What?
During our Equality, Diversity and Belonging (EDB) sessions on placement we touched on the subject of conscious vs unconscious biases, and were challenged to recognise some of our own. Fortunately none of us had any particular conscious biases with regards to protected characteristics, but all of us had could recognise at least one unconscious bias in our own thought processes. I didn't like that about myself one bit! Immediately I wanted to change this, particularly in the context of healthcare, and sought to address these biases by finding out more about them.
So what?
Addressing unconscious bias, both in the workplace and within healthcare environments, is important for promoting a culture of inclusion and fair treatment. That being said, I realised that I didn't recognise two things: firstly, how do I address my own unconscious biases; and secondly, how do I put this in to the context of healthcare, and what would it mean for service users?
Now what?
I came across a Ted Talk by Valerie Alexander, which helped me to accept that unconscious bias is completely natural, and everyone acquires them passively from their own experiences and exposures. They serve the purpose to make us feel comfortable when faced with expected circumstances, and uncomfortable or surprised when met with unexpected circumstances. This meant that biases can not be eliminated, but we can make efforts to mitigate them instead.
The key steps towards mitigating one's own biases are firstly in recognition: noticing that you are surprised when met with certain circumstances and recognising that this is a bias you have. Secondly we can move to examining this: questioning ourselves why we might hold this bias, and examine our behaviour in response to it. Finally, we can challenge ourselves: what might we do differently if the person in question had different characteristics, either closer to or further away from what we expected.
This has given me a path to examine and challenge my own biases, but I still wanted to understand how important this was in the context of healthcare. I found an article in the BMJ, which explored the different types of unconscious bias, and some examples of how these had affected clinical outcomes.
Examples included of anchoring bias, availability bias, implicit/experience bias, and confirmation bias.
Anchoring bias describes a failure to adjust initial perceptions based off new information, which could impact reaching a correct diagnosis. Availability bias describes the influence of recent experiences on judgement, such as seeing lots of service users recently with appendicitis could lead you to think that the next person you see with abdominal pain probably has appendicitis. Implicit or experience bias describes the pre-emptive application of attributes to individuals with certain characteristic, such as assuming that older service users are more likely to be sedentary. Finally, confirmation bias describes the tendency to seek information that supports a prior theory, at the expense of not seeking evidence that refutes it, such as thinking that a service user is TATT because their ferritin is low, and treating for anaemia rather than considering ordering thyroid function tests.
I am grateful to now understand that having unconscious bias is completely normal, and the best way to mitigate them and move towards more inclusive practice involves recognising, examining, and challenging my own thoughts and behaviours.