The US experiences inequities in health outcomes by demographic factors, such as race and ethnicity. Differential treatment of individuals at the clinical level has been found to owe in part to implicit biases and incorrect information health care workers hold about racial and ethnic groups. In this brief, we demonstrate how implicit biases may contribute to inequities in health outcomes and synthesize findings from 56 studies published between 2000 and 2024 on the impact of implicit bias training among health care professionals and trainees.

Why This Matters

Implicit biases in health care settings can have consequences in numerous areas, including compromising interpersonal communication and clinical decisionmaking, which ultimately affects patient care and can contribute to health care disparities among marginalized populations.

Interest in implicit bias training among health care workers increased after the Institute of Medicine’s 2003 report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, which provided evidence that even after accounting for socioeconomic differences, race and ethnicity remained significant predictors of the quality of health care received. After two decades of research studying unconscious bias, studies have revealed that providers with higher levels of implicit bias toward Black, Hispanic, or American Indian people demonstrate poorer patient-provider communication with those groups. About 5.7 percent of adults reported experiencing unfair treatment in health care settings, with much higher rates reported by patients who are Black, Hispanic, or disabled.

What We Found

We reviewed relevant English-language, scholarly, peer-reviewed journal articles containing primary data from a health care professional or health care trainee population. Ninety-six percent of the 56 selected studies reported an overall positive association of the intervention on trainees’ knowledge, awareness, and skills. Positive outcomes included increases in knowledge, skills, and attitudes around implicit bias; increased confidence in recognizing personal implicit biases; increased awareness of personal biases; and improved ability to identify and manage one’s potential biases regarding patients.

Our results align with previous studies, demonstrating that learners had an overall positive experience engaging with the material on implicit bias. However, many studies had methodological shortcomings, and only a few were designed to assess the impacts on patient interactions and care. In summary, research in this area can be strengthened by (1) conducting follow-up evaluations at timed intervals to assess retention of skills, (2) using repeated interventions to assess for compounded impact, (3) considering confounding factors that can affect bias at the individual level, and (4) testing the impact of implicit bias training on patient care and clinical outcomes.

How We Did It

Our initial search yielded 4,405 articles published between 2000 and 2024. We then applied a filter for “bias” to be included in either the title or abstract, which yielded 714 abstracts and titles. We used the filter “bias” to capture both “unconscious bias” and “implicit bias.” From there, 162 abstracts fit our inclusion criteria, and we then conducted a final round of reviews for full-text screening. We selected 57 studies for final review for this brief.