Implicit bias can be thought of as the space that exists between our unconscious attitudes and assumptions and our conscious belief systems. In medicine, this unconscious bias can be a powerful determinant of the quality of care that we provide to a given patient. As medical trainees, we receive countless lectures on the importance of recognizing our own biases, prejudices and beliefs. This is so that when we see a patient, we can be a little bit more aware of the preconceived judgements and ideas that we bring into that interaction. It’s important to recognize that we all carry prejudices and bias as products of the cultures we operate in. Unconscious bias doesn’t make us inherently bad; it makes us humans conditioned by our environment.
While mindfulness is widely recognized for how it can be harnessed to promote wellness, it can also serve as a useful tool to bridge our conscious values and our unconscious conditioning. Regular mindfulness practice allows us to become familiar with our habits of mind and the kinds of thought patterns that we entertain. This component of a regular mindfulness practice is both confronting and rewarding. In reality, the majority of us will spend the greater portion of our day mind-wandering (and this has been proven in research), completely unaware of the various thoughts and ideas arising in our mind. When we are unaware, we can unknowingly act out these thoughts, leading to unintentional harm. Cultivating awareness can create a bit of space between our thoughts and our actions, so that we can choose how we act in the moments after a thought arises. Noticing a thought as another object in the mind also gives it a little less power and hold over us and our behaviour. In an encounter with a patient, this can be really useful. If we are able to clearly see a snap judgement, or the preconceived notions we have about someone, we are in a much better position to act in a way that is more consistent with our conscious value system.
Additionally, the practice of compassion can be extremely supportive in countering some of our conditioning and biases. When we practice compassion, we are cultivating a sense of unconditional friendliness towards others. We practice this attitude in order to make it our default, which should foster more understanding, even with those who may be very different from ourselves.
Research is beginning to bear this out, too. A 2014 study done by Leuke et al. showed that a 10-minute guided meditation reduced racial and age bias as measured on implicit association tests (IATs). Additionally, a 2017 review of the literature about how mindfulness may reduce care provider contributions to health disparities suggested that mindfulness practices may increase a provider’s ability to notice and control implicit biases and increase compassion towards patients.
Confronting our own biases is no small task, but arguably it needs to be an ongoing project for all medical trainees so as to decrease health disparities amongst patients. A regular mindfulness practice is just one way we can work towards this goal.
Resources:
(1) Burgess DJ, Beach MC, Saha S. Mindfulness practice: A promising approach to reducing the effects of clinician implicit bias on patients. Patient education and counseling. 2017 Feb 1;100(2):372-6.
(2) Lueke A, Gibson B. Mindfulness meditation reduces implicit age and race bias: The role of reduced automaticity of responding. Social Psychological and Personality Science. 2015 Apr;6(3):284-91.
This article was written by Zoe O’Neill, a medical student at McGill University and member of the Mindful Medical Learner Team.
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