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Acad Med. 2015 May;90(5):645-51. doi: 10.1097/ACM.0000000000000661.

Do Contact and Empathy Mitigate Bias Against Gay and Lesbian People Among Heterosexual First-Year Medical Students? A Report From the Medical Student CHANGE Study.

Author information

1
S.E. Burke is a doctoral candidate, Department of Psychology, Yale University, New Haven, Connecticut. J.F. Dovidio is Carl Iver Hovland Professor, Department of Psychology, Yale School of Public Health, and Center for Interdisciplinary Research on AIDS, Yale University, New Haven, Connecticut. J.M. Przedworski is a doctoral student and National Cancer Institute predoctoral fellow, Division of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota. R.R. Hardeman is research associate, University of Minnesota Department of Medicine, and associated health postdoctoral fellow, Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota. S.P. Perry is assistant professor, Department of Psychological Science, University of Vermont, Burlington, Vermont. S.M. Phelan is assistant professor, Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota. D.B. Nelson is core investigator and senior statistician, Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, and associate professor, Department of Medicine, University of Minnesota, Minneapolis, Minnesota. D.J. Burgess is core investigator, Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, and associate professor, Department of Medicine, University of Minnesota, Minneapolis, Minnesota. M.W. Yeazel is associate professor, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota. M. van Ryn is professor, Health Services Research, Mayo Clinic College of Medicine, and director, Research Program on Equity and Quality of Patient-Provider Encounters, Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota.

Abstract

PURPOSE:

A recent Institute of Medicine report concluded that lesbian and gay individuals face discrimination from health care providers and called for research on provider attitudes. Medical school is a critical juncture for improving future providers' treatment of sexual minorities. This study examined both explicit bias and implicit bias against lesbian women and gay men among first-year medical students, focusing on two predictors of such bias, contact and empathy.

METHOD:

This study included the 4,441 heterosexual first-year medical students who participated in the baseline survey of the Medical Student Cognitive Habits and Growth Evaluation Study, which employed a stratified random sample of 49 U.S. medical schools in fall 2010. The researchers measured explicit attitudes toward gay and lesbian people using feeling thermometer self-assessments, implicit attitudes using the Implicit Association Test, amount and favorability of contact using self-report items, and empathy using subscales of the Interpersonal Reactivity Index.

RESULTS:

Nearly half (45.79%; 956/2,088) of respondents with complete data on both bias measures expressed at least some explicit bias, and most (81.51%; 1,702/2,088) exhibited at least some implicit bias against gay and lesbian individuals. Both amount and favorability of contact predicted positive implicit and explicit attitudes. Both cognitive and emotional empathy predicted positive explicit attitudes, but not implicit attitudes.

CONCLUSIONS:

The prevalence of negative attitudes presents an important challenge for medical education, highlighting the need for more research on possible causes of bias. Findings on contact and empathy point to possible curriculum-based interventions aimed at ensuring high-quality care for sexual minorities.

PMID:
25674910
PMCID:
PMC4414697
DOI:
10.1097/ACM.0000000000000661
[Indexed for MEDLINE]
Free PMC Article

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