Using Case Study Methodology to Explore the Role of Discrimination in Workplace Incivility

Exclusionary behaviors can be detrimental to the health and well-being of faculty in the workplace. When colleagues are judged by their peers because of the color of their skin, the language they speak, their gender, or who they choose to love (lesbian, gay, bisexual, transgender, asexual, or questioning), affected faculty are left emotionally and physically vulnerable. Institutions of higher learning must set standards of zero tolerance for faculty-to-faculty incivility. With standards taken from each faculty discipline, codes of conduct can be implemented not only at a departmental level, but also throughout the educational system.

Workplace Incivility as Modern Sexual Prejudice

Although discrimination on grounds of sexual orientation is prohibited by law in many countries, negative prejudices against Lesbian and Gay (LG) people, as a stigmatized minority, might be internalized by co-workers, being a source of a modern and subtle form of discrimination. Results from 39 in-depth semi-structured interviews with LG employees show that they are victims of workplace incivility which is manifested through jokes, use of language, stereotypes, and intrusive behaviors. Such acts are barely recognizable as a form of discrimination, due to the absence of any reference to sexual orientation, and for this reason it is more difficult to act against them at an organizational level. This is the first study that demonstrates how workplace incivility toward LG employees can be an expression of a subtle form of discrimination. It shows that discrimination on grounds of sexual orientation has not disappeared; it has simply changed its manifestations. Contributions and implications of the study are discussed from a theoretical and a practical perspective.

'Hidden identities': perceptions of sexual identity in Beijing

This article draws upon responses given by volunteers who work in the Beijing LGBT Centre regarding perceptions of sexual identity, and how Chinese culture affects hidden or open sexual identities of Chinese lesbian and gay people in this region. The insights gained from those working carefully to create social change offers an important and original contribution to the field of gay and lesbian studies in China. The findings indicate the volunteers at the Beijing LGBT Centre are frustrated by the lack of acceptance of non-heterosexual relationships among Chinese culture and society, and by the disregard of lesbian gay and bisexual (LGB) people by the Chinese government. The findings also illustrate stigmatization of homosexuality in China is enacted in structural terms (such as in the lack of policy, legislation and positive endorsement by governmental and socio-political organizations), public expression (such as negative attitudes, beliefs or reactions towards LGB people) and internalized repression (through fear of stigmatization, and subsequent abuse due to negative societal attitudes and discrimination). Influenced by the Chinese tradition of conforming to group values, the findings from this study show that volunteers at the Beijing LGBT Centre believe LGB people in China are generally hesitant to disclose their sexual identities, and reject the idea that there had been a collective shift in Chinese culture regarding increased acceptance of LGB people. It also finds volunteers at the LGBT Centre in Beijing blame Chinese culture for its lack of acceptance of non-heterosexual relationships, and state stigmatization of homosexuality in China is due to deep-rooted cultural homophobia.

The Role of Distal Minority Stress and Internalized Transnegativity in Suicidal Ideation and Nonsuicidal Self-Injury Among Transgender Adults

Transgender people are at elevated risk for nonsuicidal self-injury (NSSI) and suicidal ideation compared to the general population. Transgender (trans) refers to a diverse group of people who experience incongruence between their gender identity and sex assigned at birth. The present study is guided by the minority stress model and the psychological mediation framework, which postulate that sexual minority groups experience elevated stress as a result of anti-minority prejudice, contributing to negative mental health outcomes. This study utilized these theories to investigate the role of internalized transnegativity-internalization of negative societal attitudes about one's trans identity-in the relationships of distal trans stress to suicidal ideation and NSSI. A U.S. national sample of trans adults (N = 237) completed a battery of online measures. Structural equation modeling (SEM) was used to compare models with mediation and moderation effects. Results suggested that internalized transnegativity acts as both a mediator and a moderator in the relationship between distal trans stress and suicidal ideation. Log likelihood comparisons suggested moderation models had the superior fit for these data. Results suggest that clinical interventions should directly target individuals' internalized transnegativity as well as societal-level transnegativity.

Modeling racial disparities in physical health via close relationship functioning: A life course approach

OBJECTIVE

The aim of the present study was to test a life course model in which racial disparities in physical health between Caucasian and African Americans are driven by disparities in close relationship functioning. This model also examined relative evidence for intergenerational transmission of relationship functioning and ongoing exposure to prejudice and discrimination as two pathways that might shape adult relationship functioning.

