Implicit Bias

Nurse Educators should provide students with a well-rounded education that prepares them for diverse patient populations and complex cultural experiences. To do that, Nurse Educators must lead class and clinical conversations related to diversity, equity and inclusion (DEI). Congruently, the educator must also assess, understand, evaluate and contend with their personal feelings and ideas about DEI before discussions and activities are introduced to students. This process includes a self-assessment to identify implicit bias. One widely used self-assessment tool is the Implicit Association Test developed by Harvard University (available at https://implicit.harvard.edu/implicit/), which “measures attitudes and beliefs that people may be unwilling or unable to report” (2011).
Implicit bias can be defined as unconscious attitudes, ideas, or thoughts that individuals make about members of a group that can be favorable or unfavorable (Kim & Roberson, 2021). Such unconscious thoughts derive from past experience, values, childhood, exposure to media, exposure to groups of people, etc. Still, implicit bias is not to be confused with explicit bias where individuals are consciously aware of their attitudes and beliefs about a person or group and believes them to be valid and true (Kim & Roberson, 2021). Though implicit bias is derived from unconscious thinking, if left unchecked it can lead to unfavorable responses in the classroom and clinical setting.

The first step in reducing implicit bias is personal reflection. One has to first acknowledge that every person has some level of bias. And it is the responsibility of each individual to assess the extent of that bias and the potential consequence of leaving that bias unchecked. When a bias has been identified, it is important to incorporate self-regulation techniques to avoid allowing that bias to develop into prejudice or stereotyping. So, when a specific bias is revealed, consider being intentional when encountering it. Slow down when that cue is experienced so as to purposefully refrain from negative behaviors prompted by that bias (Kim & Roberson, 2021). Otherwise, the biased individual’s behaviors can be viewed as unapproachable, judgmental, or offensive based on the response to the bias.

Both the Nurse Educator and student can use experiential learning opportunities to reduce implicit bias and increase exposure to diverse groups of people. These activities develop new positive associations and subconscious ideas that can slowly and purposefully reshape one’s bias (Kim & Roberson, 2021). Intergroup engagement can foster increased empathy and strengthen associations between self and the groups outside of oneself (Kawakami et al., 2017). Nurse Educators may have to seek out intergroup engagement and can incorporate diverse experiential learning opportunities into the curriculum for students. Such exposure will increase critical thinking skills, increase problem solving skills, and fine tune soft skills like empathy and effective communication (Alston, 2021).

Creating opportunities for open discussions related to DEI is also an option for addressing an individual’s implicit bias. Discussion exposes participants to varying perspectives and to diverse points of view. Participation in DEI discussions also promotes the development of well rounded, well versed individuals. Still, the Nurse Educator must be mindful of the fact that discussions associated with DEI can potentially become emotionally charged. So, it is important to create a safe and non-punitive learning environment where individuals can be heard (Prasad-Reddy, et al., 2022). Nurse Educators should set the stage in the classroom, establishing an environment where diversity is promoted and inclusion is supported.

Preparing nursing students to effectively engage with their peers, patients, superiors, and the diverse world around them is no small task. To begin this process the Nurse Educator acknowledges the reality of implicit bias, then moves on to implementing ways to reduce personal implicit bias and the implicit bias of the student participants. Experiential earning opportunities and in-class discussions related to DEI topics are ways the Nurse Educator can bring awareness to implicit bias while simultaneously promoting inclusion. Confronting one’s personal bias can be an uncomfortable task, but it is well worth the effort when the result is more patience, understanding, and cultural competence.