Clinician unconscious bias and its impact on trauma patients

In the effort to understand the persistence of healthcare inequities, even in the high-stakes field of trauma, this chapter examines the personal ethos of the clinicians involved in the care of injured patients. It describes the cognitive and behavioral science basis of unconscious bias or the socially driven automated, implicit preferences for specific racial/ethnic groups. The authors describe how the unique features of trauma care, such as the diverse patient population and the high cognitive load associated with caring for acutely and critically ill patients, can predispose to the formation of unconscious biases. The current literature on the impact of unconscious bias on clinical decision-making in trauma and acute care surgery is reviewed; research has yet to uncover a clear relationship between unconscious bias and clinical decision-making, although there are other causal pathways that have yet to be examined. We conclude by proposing educational and cognitive strategies for reducing surgeons’ unconscious biases, including cross-cultural communication training, that aim to better equip surgeons to care for injured patients from all racial/ethnic and social backgrounds.