The Washington Post
Implicit bias training at work
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have unreliably small sample sizes, to be conducted only in academic settings, to overstate positive results, and to go unpublished if the results are null or negative.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.