Abstract PO-078: Introduction of implicit bias training to oncology faculty as a quality improvement initiative
Authors: Taylor Renee C. , Silber Andrea 
Published: January 2022

Abstract
Background: In a review, Hall (2015) found that implicit bias was significantly related to patient-provider interactions and health outcomes. Implicit Bias Training is a tool to help individuals understand and take corrective action for unfair behaviors. Purpose: Our goal was to assess physician attitudes towards Implicit Bias Training and to measure physician participation in the training when implemented as an NCCN quality measure. Methodology: Implicit Bias Training was offered by the DEI Office at Yale-New Haven Health. This incentivized quality initiative was required for all practicing oncologists. Of 109 physicians, 45 (41.3%) completed this training. The anonymous survey, which included a link to the Harvard Implicit Project's Implicit Association Test (IAT), was emailed to the 45 oncologists prior to participation in the session. There were 21 respondents (46.7% response rate). Results: The self-reported results of the IAT are as follows: 9.5% (n=2) report a strong automatic preference for European Americans (EA) vs. African Americans (AA). 23.8% (n=5) report a moderate automatic preference for EAs vs. AAs 42.9% (n=9) reported little to no automatic preference between AAs vs. EAs. 4.8% (n=1) report a slight automatic preference for AAs vs. EAs. 19% (n=4) did not participate in the IAT. 33.3% (n=7) of physicians report being either extremely or moderately surprised by the result of their IAT, while 33.3% (n=7) report being neither surprised nor unsurprised. 14.3% (n=3) report being moderately unsurprised, and the remainder did not respond. Physicians were asked to report their enthusiasm about Implicit Bias Training on a scale of 0 to 10. The Mean was 6. While physician enthusiasm reports show polarization not apparent by the mean, 57.1% (n=12) of physicians report being hopeful or very hopeful that training would help to improve both collegial and patient-physician relationships. Conclusion: Though this was a mandatory quality initiative that was incentivized, participation was less than 50%. Explanations for the observed participation rate are multifactorial and nuanced. Of the 17 respondents who completed the IAT, nearly one-half (n=7) reported strong or moderate bias for one racial group, and 41% report being surprised by their result. Our findings suggest that unconscious bias was demonstrated in a significant percentage of participants, many of whom were surprised by their results. The results support the need for Implicit Bias Training as part of ongoing oncology quality improvement. 57% of participating physicians were optimistic that the initiative would lead to positive changes. Future Work: We postulate that bias training could increase awareness and result in improved communication with minority patients. Our next project will evaluate the effect of Implicit Bias Training on minority participation in clinical trials. Inclusivity and representation in clinical trials is paramount in efforts to democratize cancer care and our study suggests that bias training could be a valuable tool to achieve this goal.
Citation Format: Renee C. Taylor, Andrea Silber. Introduction of implicit bias training to oncology faculty as a quality improvement initiative [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-078.