METHOD

A sample of 523 Caucasian and African American men and women were prospectively tracked from a birth cohort initiated in the 1960s. Reports of parental relationship functioning were obtained from participants and their mothers in adolescence. In midlife, participants completed measures of perceived discrimination (lifetime and everyday discrimination), close relationship functioning (relationship strain and support) and physical health (self-rated health, resting heart rate and systolic blood pressure).

RESULTS

As hypothesized, close relationship functioning was a strong predictor of physical health in adulthood. Furthermore, we observed that perceived discrimination over the life course was linked to impaired relationship functioning. Evidence for intergenerational transmission of relationship functioning was more equivocal.

CONCLUSION

Racial disparities in physical health may be maintained via social factors throughout the life course. Although such factors have sometimes been considered outside the purview of the medical field, it is vital that researchers and clinicians begin to more fully address the implications of social forces in order to remediate racial health disparities.

Community health worker interventions to promote psychosocial outcomes among people living with HIV-A systematic review

Background

Community health worker (CHW) interventions are a successful strategy to promote health among HIV-negative and persons living with HIV (PLWH). Psychosocial factors are critical dimensions of HIV/AIDS care contributing to prognosis of the disease, yet it is unclear how CHW interventions improve psychosocial outcomes in PLWH. The purpose of this study was to critically appraise the types, scope, and nature of CHW interventions designed to address psychosocial outcomes in PLWH.

Methods

We performed database searches—PubMed, EMBASE, CINAHL, and Cochrane—to identify randomized controlled trials published in English before April 2017. Fourteen articles met the eligibility criteria.

Results

Half of the studies were conducted in the United States. Social cognitive theory was used more than once in nine theory-guided studies. CHW interventions were largely focused on reducing depression (n = 6) or stigma related to HIV (n = 4), or promoting quality of life (n = 4), social support (n = 4), and self-efficacy (n = 4). Didactic methods and role-playing were used to train CHWs. CHWs played multiple roles in delivering intervention, including a counselor and a supporter (n = 10), educator (n = 5), or a navigator (n = 3). CHW intervention fidelity was assessed in 4 studies. Five studies found positive changes in six psychosocial outcomes including quality of life (2 of 4) and self-efficacy (2 of 4). CHW interventions had no effect on social support in 2 of 4 studies, and stigma in 3 of 4 studies. None of the CHW interventions were successful in reducing depressive symptoms among PLWH.

Conclusions

Evidence partially supported the use of CHWs in promoting psychosocial outcomes in PLWH. Future CHW intervention should be expanded in scope to address key psychosocial determinants of HIV/AIDS outcomes such as health literacy. Further, fidelity measures should be incorporated into intervention delivery.

Is empathy one of the Big Three? Identifying its role in a dual-process model of ideology and blatant and subtle prejudice

In the field of the social psychology of prejudice, John Duckitt's Dual-Process Cognitive-Motivational Model of Ideology and Prejudice has gained a firm grounding over the past decade and a half, while empathy has become one of the most powerful predictors of prejudice, alongside right-wing authoritarianism and social dominance orientation. This study integrates empathy into the dual-process model, exploring the effects of this variable, along with the impact of personality and ideological attitudes, on prejudice in both its blatant and subtle forms. A cross-sectional research design was used to collect data from 260 university students by self-report measures. Despite its cross-sectional nature, a pattern of causal relationships was hypothesized according to experimental and longitudinal findings from previous studies. The path analysis results show that in the model fitted to the data, empathy does not have any direct impact on prejudice, although it plays a significant role in the prediction of prejudice towards a particular immigrant group. On the other hand, the dual-process model is confirmed in the explanation of blatant prejudice and, in a weaker and indirect way, of subtle prejudice; sustaining the distinctive nature of these constructs on some differential predictors and paths. In the discussion, this study proposes that when ideological and personality-based variables are both included in the model, general empathy is not so robust in the explanation of prejudice, since some of the empathetic components might become diluted among other covariates. But even so, its indirect effectiveness through personality and ideological attitudes remains relevant.

Diagnostic Reasoning and Cognitive Biases of Nurse Practitioners

BACKGROUND

Diagnostic reasoning is often used colloquially to describe the process by which nurse practitioners and physicians come to the correct diagnosis, but a rich definition and description of this process has been lacking in the nursing literature.

