Cultural Competency and Cognitive Bias

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Cultural Competency and Cognitive Bias

January 15, 2020

In this episode Dr. Agboola, and Dr. Heron discuss the role of cultural competency and cognitive bias play in the ED. They unpack important terminology as well as discuss specific patient populations that are at risk; They also discuss studies that have demonstrated the need for cultural competency in physicians.

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Host

Isaac Agboola, MD, MS

Yale New Haven Medical Center
PGY3
EMRA*Cast Episodes

Guests

Sheryl Heron, MD, MDP, FACEP

Assistant Dean of Medical Education and Student Affairs - Emory University
School of Medicine
Vice Chair of Administrative Affairs
Professor of Emergency Medicine
Hospital Affiliation: Emory University

Twitter: @SherylHeron

Overview

On today’s episode, Drs. Agboola and Heron discuss the intricacies of cognitive bias and cultural competency and the roles it plays in the emergency department. They discuss ways that individuals and residency programs alike can approach ensuring that they are rendering more culturally competent care. Additionally, they spend time addressing communities that are at risk for such biases such as undomiciled populations, individuals from lower socioeconomic status, and racial minorities.

Key Resources

EMRA Diversity and Inclusion Committee

Key Points:

  • Cognitive bias, microaggressions and cultural humility should compel us to think more deeply on how we can deconstruct the “-isms”.
  • It is important to create and nurture an environment that allows for open dialogue in a safe space.
  • As a health care provider there are critical steps that need to be taken:
    • Appreciate and understand that we are all different - diversity is a good thing!
    • Be prepared to “call the card” if you experience a discriminatory comment/action. It is important to address it. Do not ignore it.
    • Eliminating bias is not an individual effort; it is institutionally and systemically driven.
    • Patient populations with common negative biases include those with cardiovascular disease, high utilizers/low socioeconomic status, and the incarcerated.
    • There is a large amount of research that demonstrates disparities and inequities in care but more work is still left to be done.

References:

  • Martin ML, Heron SL, Moreno-Walton L, Strickland M. Diversity and Inclusion in Quality Patient Care: Your Story/Our Story: a Case-Based Compendium. Cham: Springer; 2019
  • Dehon E, Weiss N, Jones J, Faulconer W, Hinton E, Sterling S. A Systematic Review of the Impact of Physician Implicit Racial Bias on Clinical Decision Making. Academic Emergency Medicine. 2017;24(8):895-904. doi:10.1111/acem.13214.
  • ACEP Implicit Bias and Cultural Sensitivity Paper