Table 3.
Multivariable Relationship Between Medical School Experiences and Change in Student Implicit Racial Bias
| Model 1: Multivariable Relationship Between Participation in Formal Curricula and Change in Student Implicit Racial Bias* | |||
| Training | Coefficient (SE) | Statistical Significance | |
| Took a seminar (course, workshop) on minority health (ref = No) | −2.15 (1.12, −5.41) | 0.198 | |
| Took a seminar (course, workshop) on cultural awareness or competence (ref = No) | 1.74 (−2.13, 5.61) | 0.377 | |
| Completed Race Implicit Associations Test as part of medical school (ref = No) | −4.49 (−1.12, −7.86) | 0.009 | |
| Hours of training devoted to racial disparities in health care | −0.15 (−0.33, 0.04) | 0.114 | |
| Hours of training devoted to identifying cultural customs that might affect care. | 0.05 (−0.15, 0.24) | 0.633 | |
| Hours of training devoted to seeing things from patient’s perspective (cognitive empathy) | −0.05 (−0.16, 0.06) | 0.392 | |
| Self-efficacy regarding providing care for black patients (scale) | −2.38 (−4.62, −0.14) | 0.037 | |
| Model 2: Multivariable Relationship Between Medical School Informal Curricula and Change in Student Implicit Racial Bias1 | |||
| Climate | Coef. (SE) | P Value | |
| Heard attendings or residents make negative comments about black patients (ref = No) | 3.66 (0.90, 6.43) | 0.009 | |
| Learning Orientation to Interracial Interactions Scale | −1.36 (−2.40, −0.32) | 0.01 | |
| Model 3: Multivariable Relationship Between Interracial Contact and Change in Student Implicit Racial Bias1 | |||
| Interracial Contact | Coefficient (SE) | Statistical Significance | Wald P |
| Amount of interaction with black medical students (ref = Substantial) | 0.180 | ||
| None | 8.75 (−0.48, 17.99) | 0.063 | |
| Little | 1.60 (−3.18, 6.37) | 0.512 | |
| Some | −0.76 (−4.65, 3.13) | 0.701 | |
| Amount of interaction with black faculty, attending physicians and/or residents (ref = Substantial) | 0.233 | ||
| None | 7.30 (−3.16, 17.75) | 0.171 | |
| Little | 3.40 (−1.70, 8.50) | 0.191 | |
| Some | 4.21 (−0.11, 8.53) | 0.056 | |
| Favorability of interaction with black faculty, attending physicians and/or residents (ref = Very Favorable) | 0.057 | ||
| Very unfavorable | 3.17 (−18.62, 24.96) | 0.776 | |
| Unfavorable | 17.76 (5.04, 30.49) | 0.006 | |
| Favorable | 1.39 (−2.61, 5.40) | 0.496 | |
| Favorability of interaction with black allied health staff (ref = Very favorable) | 0.083 | ||
| Very unfavorable | 18.10 (3.52, 32.69) | 0.015 | |
| Unfavorable | 3.84 (−3.24, 10.91) | 0.288 | |
| Favorable | 0.83 (−3.22, 4.88) | 0.687 | |
*Adjusted for other factors within the same domain and Y1 implicit bias. Mixed effects models with random intercept across schools. Positive coefficients indicate an increase in implicit racial bias