METHOD

A literature review was conducted with theoretical sampling seeking conceptual insight into diagnostic reasoning.

RESULTS

Four common themes emerged: Cognitive Biases and Debiasing Strategies, the Dual Process Theory, Diagnostic Error, and Patient Harm. Relevant cognitive biases are discussed, followed by debiasing strategies and application of the dual process theory to reduce diagnostic error and harm.

CONCLUSION

The accuracy of diagnostic reasoning of nurse practitioners may be improved by incorporating these items into nurse practitioner education and practice. [J Nurs Educ. 2018;57(4):203-208.].

Caste matters: perceived discrimination among women in rural India

The aim of this study is to examine the relationship of caste and class with perceived discrimination among pregnant women from rural western India. A cross-sectional survey was administered to 170 pregnant women in rural Gujarat, India, who were enrolled in a longitudinal cohort study. The Everyday Discrimination Scale and the Experiences of Discrimination questionnaires were used to assess perceived discrimination and response to discrimination. Based on self-report caste, women were classified into three categories with increasing historical disadvantage: General, Other Backward Castes (OBC), and Scheduled Caste or Tribes (SC/ST). Socioeconomic class was determined using the standardized Kuppuswamy scale. Regression models for count and binomial data were used to examine association of caste and class with experience of discrimination and response to discrimination. Sixty-eight percent of women experienced discrimination. After adjusting for confounders, there was a consistent trend and association of discrimination with caste but not class. In comparison to General Caste, lower caste (OBC, SC/ST) women were more likely to (1) experience discrimination (OBC OR: 2.2, SC/ST: 4.1; p trend: 0.01); (2) have a greater perceived discrimination score (OBC IRR: 1.3, SC/ST: 1.5; p trend: 0.07); (3) accept discrimination (OBC OR: 6.4, SC/ST: 7.6; p trend: < 0.01); and (4) keep to herself about discrimination (OBC OR: 2.7, SC/ST: 3.6; p trend: 0.04). The differential experience of discrimination by lower caste pregnant women in comparison to upper caste pregnant women and their response to such experiences highlight the importance of studying discrimination to understand the root causes of existing caste-based disparities.

Justifying treatment bias: The legitimizing role of threat perception and immigrant-provider contact in healthcare

OBJECTIVE

Immigrants tend to receive a lower quality of healthcare, which can be a sign of healthcare bias. We examined whether this bias in medical care is associated with a legitimizing process involving two psychosocial factors: threat perception and level of intergroup contact.

METHOD

One hundred eighty six Portuguese health professionals (55.6% clinicians; 44.4% nurses; 78.5% female; Mage = 45.83, range = 23 and 71) completed a questionnaire on prejudiced attitudes toward immigrants, perceptions of health-specific threats, bias in medical practice and level of contact with immigrant patients.

RESULTS

For healthcare providers who have more contact with immigrant patients, the perceived health threat mediated the relationship between prejudiced attitudes and treatment bias. In contrast, for healthcare providers with less contact with immigrant patients, the perceived threat was not associated with treatment bias.

CONCLUSIONS

These findings help to understand the persistence of lower quality medical treatment among immigrants, providing guidelines for future research. In particular, they suggest that perceiving immigrants as a threat to public health is indicative of the providers' engagement in a legitimizing process of self-reported biased treatment, making this engagement necessary only for providers with greater levels of contact with immigrant patients. (PsycINFO Database Record

On the nature of real and perceived bias in the mainstream media

News consumers expect news outlets to be objective and balanced in their reports of events and opinions. However, there is a growing body of evidence of bias in the media caused by underlying political and socio-economic viewpoints. Previous studies have tried to classify the partiality of the media, but there is little work on quantifying it, and less still on the nature of this partiality. The vast amount of content published in social media enables us to quantify the inclination of the press to pre-defined sides of the socio-political spectrum. To describe such tendencies, we use tweets to automatically compute a news outlet’s political and socio-economic orientation. Results show that the media have a measurable bias, and illustrate this by showing the favoritism of Chilean media for the ruling political parties in the country. This favoritism becomes clearer as we empirically observe a shift in the position of the mass media when there is a change in government. Even though relative differences in bias between news outlets can be observed, public awareness of the bias of the media landscape as a whole appears to be limited by the political space defined by the news that we receive as a population. We found that the nature of the bias is reflected in the vocabulary used and the entities mentioned by different news outlets. A survey conducted among news consumers confirms that media bias has an impact on the coverage of controversial topics and that this is perceivable by the general audience. Having a more accurate method to measure and characterize media bias will help readers position outlets in the socio-economic landscape, even when a (sometimes opposite) self-declared position is stated. This will empower readers to better reflect on the content provided by their news outlets of choice.

