Objectives. Evaluate the effectiveness and unintended effects of healthcare worker (HCW) implicit bias training and education interventions on patient safety, health, and healthcare outcomes.
Methods. We followed rapid review processes of the Agency for Healthcare Research and Quality Evidence-based Practice Center Program. We searched PubMed, Embase, CINAHL, PsycINFO, and the Cochrane Library from March 2013 to June 2023, in addition to a narrowly focused search for unpublished reports. We included systematic reviews, randomized controlled trials (RCTs), and observational studies with a comparison group that evaluated HCW implicit bias training and education.
Findings. Six primary studies were included (five RCTs and one pre/post study design). No included primary study evaluated HCW implicit bias training and education specifically, but each reported outcomes of interest for related, indirect interventions. One study evaluated cultural sensitivity training versus no training, two evaluated cultural competency training plus feedback versus feedback only, one evaluated communication skills training versus no training, one three-arm study evaluated education versus education plus cross-cultural communication training versus usual care, and one evaluated a communication skills training pre/post implementation. Although four of the six studies found significant improvement in select secondary HCW-related outcomes of interest after training completion, such as cultural awareness, only the pre/post study on communication skills found a significant impact on patient outcomes. Substantial heterogeneity across studies prevented any strength of evidence conclusions.
Conclusions. Only clinically heterogeneous, indirect evidence of interventions related to implicit bias training were identified for primary outcomes of interest. As no included study evaluated HCW implicit bias training and education specifically, no conclusions could be drawn regarding the impact of the intervention on patient outcomes.
Fricke J, Siddique SM, Aysola J, Cohen ME, Mull NK. Healthcare Worker Implicit Bias Training and Education: A Rapid Evidence Review (Prepared by the ECRI-Penn Medicine AHRQ Evidence-based Practice Center under Contract No. 75Q80120D00003). AHRQ Publication No. 23(24)-EHC019-9. Rockville, MD: Agency for Healthcare Research and Quality. January 2024. DOI: https://doi.org/10.23970/AHRQEPC_MHS4BIAS. Posted final reports are located on the Effective Health Care Program search page.
