Table 4.
Associations between ethnic bias measures (implicit and explicit) and student diagnosis and treatment in vignettes by patient ethnicity
| Cardiovascular disease vignette | Patient Described as: | Difference in | ||||
| Vignette question | NZ European | Māori | slope (NZE-Māori) | p-value | ||
| -bias measure | n | slope (95% CI) | n | slope (95% CI) | (95% CI) | |
| Please assess the likelihood that Mr. [Wiremu’s/Williams’] pain is due to coronary artery diseasea | ||||||
| -IAT ethnicity preference | 95 | −0.11 (− 0.63, 0.41) | 103 | − 0.15 (− 0.63, 0.32) | 0.04 (− 0.66, 0.75) | 0.906 |
| -IAT ethnicity and compliant patient | 75 | 0.17 (− 0.57, 0.91) | 69 | 0.02 (− 0.67, 0.72) | 0.15 (− 0.87, 1.16) | 0.777 |
| -explicit ethnic preference | 118 | 0.03 (−0.23, 0.30) | 115 | − 0.08 (− 0.34, 0.18) | 0.12 (− 0.26, 0.49) | 0.539 |
| -explicit ethnic warmth difference | 118 | 0.01 (− 0.18, 0.19) | 115 | 0.11 (−0.08, 0.30) | − 0.10 (− 0.37, 0.17) | 0.456 |
| Using the information available, what would your recommendation be regarding thrombolysis for Mr. [Wiremu/Williams] when you discuss this case with your consultant?b | ||||||
| -IAT ethnicity preference | 95 | 0.56 (0.10, 1.03) | 103 | −0.23 (− 0.65, 0.19) | 0.79 (0.17, 1.42) | 0.013 |
| -IAT ethnicity and compliant patient | 75 | 0.68 (0.00, 1.35) | 69 | −0.09 (− 0.72, 0.54) | 0.77 (− 0.16, 1.69) | 0.104 |
| -explicit ethnic preference | 118 | −0.03 (− 0.28, 0.21) | 115 | − 0.28 (− 0.52, − 0.03) | 0.24 (− 0.11, 0.59) | 0.173 |
| -explicit ethnic warmth difference | 118 | 0.08 (− 0.09, 0.26) | 115 | −0.12 (− 0.30, 0.06) | 0.20 (− 0.05, 0.45) | 0.120 |
| If Mr. [Wiremu/Williams] refuses thrombolysis, how would you describe your subsequent management regarding thrombolysis?c | ||||||
| -IAT ethnicity preference | 95 | 0.39 (−0.06, 0.84) | 103 | 0.41 (0.00, 0.82) | −0.02 (− 0.63, 0.59) | 0.946 |
| -IAT ethnicity and compliant patient | 75 | 0.47 (−0.15, 1.08) | 69 | 0.27 (−0.31, 0.84) | 0.20 (−0.64, 1.05) | 0.634 |
| -explicit ethnic preference | 118 | 0.09 (−0.15, 0.32) | 115 | −0.04 (− 0.28, 0.19) | 0.13 (− 0.20, 0.46) | 0.438 |
| -explicit ethnic warmth difference | 118 | 0.07 (−0.10, 0.23) | 115 | −0.07 (− 0.24, 0.10) | 0.13 (− 0.11, 0.37) | 0.277 |
| Depression vignette | Patient described as: | Difference in | ||||
| Vignette question | NZ European | Māori | slope (NZE-Māori) | p-value | ||
| -bias measure | n | slope (95% CI) | n | slope (95% CI) | (95% CI) | |
| Please assess the likelihood that Mr. [Tipene/Stephens’s] symptoms are due to depressiona | ||||||
| -IAT ethnicity preference | 105 | 0.00 (− 0.33, 0.33) | 93 | −0.25 (− 0.60, 0.10) | 0.25 (− 0.24, 0.73) | 0.316 |
| -IAT ethnicity and compliant patient | 71 | −0.09 (− 0.60, 0.42) | 73 | 0.00 (− 0.53, 0.53) | −0.09 (− 0.83, 0.64) | 0.801 |
| -explicit ethnic preference | 122 | −0.02 (− 0.21, 0.17) | 111 | 0.02 (− 0.17, 0.20) | −0.04 (− 0.30, 0.22) | 0.768 |
| -explicit ethnic warmth difference | 122 | 0.06 (−0.09, 0.21) | 111 | 0.03 (−0.09, 0.15) | 0.03 (−0.16, 0.22) | 0.754 |
| Based on the information you have, how would you rate the severity of Mr. [Tipene/Stephens’s] symptoms?d | ||||||
| -IAT ethnicity preference | 105 | 0.14 (−0.08, 0.35) | 93 | −0.05 (− 0.28, 0.18) | 0.18 (− 0.13, 0.50) | 0.257 |
| -IAT ethnicity and compliant patient | 71 | 0.07 (−0.24, 0.38) | 73 | −0.21 (− 0.53, 0.11) | 0.28 (− 0.16, 0.72) | 0.212 |
| -explicit ethnic preference | 122 | −0.01 (− 0.13, 0.11) | 111 | − 0.07 (− 0.19, 0.04) | 0.06 (− 0.10, 0.23) | 0.466 |
| -explicit ethnic warmth difference | 122 | − 0.03 (− 0.12, 0.07) | 111 | 0.05 (− 0.03, 0.12) | −0.07 (− 0.20, 0.05) | 0.236 |
| Please rate the likelihood that Mr. [Tipene/Stephens] will benefit from your selected initial management approache | ||||||
| -IAT ethnicity preference | 105 | 0.04 (−0.31, 0.40) | 93 | −0.02 (− 0.40, 0.36) | 0.06 (− 0.46, 0.59) | 0.811 |
| -IAT ethnicity and compliant patient | 71 | −0.17 (− 0.69, 0.35) | 73 | 0.20 (− 0.34, 0.73) | −0.37 (− 1.11, 0.38) | 0.330 |
| -explicit ethnic preference | 122 | 0.36 (0.17, 0.54) | 111 | 0.02 (−0.16, 0.20) | 0.34 (0.08, 0.60) | 0.011 |
| -explicit ethnic warmth difference | 122 | −0.19 (− 0.34, − 0.04) | 111 | −0.08 (− 0.20, 0.04) | −0.11 (− 0.30, 0.09) | 0.285 |
aResponse options (1 = very unlikely (< 20%), 2 = somewhat unlikely (20–40%), 3 = as likely as not (41–59%), 4 = somewhat likely (60–80%), 5 = very likely (> 80%))
bResponse options reverse scored so (1 = would definitely NOT recommend thrombolysis, 2 = would probably NOT recommend thrombolysis, 3 = not sure, 4 = would probably recommend thrombolysis, 5 = would definitely recommend thrombolysis)
cResponse options (1 = I would not try to persuade him any further to 5 = I would try very hard to persuade him)
dResponse options (1 = none-slight, 2 = mild, 3 = moderate, 4 = severe)
eResponse options (1 = very unlikely, 2 = somewhat unlikely, 3 = as likely as not, 4 = somewhat likely, 5 = very likely)