Impact of Implicit Bias Course Gives Nurses New Perspectives

Healthcare works in blue scribs.

"What drives me specifically in the space of diversity, equity, and inclusion is recognizing how important it is for us to have these conversations in a safe space," explains Yolanda Brown-Spidell, the primary facilitator and creator of the course content for the Impact of Implicit Bias course at EMU PPAT.

Taught virtually, Brown-Spidell's course is designed to define implicit bias and create discussions around how implicit biases can adversely impact the way in which healthcare services are provided to clients, as well as provide strategies to ameliorate the adverse effects of inequitable access to healthcare.

Origin of Implicit Bias

The term implicit bias was coined by psychologists Mahzarin Banaji and Anthony Greenwald in 1995 in their article Implicit social cognition: Attitudes, self-esteem, and stereotypes, which brought to light the idea that stereotypes can unconsciously affect how we treat one another.

Addressing implicit biases in healthcare is particularly imperative, as certain biases can directly impact the quality of healthcare being administered to certain demographics.

Studies have found disparities in healthcare stemming from biases related to gender, weight, race, and more. These can include scenarios where male healthcare staff are mistaken for doctors — despite the presence of a female leader, doctors demonstrating weight biases on the Implicit Association Test, and maternal and perinatal mortality in pregnancy being three to five times higher in Black women compared with White women.

While discussing the idea that most people harbor unconscious biases can be uncomfortable, Brown-Spidell is creating an environment that's about uncovering where these biases come from, rather than emphasizing and continuing a cycle of negativity.

"I built this class from a place of no guilt, no shame, we're not fighting. These are conversations," says Brown-Spidell. "You're not coming into a space to have someone beat you up and tell you how much of a bad human you are. It's to come into a space and to hear how our history, particularly in American society, is impacting the way in which we see each other."

For Brown-Spidell, Implicit Bias is Personal


Brown-Spidell's own family history has led her to become a leader in Implicit Bias Education. Being the daughter of two Black parents who graduated from a Black-only high school (historically known as a segregated high school in the South), she became a first-generation college graduate. Her greatest accomplishment is her five children, four of whom are currently in college, and her youngest daughter is completing her college applications.

The Impact of Implicit Bias course is taught virtually and students will see Brown-Spidell's office adorned with reminders of her family's history, as she teaches the history that has shaped our healthcare.

"This speaks to how I'm not here by myself."

Brown-Spidell's family and her desire to help others were two of her biggest inspirations to create the Impact of Implicit Bias course.

"I had the privilege of walking my mother and my father through the time of their illnesses to the time of their death. But I had some experiences and my parents had some experiences because they were African American, that really concerned me. If I wasn't such an advocate for them, I'd be very concerned about what that experience would have been for them. So this is professional but it's also personal."

Brown-Spidell's experience in her personal life, as well as her professional life as an educator, helped shape the content of the Impact of Implicit Bias Course

"70 to 80% of our teachers in the American education system are white middle-class women," Brown-Spidell shares. "The data shows that it is children who are either impoverished, and the majority of those children are children of color, who are dealing with suspensions, who are dropping out, and who are failing. Because I have a background in sociology and psychology, this really intrigues me."

"As an alternative education educator, I was successful. So what the data was saying and what my experiences with students were, it wasn't gelling. Then I ran across the idea of the school-to-prison pipeline, how people are being tracked, and how institutions are set to fail certain groups of people."

According to the American Civil Liberties Union, Black youth are incarcerated at five times the rate white youth are. Rather than supporting or providing resources for impoverished children, they are criminalized for minor school infractions, which eventually leads to them being pushed out of school and toward the criminal legal system.

"I said somebody needs to put language to this where people are not feeling guilty or beat up," says Brown-Spidell. "Nobody wants to come into a space and have you beat me up, right? Especially when you paid to be here! As my father would say, it was like putting a rabbit in the briar patch. Teaching something that I have the knowledge of, to make the connections historically, to what we're dealing with contemporarily, because people want to know why are we like we are. We didn't just wake up and this is what we had. We woke up, and this is what we inherited."

Impact of Implicit Bias Course

Thanks to her experience in the alternative education space, work in the implicit bias space, and social work— Trinity Health and Eastern Michigan University reached out to Brown-Spidell to begin creating a course for EMU PPAT, which has now become the Impact of Implicit Bias course.

The course has been offered at EMU since 2022, and Brown-Spidell is excited to continue to create an environment where people feel comfortable discussing biases and content that widens perspectives.

"I do a piece in the class called Confessions of Your Facilitator. I'm asking for people to get vulnerable, but I want you to know that as long as I've been teaching this and as long as I've been living, there's work that I still have to be conscious of to do myself."

We can all work on our own biases, and the class is primarily focused on addressing biases held by practitioners, but the class also touches on the patient's perspective and biases.

"We address how patients have biases that impact their compliance with what the medical practitioners are trying to get them to do," Brown-Spidell explains.

Brown-Spidell also walks through her experiences as a patient in the American healthcare system, which allows students to feel comfortable sharing their experiences.

"What I believe to be true is people who come into this space with me, walk away being better humans — even if your mind isn't changed, at least your thoughts were challenged. I'm not looking for people to say — boom, I'm a new creation. That's just not how growth happens."

"But one of the greatest benefits, outside of that credit you need for your license," laughs Brown-Spidell. "Is that you walk away having heard different perspectives, on something that you're doing, that you love, that's every day in your life. You walk away with a different perspective on humanity."

The Impact of Implicit Bias course has been approved for two Nursing CEUs and should meet initial licensure and renewal licensure requirements in the State of Michigan. Register for the two-hour virtual course today.