Implicit Bias and Health Disparities Education in the Neonatal Intensive Care Unit

Nicolle Fernández Dyess; Cara Beth Carr; Stephanie C. Mavis; Catherine G. Caruso; Susan Izatt; Heather French; Rita Dadiz; Elizabeth M. Bonachea; Megan M. Gray

doi:10.1055/a-2240-1979

American Journal of Perinatology, Table of Contents

Am J Perinatol 2024; 41(12): 1634-1644
DOI: 10.1055/a-2240-1979

Original Article

Implicit Bias and Health Disparities Education in the Neonatal Intensive Care Unit

Nicolle Fernández Dyess ‡^*

¹Section of Neonatology, Department of Pediatrics, University of Colorado, Aurora, Colorado

,

Cara Beth Carr‡^*

²Division of Neonatology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

,

Stephanie C. Mavis

³Division of Neonatal Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota

,

Catherine G. Caruso

⁴Division of Neonatology, Department of Pediatrics, Oregon Health and Science University, Portland, Oregon

,

Susan Izatt

⁵Division of Neonatology, Department of Pediatrics, Duke University, Durham, North Carolina

,

Heather French

⁶Division of Neonatology, Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania

,

Rita Dadiz

⁷Division of Neonatology, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York

,

Elizabeth M. Bonachea

⁸Division of Neonatology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio

,

Megan M. Gray

⁹Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington

› Author Affiliations

Abstract

Objective This study aimed to characterize implicit bias (IB) and health disparities (HD) education in neonatal–perinatal medicine (NPM), including current educational opportunities, resources, and barriers.

Study Design A national web-based survey was sent to NPM fellows, neonatologists, and frontline providers after iterative review by education experts from the National Neonatology Curriculum Committee. Quantitative data were analyzed with chi-square and Fisher's exact tests. Qualitative data were evaluated using thematic analysis.

Results Of the 452 NPM survey respondents, most desired additional IB (76%) and HD (83%) education. A greater proportion of neonatologists than fellows received IB (83 vs. 57%) and HD (87 vs. 74%) education. Only 41% of neonatologists reported that their institution requires IB training. A greater proportion of fellows than neonatologists expressed dissatisfaction with the current approaches for IB (51 vs. 25%, p < 0.001) and HD (43 vs. 25%, p = 0.015) education. The leading drivers of dissatisfaction included insufficient time spent on the topics, lack of specificity to NPM, inadequate curricular scope or depth, and lack of local educator expertise. A minority of faculty who were tasked to educate others have received specific educator training on IB (21%) and HD (16%). Thematic analysis of survey free-text responses identified three main themes on the facilitators and barriers to successful IB and HD education: individual, environmental, and curricular design variables.

Conclusion NPM trainees and neonatologists desire tailored, active, and expert-guided IB and HD education. Identified barriers are important to address in developing an effective IB/HD curriculum for the NPM community.

Key Points

There is a gap between the current delivery of IB/HD education and the needs of the NPM community.
NPM trainees and neonatologists desire tailored, active, and expert-guided IB and HD education.
A successful curriculum should be widely accessible, NPM-specific, and include facilitator training.

Keywords

implicit bias - health disparities - neonatal–perinatal medicine - curriculum development

Full Text

References

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