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

Authors

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

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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