Psychosocial Final 1

RESPECT model, Bias in Healthcare

What does RESPECT stand for in the model of cross-cultural communication?

rapport, empathy, support, partnership, explanations, cultural competence, and trust

what does rapport mean in the RESPECT model?

connect on a social level, seek the patient’s POV, consciously attempt to suspend judgement, and recognize and avoid making assumptions

what does partnership mean in the RESPECT model?

be flexible regarding issues of control, negotiate roles when necessary, and stress that you will be working together to address medical problems

what part of the RESPECT model describes asking about and trying to understand barriers to care and compliance, helping the patient overcome barriers, involving family members if appropriate, and reassuring the patient you are and will be available to help?

support

What are the 5th and 6th rules for redesign in healthcare?

(5) decision making is based on evidence and (6) system is safe

T/F: According to Berner and Graber, 10-15% of diagnoses are incorrect

true

25-59% of malpractice claims are attributable to what?

diagnostic errors

T/F: In the Van Such et al article, cases that had the wrong diagnosis had higher healthcare cost

true

what are the conditions most likely to be misdiagnosed in emergency departments?

CVA, MI, SCI, AAA, DVT

a systematic review found a link between diagnostic errors and what?

cognitive biases

according to the bar graph in the “bias in healthcare” slides, what accounts for most treatment errors?

adverse drug events (pressure ulcers is #2)

T/F: the physicians were the ones catching the treatment errors, not nurses, techs and other healthcare staff

false!

Which state is doing the worst with treatment errors?

US

what is the example Dannecker gave about biases with imaging?

history of ordering low-value imaging was correlated with ownership of imaging equipment; bill was passed so physicians were not allowed to own imaging equipment

what is the example Dannecker gave about biases in forensic pathology decisions?

forensic pathologists were more likely to rule “homicide” rather than “accident” for deaths of black children compared to white children; the caregiver and race of the child influenced bias

In the Phelan et al article, weight bias was predicted by what 3 factors?

lower BMI, male biological sex, and non-African American race

T/F: HCPs communicate differently with patients whom they respect less and HCPs respect obese patients less than non-obese patients

true

what is a preference for a social category that operates outside of awareness?

implicit bias

what is conscious preference (positive or negative) for a social category?

explicit bias

which type of biases is more common?

implicit

what are the “seeds of bias”

similarity, expedience, experience, distance, and safety

what is expedience?

one of the seeds of bias that means “If it feels right, it must be true”

what are key takeaways from the recording about the D-Day invasion?

Germans had bias! They didn’t want the Americans treating them. When medics went out on the field, the shooting stopped. Mitigation strategy of acceptance was employed by the medics.

what are the types of cognitive mitigation strategies?

understand and respect the tremendous influence of unconscious bias, perspective taking, counter stereotype imaging, individuation, and partnership building

“being thin can be unhealthy”is an example of what cognitive mitigation strategy?

counter stereotype imaging

Instead of using traditional patient classifications to identify patients focus on a common identity that you have with that person

individuation

Thinking about “win win” opportunities and shared goals is an example of which cognitive mitigation strategy?

partnership building

what are the behavioral mitigation strategies?

increase your contact with individuals from different groups and stereotype replacement

spending time with med students would be an example of which behavioral mitigation strategy?

increase your contact with individuals from different groups

patients prefer when health professionals refer to their “weight” rather than using the words like “obesity”

stereotype replacement