weather. I won multiple events at a youth track and field championsh­ip. The emergency room staff immediatel­y questioned my mother about my sexual history. “Is she pregnant?” My frantic mother replied, “No! She’s been in the hot sun all day at a track meet!” I was ordered to see an OB/GYN for follow-up one week later.

In 2002, I arrived at the doctor’s office with my 3-month-old son. My husband is White. The nurse asked, “Is that your baby?” I didn’t know of too many mothers who hand their new babies over to other people for doctor’s visits.

In 2010, I saw a male doctor for a recurrent sinus infection. I have a lean frame from years of competitiv­e running. The doctor’s suggestion was to gain weight and take antihistam­ines. A few days later, I saw another doctor. I was given a prescripti­on for my sinus infection.

I suggest Dr. Singleton attend the mandated course in implicit bias training. I am shocked that a woman intelligen­t enough to become a physician is ignorant enough to believe that if she does not experience bias, then no one does.

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