Exploring the Barriers: A Qualitative Study about the Experiences of Mid-SES Roma Navigating the Spanish Healthcare System

Whereas the topic of the ‘cultural sensitivity’ of healthcare systems has been addressed extensively in the US and the UK, literature on the subject in most European countries, specifically looking at the situation of Roma, is still scarce. Drawing on qualitative research conducted mainly in the city of Barcelona under the communicative approach with Roma subjects who have stable socioeconomic positions and higher cultural capitals (end-users, professionals of the healthcare system, and key informants of a regional policy oriented to the improvement of Roma living conditions), the present study aims to fill this gap. We explore the barriers that the Roma face in accessing the healthcare system, reflecting on how these barriers are accentuated by the existing anti-Roma prejudices and institutional arrangements that do not account for minority cultures. Our results point out a series of obstacles at two levels, in the interaction with healthcare professionals, and in relation to existing institutional arrangements, which prevent Roma families from having equal access to the healthcare system. Education stands up as a mechanism to contest anti-Roma sentiments among healthcare professionals.

The limited prosocial effects of meditation: A systematic review and meta-analysis

Many individuals believe that meditation has the capacity to not only alleviate mental-illness but to improve prosociality. This article systematically reviewed and meta-analysed the effects of meditation interventions on prosociality in randomized controlled trials of healthy adults. Five types of social behaviours were identified: compassion, empathy, aggression, connectedness and prejudice. Although we found a moderate increase in prosociality following meditation, further analysis indicated that this effect was qualified by two factors: type of prosociality and methodological quality. Meditation interventions had an effect on compassion and empathy, but not on aggression, connectedness or prejudice. We further found that compassion levels only increased under two conditions: when the teacher in the meditation intervention was a co-author in the published study; and when the study employed a passive (waiting list) control group but not an active one. Contrary to popular beliefs that meditation will lead to prosocial changes, the results of this meta-analysis showed that the effects of meditation on prosociality were qualified by the type of prosociality and methodological quality of the study. We conclude by highlighting a number of biases and theoretical problems that need addressing to improve quality of research in this area.

What Makes You So Sure? Dogmatism, Fundamentalism, Analytic Thinking, Perspective Taking and Moral Concern in the Religious and Nonreligious

Better understanding the psychological factors related to certainty in one's beliefs (i.e., dogmatism) has important consequences for both individuals and social groups. Generally, beliefs can find support from at least two different routes of information processing: social/moral considerations or analytic/empirical reasoning. Here, we investigate how these two psychological constructs relate to dogmatism in two groups of individuals who preferentially draw on the former or latter sort of information when forming beliefs about the world-religious and nonreligious individuals. Across two studies and their pooled analysis, we provide evidence that although dogmatism is negatively related to analytic reasoning in both groups of individuals, it shares a divergent relationship with measures of moral concern depending on whether one identifies as religious or not. Study 1 showed that increasing levels of dogmatism were positively related to prosocial intentions among the religious and negatively related to empathic concern among the nonreligious. Study 2 replicated and extended these results by showing that perspective taking is negatively related to dogmatism in both groups, an effect which is particularly robust among the nonreligious. Study 2 also showed that religious fundamentalism was positively related to measures of moral concern among the religious. Because the current studies used a content-neutral measure to assess dogmatic certainty in one's beliefs, they have the potential to inform practices for most effectively communicating with and persuading religious and nonreligious individuals to change maladaptive behavior, even when the mode of discourse is unrelated to religious belief.

