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My Implicit Bias Test Results, Why I'm Biased Against It, and Why Does It Matter in Healthcare?

According to Oxford University Press (2021), bias is defined as, a strong feeling in favor of or against one group of people, or one side in an argument, often not based on fair judgement. Most of us have good intentions when interacting with others so it can be difficult to admit that we all have biases. But the truth is, we do have biases. Most of them are implicit or unintentional. We develop bias through past experiences, stories we've heard from others, how we were raised as a child, social influences, and portrayal of groups through the media. Because we all have bias that we may not be aware of, it is important to find out what these biases are. Well, here is a test that claims to test our bias. It is called the Implicit Associations Test (IAT).


The IAT test is meant to test our implicit associations relating to a topic. The test requires participants to essentially sort between "good" and "bad" words as well as sort groups by topic. I chose to take three tests which were, race, disability, and skin tone.


Here are my results:


Results for Race

I was very surprised with my results for this one. I am a Filipina woman who grew up in the Philippines. I did not grow up around White or Black people. However, there is colorism embedded within Filipino history due to the colonial mentality that was instilled by the Spanish and American culture. I was also surprised because I was very careful about my answers to ensure I did not miss-click. While I do not agree with this result, I am going to explore this further.


Results for Disability

As someone who works closely with individuals with developmental disabilities I was hoping my results would say, I had no bias. However, my results showed that I had a slight preference for Disabled Persons over Abled Persons. I grew up taking care of my sister who is diagnosed with Cerebral Palsy and utilizes a wheelchair. I may have developed a slight preference for Disabled Persons due as I am comfortable with this population. A question I would need to ask my self is, does my bias help or hurt this population? The questions for this topic included visuals that I found to be hurting the disabled population as the icons only depicted visible disabilities such as people who need crutches or a wheel chair. This test did not account for disabled individuals whose disability is not visible.


Results for Skin Tone

I need to be honest. When I took this test, I was over it! I will get into details as to why in a little bit. I was so over it that I decided to just take the test as fast as I could without ensuring that I was answering each question carefully. I made many mistakes that were immediately followed by an "x" marker. I was sure that I would get results that I do not agree with. Low and behold, my results show that I had no preference between Dark skinned people and Light Skinned people. Although I am still questioning the accuracy of these results, I do agree as I personally don't believe I have a preference between Dark and Light skin.


Some Problems With The Test

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As a Behavior Analyst who has studied Relational Frame Theory, Stimulus Equivalence, and other behavior modification techniques, I am biased against this test. I've listed some of the reasons why I think this test does not provide us an accurate interpretation of our own bias:

  1. The first big problem is that the creators of the test do not claim that the interpretations of this test is valid.

  2. The second problem is the method in which this test is being delivered. It starts off by training you to respond and categorize topics and words. Then they switch sides. As a Behavior Analyst, I know that behaviors we have previously learned could spill over to new environments. This test teaches us to form relationships in our head as well as conditions our bodies to make selections then switches the stimuli. Our formed relations and the conditioning of our body will spill over to the new environmental conditions of the test.

  3. The third problem is the use of pictures and icons that are already stereotypical. They utilized icons such as a wheelchair, crutches, and a cane to signify a disability however, disability does not always require a visible equipment.

Although I'm not a fan of this test, I do encourage others to take it anyway. Have fun with it and share it with your friends. Most importantly, think about your own implicit bias and how it may affect your day-to-day interactions with others.


Why is it important to learn about our own Bias?

When we have implicit Biases we may inadvertently behave in ways that could be harmful to others. Microaggressions are mostly unintentional however, we cannot allow ignorance to be excused especially if it can harm others. Implicit bias in healthcare can be especially harmful as we are dealing with human quality of life. Our bias can easily affect how we communicate, interact, and treat patients. Our bias can also affect how we perceive the information we are receiving from our patients. Unfortunately, our healthcare system has a long history of creating treatments based on stereotypical and biased ideas. This has caused and continues to cultivate systemic health inequities and disparities.


According to Krolak (20201), health inequities are defined as, the unfair differences that prevent all from the opportunity to have good health, while health disparities are the measurable difference or gaps seen in one group's health in relation to others.


How Can We Find a Balance Between Addressing Our Bias, Disparity and Inequality?

I've wondered if we did not know any background information about a patient's race, ethnicity, gender, socioeconomic status, disability, or even their skin tone, would it prevent bias? My immediate answer is, NO WAY! There are health implications that are related to a patient's intersectionality whether it be their race, gender, sexuality, disability, etc. It is important to understand these interactions so that we may tailor our healthcare treatments to best accommodate the individual's needs. For example, If a patient presents with a disability that has a high comorbidity with obesity, it is important to find out if this patient has access to healthy food options to prevent obesity. If a healthcare provider learns that this patient lives in a low income community where healthy organic food is inaccessible, the patient can be provided with resources on how to access healthy food options and manage their health to prevent obesity.


As you can see, there are benefits to understanding individual attributes such as, race, ethnicity, level of education, and disability. We need to be conscious about our own bias when utilizing this information. We have to keep in mind that human beings are complex and acknowledge that each individual has their own unique intersectionality that calls for individualized care.



References:


Krolak, K. (2021). Implicit Bias, Health Inequities and Health Disparities - NCNA’s Membership Forum. Tar Heel Nurse, 83(1), 6.


Oxford University Press. (2021) Emotional Intelligence. Oxford English dictionary. Retrieved October, 30, 2021, from https://www.oxfordlearnersdictionaries.com/us/definition/english/bias_1

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About Pauline Tolentino Pablo

Pauline is a Board Certified Behavior Analyst experienced in providing Applied Behavior Analysis  services to individuals on the autism spectrum and/or diagnosed with developmental delays. She  is currently enrolled in a Doctor of Behavioral Health program at Cummings Graduate Institute. 

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