Flashback Friday: Cultural Competency and Cognitive Bias

Host: Dr. Isaac Agboola, MD, MS Guest: Dr. Sheryl Heron, MD, MDP, FACEP Assistant Dean of Medical Education and Student Affairs at Emory University School of Medicine  Vice Chair of Administrative Affairs Professor of Emergency Medicine OverviewDrs. Agboola and Heron discuss the intricacies of cognitive bias and cultural competency and the role it plays in the emergency department. They discuss ways that individuals and residency programs alike can ensure they are rendering more culturally competent care - and model that for medical trainees. Additionally, they spend time addressing communities at risk for such biases such as undomiciled populations, individuals from lower socioeconomic status, and racial minorities. Key Resources EMRA Diversity and Inclusion Committee  Implicit Bias: What Can We Do? Implicit Bias and ED Overcrowding Key Points Cognitive bias, microaggressions and cultural humility should compel us to think more deeply on how we can deconstruct the "-isms". It is important to create and nurture an environment that allows for open dialogue in a safe space.  As a health care provider there are critical steps that need to be taken:  Appreciate and understand that we are all different - diversity is a good thing! Be prepared to "call the card" if you experience a discriminatory comment/action. It is important to address it. Do not ignore it.  Eliminating bias is not an individual effort; it is institutionally and systemically driven. Patient populations with common negative biases include those with cardiovascular disease, high utilizers/low socioeconomic status, and the incarcerated. There is a large amount of research that demonstrates disparities and inequities in care but more work is still left to be done. References Martin ML, Heron SL, Moreno-Walton L, Strickland M. Diversity and Inclusion in Quality Patient Care: Your Story/Our Story: a Case-Based Compendium. Cham: Springer; 2019 Dehon E, Weiss N, Jones J, Faulconer W, Hinton E, Sterling S. A Systematic Review of the Impact of Physician Implicit Racial Bias on Clinical Decision Making. Academic Emergency Medicine. 2017;24(8):895-904. doi:10.1111/acem.13214. ACEP Implicit Bias and Cultural Sensitivity Paper