Individual factors that influence experiences and perceptions of stigma and discrimination towards people with mental illness in Ghana

People with a mental illness often encounter stigma and discrimination from a variety of sources, reinforcing negative self-perceptions and influencing their health and well-being. Even though support systems and attitudes of the general public act as powerful sources of stigma, views and perceptions held by people with mental illness also influence their sensitivity to the experiences they encounter. The aim of the present qualitative study was to examine perceptions of stigma and discrimination and self-stigma in individuals diagnosed with a mental illness. This study adopted a narrative, descriptive method, using a semistructured interview guide to elicit participant perceptions regarding sources of stigma, discrimination, and personal factors that might influence their experiences. Twelve outpatients attending a clinic in Ghana were interviewed. Thematic content analysis was completed and augmented by field notes. Participants' perceptions about personal impacts of stigma were found to be influenced by self-stigma, anticipated stigma and discrimination, perceived discrimination, and their knowledge about their illness. For many participants, their views served to augment societal views, and thus reinforce negative self-perceptions and their future. However, for other participants, their views served as a buffer in the face of environmental situations that reflect stigma and discrimination. Stigma is a complex, socially-sanctioned phenomenon that can seriously affect the health of people with mental illness. As such, it requires coordinated strategies among public policy makers, governmental bodies, and health-care providers to address stigma on a societal level, and to address its potential impacts on broad health outcomes for individuals with mental illness.

Attitudes toward mental illness among Caribbean medical students

BACKGROUND

There are limited empirical data on all matters pertaining to mental illness in the Caribbean but what little there is suggests significant levels of stigmatization exist. In this context, health professionals reveal at least equal to or only slightly improved attitudes to mental illness as compared to the general population. In addition, while there is evidence of improved attitudes among the population at large over the past decade this trend has not been observed among health professionals. This study, therefore, sought to assess medical students' knowledge about and attitudes toward mental illness as they traversed medical school.

METHODS

Preclinical medical students were surveyed and then retested in their final year of training. Students completed a knowledge scale, and the medical conditions regard scale comparing attitudes to four mental illness and three physical illness.

RESULTS

Knowledge about and attitudes toward mental illness showed significant improvement over the 5-year period. However, both preclinical and clinical students revealed significant levels of stigmatization toward mental illness despite improvements in knowledge. Students recognized the need to prioritize treatment for persons with mental illness but did not want to be personally involved in the treatment process.

DISCUSSION

Results highlight that significant negative attitudes still exist among medical students toward mental illness and these persist up until graduation. There is a need for further research into innovations and interventions to address this matter.

Sociocultural and Familial Factors Associated with Weight Bias Internalization

BACKGROUND/AIMS

Sociocultural and familial factors associated with weight bias internalization (WBI) are currently unknown. The present study explored the relationship between interpersonal sources of weight stigma, family weight history, and WBI.

METHODS

Participants with obesity (N = 178, 87.6% female, 71.3% black) completed questionnaires that assessed the frequency with which they experienced weight stigma from various interpersonal sources. Participants also reported the weight status of their family members and completed measures of WBI, depression, and demographics. Participant height and weight were measured to calculate body mass index (BMI).

RESULTS

Linear regression results (controlling for demographics, BMI, and depression) showed that stigmatizing experiences from family and work predicted greater WBI. Experiencing weight stigma at work was associated with WBI above and beyond the effects of other sources of stigma. Participants who reported higher BMIs for their mothers had lower levels of WBI.

CONCLUSION

Experiencing weight stigma from family and at work may heighten WBI, while having a mother with a higher BMI may be a protective factor against WBI. Prospective research is needed to understand WBI's developmental course and identify mechanisms that increase or mitigate its risk.

External motivation to avoid prejudice alters neural responses to targets varying in race and status

Those who are high in external motivation to respond without prejudice (EMS) tend to focus on non-racial attributes when describing others. This fMRI study examined the neural processing of race and an alternative yet stereotypically relevant attribute (viz., socioeconomic status: SES) as a function of the perceiver's EMS. Sixty-one White participants privately formed impressions of Black and White faces ascribed with high or low SES. Analyses focused on regions supporting race- and status-based reward/salience (NAcc), evaluation (VMPFC) and threat/relevance (amygdala). Consistent with previous findings from the literature on status-based evaluation, we observed greater neural responses to high-status (vs low-status) targets in all regions of interest when participants were relatively low in EMS. In contrast, we observed the opposite pattern when participants were relatively high in EMS. Notably, all effects were independent of target race. In summary, White perceivers' race-related motivations similarly altered their neural responses to the SES of Black and White targets. Specifically, the findings suggest that EMS may attenuate the positive value and/or salience of high status in a mixed-race context. Findings are discussed in the context of the stereotypic relationship between race and SES.

