How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience?
Abstract Background Implicit prejudice can lead to disparities in treatment. The effects of specialty and experience on implicit obesity and mental illness prejudice had not been explored. The main objective was to examine how specializing in psychiatry/general medicine and years of experience moder...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Medical Ethics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12910-022-00815-7 |
| _version_ | 1811189029298765824 |
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| author | Chloë FitzGerald Christian Mumenthaler Delphine Berner Mélinée Schindler Tobias Brosch Samia Hurst |
| author_facet | Chloë FitzGerald Christian Mumenthaler Delphine Berner Mélinée Schindler Tobias Brosch Samia Hurst |
| author_sort | Chloë FitzGerald |
| collection | DOAJ |
| description | Abstract Background Implicit prejudice can lead to disparities in treatment. The effects of specialty and experience on implicit obesity and mental illness prejudice had not been explored. The main objective was to examine how specializing in psychiatry/general medicine and years of experience moderated implicit obesity and mental illness prejudice among Swiss physicians. Secondary outcomes included examining the malleability of implicit bias via two video interventions and a condition of cognitive load, correlations of implicit bias with responses to a clinical vignette, and correlations with explicit prejudice. Methods In stage 1, participants completed an online questionnaire including a clinical vignette. In stage 2, implicit prejudice pre- and post- intervention was tested using a 4 × 4 between-subject design including a control group. In stage 3, explicit prejudice was tested with feeling thermometers and participants were debriefed. Participants were 133 psychiatrists and internists working in Geneva, hospital-based and private practice. Implicit prejudice was assessed using a Weight IAT (Implicit Association Test) and a Mental Illness IAT. Explicit feelings towards the obese and the mentally ill were measured using Feeling Thermometers. A clinical vignette assessed the level of concern felt for a fictional patient under four conditions: control, obese, depression, obese and depression. Linear regression was conducted to test for association of gender, experience, and specialty with responses to vignettes, pre-intervention IATs and explicit attitudes, and to test for association of interventions (or control) with post-intervention IATs and explicit attitudes. Reported effect sizes were computed using Cohen’s d. Two-tailed p < 0.05 was selected as the significance threshold. Results Compared to internists, psychiatrists showed significantly less implicit bias against mentally vs. physically ill people than internists and warmer explicit feelings towards the mentally ill. More experienced physicians displayed warmer explicit feelings towards the mentally ill and a greater level of concern for the fictional patients in the vignette than the less experienced, except when the patient was described as obese. Conclusions Specialty moderates both implicit and explicit mental illness prejudice. Experience moderates explicit mental illness bias and concern for patients. The effect of specialty on implicit prejudice seems to be based principally on self-selection. |
| first_indexed | 2024-04-11T14:28:06Z |
| format | Article |
| id | doaj.art-b6ae87c9805546e99142d5feb8863b24 |
| institution | Directory Open Access Journal |
| issn | 1472-6939 |
| language | English |
| last_indexed | 2024-04-11T14:28:06Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Ethics |
| spelling | doaj.art-b6ae87c9805546e99142d5feb8863b242022-12-22T04:18:47ZengBMCBMC Medical Ethics1472-69392022-08-0123111110.1186/s12910-022-00815-7How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience?Chloë FitzGerald0Christian Mumenthaler1Delphine Berner2Mélinée Schindler3Tobias Brosch4Samia Hurst5iEH2 (Institute for Ethics, History and the Humanities), Faculty of Medicine, University of GenevaDepartment of Information Science, Geneva School of Business AdministrationiEH2 (Institute for Ethics, History and the Humanities), Faculty of Medicine, University of GenevaiEH2 (Institute for Ethics, History and the Humanities), Faculty of Medicine, University of GenevaCISA (Swiss National Centre for Affective Sciences), University of GenevaiEH2 (Institute for Ethics, History and the Humanities), Faculty of Medicine, University of GenevaAbstract Background Implicit prejudice can lead to disparities in treatment. The effects of specialty and experience on implicit obesity and mental illness prejudice had not been explored. The main objective was to examine how specializing in psychiatry/general medicine and years of experience moderated implicit obesity and mental illness prejudice among Swiss physicians. Secondary outcomes included examining the malleability of implicit bias via two video interventions and a condition of cognitive load, correlations of implicit bias with responses to a clinical vignette, and correlations with explicit prejudice. Methods In stage 1, participants completed an online questionnaire including a clinical vignette. In stage 2, implicit prejudice pre- and post- intervention was tested using a 4 × 4 between-subject design including a control group. In stage 3, explicit prejudice was tested with feeling thermometers and participants were debriefed. Participants were 133 psychiatrists and internists working in Geneva, hospital-based and private practice. Implicit prejudice was assessed using a Weight IAT (Implicit Association Test) and a Mental Illness IAT. Explicit feelings towards the obese and the mentally ill were measured using Feeling Thermometers. A clinical vignette assessed the level of concern felt for a fictional patient under four conditions: control, obese, depression, obese and depression. Linear regression was conducted to test for association of gender, experience, and specialty with responses to vignettes, pre-intervention IATs and explicit attitudes, and to test for association of interventions (or control) with post-intervention IATs and explicit attitudes. Reported effect sizes were computed using Cohen’s d. Two-tailed p < 0.05 was selected as the significance threshold. Results Compared to internists, psychiatrists showed significantly less implicit bias against mentally vs. physically ill people than internists and warmer explicit feelings towards the mentally ill. More experienced physicians displayed warmer explicit feelings towards the mentally ill and a greater level of concern for the fictional patients in the vignette than the less experienced, except when the patient was described as obese. Conclusions Specialty moderates both implicit and explicit mental illness prejudice. Experience moderates explicit mental illness bias and concern for patients. The effect of specialty on implicit prejudice seems to be based principally on self-selection.https://doi.org/10.1186/s12910-022-00815-7Implicit biasPrejudiceStereotypeSpecializationExperienceTraining |
| spellingShingle | Chloë FitzGerald Christian Mumenthaler Delphine Berner Mélinée Schindler Tobias Brosch Samia Hurst How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience? BMC Medical Ethics Implicit bias Prejudice Stereotype Specialization Experience Training |
| title | How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience? |
| title_full | How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience? |
| title_fullStr | How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience? |
| title_full_unstemmed | How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience? |
| title_short | How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience? |
| title_sort | how is physicians implicit prejudice against the obese and mentally ill moderated by specialty and experience |
| topic | Implicit bias Prejudice Stereotype Specialization Experience Training |
| url | https://doi.org/10.1186/s12910-022-00815-7 |
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