Explicit and implicit racial attitudes among clinicians, educators, and students in orthotics and prosthetics.

Abstract

Background: Racial health disparities are well documented in the United States. Implicit and explicit racial preferences can negatively affect patient-clinician communication and relationships and contribute to racial health disparities.

Objectives: To examine the implicit and explicit racial attitudes in orthotics and prosthetics.

Study design: Cross-sectional survey.

Methods: An online survey including the Race Attitudes Implicit Association Test was administered to a volunteer sample of clinicians, residents, students, and educators. Survey questions related to demographics, roles within orthotics and prosthetics, explicit racial preferences, and implicit racial bias. Implicit racial bias scores and group means were calculated. Group-level comparisons were made by role, gender, and race/ethnicity. Results were categorized using the 2-dimensional model of prejudice of Son Hing et al.

Results: The survey was completed by 454 participants (clinicians/residents: 294; students: 136; and educators: 24). Most participants reported no explicit racial preference; however, implicit racial preference was similar to that of the general US population. The majority of participants were aversive racists (low explicit, high implicit; pro-White n = 201; pro-Black n = 29), with the next largest group being truly low prejudice (low explicit, low implicit; n = 206). Implicit racial bias was lowest among Black individuals with slight preference for Black people on average.

Conclusion: Implicit racial bias in the orthotic and prosthetic community is similar to the general US population and does not differ by role. Efforts to elucidate, examine, and interrupt implicit racial bias are needed in orthotics and prosthetics to prevent common racial attitudes from negatively influencing patient outcomes.