A Study of Anti-Fat Bias among Danish General Practitioners and Whether This Bias and General Practitioners' Lifestyle Can Affect Treatment of Tension Headache in Patients with Obesity

OBJECTIVES

The study investigated whether treatment options for episodic tension-type headache vary among general practitioners (GPs) in Denmark depending on the patients' weight status and gender, and whether these decisions can be explained by the GPs' own anti-fat bias and lifestyle.

METHODS

A cross-sectional questionnaire study with responses from 240 GPs on measures of anti-fat bias, healthiness of GPs' lifestyles, and reported patient treatment decisions.

RESULTS

GPs tended to exhibit negative explicit and implicit anti-fat bias. There were no differences in choice of medical treatment for patients with obesity and those of a normal weight. GPs were more likely to advise a general health check to a patient with obesity (p < 0.001). GPs treating a male patient with obesity were less likely to believe that their patient would comply with the advised treatment compared to those with a male patient of normal weight. Compared with other patient types (4.4-7.7%), GPs who treated a male patient with obesity (27.9%) were more likely to advise a general health check only and no diary-keeping or follow-up consultation (p < 0.001). This was explained by the healthiness of the GPs' lifestyles (Spearman's ρ = 0.367; p < 0.01).

CONCLUSION

Despite the presence of clear anti-fat bias, there were no differences in medical treatment, and GPs managed the general health of patients with obesity proactively. The fact that the GPs' own lifestyle influenced the likelihood that they would recommend diary-keeping and follow-up consultations for male patients with obesity is remarkable and requires further investigation.

Can interpersonal contact help improve attitudes toward soldiers with intellectual disability? An Israeli study

BACKGROUND

It has been argued that interpersonal contact is the best intervention for reducing negative attitudes and discrimination toward individuals with intellectual disabilities (ID). In Israel, the Equal in Uniform project makes it possible for individuals with ID to serve alongside soldiers without ID in ordinary military units in the Israeli Defense Forces. The project provided the opportunity to examine the effect of contact on the attitudes of soldiers without ID.

METHODS

Data analyses are based on data collected from 220 soldiers without ID via a self-administered questionnaire based on the Multidimensional Attitudes Scale. Of these, 138 were in contact with soldiers with ID as part of the project.

RESULTS

A mediation model showed that the impact of contact with a soldier with ID on withdrawal behaviour was mediated by cognitive attributions and negative affect. Contact was directly associated with prosocial behaviour.

DISCUSSION

Results support the importance of contact between soldiers with and without ID to bring about improved attitudes toward the former.

Addressing patient biases toward physicians

[Full article available at http://rimed.org/rimedicaljournal-2017-12.asp].

Medical School Factors Associated with Changes in Implicit and Explicit Bias Against Gay and Lesbian People among 3492 Graduating Medical Students

BACKGROUND

Implicit and explicit bias among providers can influence the quality of healthcare. Efforts to address sexual orientation bias in new physicians are hampered by a lack of knowledge of school factors that influence bias among students.

OBJECTIVE

To determine whether medical school curriculum, role modeling, diversity climate, and contact with sexual minorities predict bias among graduating students against gay and lesbian people.

DESIGN

Prospective cohort study.

PARTICIPANTS

A sample of 4732 first-year medical students was recruited from a stratified random sample of 49 US medical schools in the fall of 2010 (81% response; 55% of eligible), of which 94.5% (4473) identified as heterosexual. Seventy-eight percent of baseline respondents (3492) completed a follow-up survey in their final semester (spring 2014).

MAIN MEASURES

Medical school predictors included formal curriculum, role modeling, diversity climate, and contact with sexual minorities. Outcomes were year 4 implicit and explicit bias against gay men and lesbian women, adjusted for bias at year 1.

KEY RESULTS

In multivariate models, lower explicit bias against gay men and lesbian women was associated with more favorable contact with LGBT faculty, residents, students, and patients, and perceived skill and preparedness for providing care to LGBT patients. Greater explicit bias against lesbian women was associated with discrimination reported by sexual minority students (b = 1.43 [0.16, 2.71]; p = 0.03). Lower implicit sexual orientation bias was associated with more frequent contact with LGBT faculty, residents, students, and patients (b = -0.04 [-0.07, -0.01); p = 0.008). Greater implicit bias was associated with more faculty role modeling of discriminatory behavior (b = 0.34 [0.11, 0.57); p = 0.004).

CONCLUSIONS

Medical schools may reduce bias against sexual minority patients by reducing negative role modeling, improving the diversity climate, and improving student preparedness to care for this population.