Reducing unconscious biases in medicine

The College of Medicine’s department of medicine has taken steps to help faculty reduce unconscious biases — and now the group is hoping to share what they’ve learned.

The knowledge-sharing initiative grew from the department’s participation in a study called Bias Reduction in Internal Medicine, or BRIM. The study, designed by researchers at the University of Wisconsin-Madison, makes people aware of the biases and cultural stereotypes they may harbor, even if they do so unconsciously.

“Implicit bias, bias that occurs unconsciously, can affect our behavior and decision making,” said Andrew Trotter, assistant professor of clinical medicine. “In the setting of academic medicine, it can affect not just your patient care, but also how you interact with or teach residents and medical students, how you are involved in promotion and tenure, grant approvals and other academic functions that we have as faculty members.” 

Biases can also affect colleague interaction, overall work environment and turnover rates, more reasons why the department elected to participate in the study.

“We’re an institution of inclusion and diversity,” said Waddah Alrefai, professor of medicine. “It is not sufficient to say that only in the mission statement of the institution. There should be a more active intervention to solve the problem of bias and promote diversity, and I felt that this program was innovative in its approach to solve this problem.”

On the national level, the BRIM program included 20 departments of medicine and has lasted about two years at each institution. During that time, the department of medicine, made up of nine divisions, received training through workshops titled “Breaking the Bias Habit: Bias Reduction in Internal Medicine.” BRIM creators and 10 faculty members from the department of medicine — or BRIM implementers — delivered the workshops, which covered things like labeling and identifying bias and following strategies to break related habits.

“I think everyone said they had this moment of self-reflection,” Alana Biggers, assistant professor of medicine, said about the workshops. “That in itself was transformative in our department and divisions.”

The final step for participation in BRIM includes completing surveys, which test if and how the workshops affected the overall environment of the department. The last survey will be administered in October.

But UIC faculty members say their work isn’t done yet.

“Now it is our job and passion to extend this training to other members of the department, of the college,” Alrefai said. “We need to expand as much as we can.”

Alrefai said he and his colleagues plan to deliver similar workshops to staff and all internal medicine residents in the coming months. Training for residents will start once a month every year. Makeup sessions for faculty who have not yet attended a workshop will also be offered after the study is complete in October.

In the near future, local leads for BRIM hope to train medical students and to share the curriculum with others. 

“Other departments are interested in what we’re doing here,” Biggers said.

“Our vision is to try to work with any level we can,” Trotter added. “The idea is we train [people in other disciplines] in the core parts of the curriculum and then they adapt and implement it.”

Departments should contact local implementer Waddah Alrefai for questions about learning opportunities at walrefai@uic.edu.

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