About this document

Equity and Anti-Racism in Global Healthcare Journal Entries 1

At key moments in the Bodyswaps experience, useful notes are added to the learner’s virtual journal as a memory prompt that they can refer back to, as and when required.

In VR, learners access their journal by looking at their avatar’s left hand. On other devices, it can be accessed via a ‘burger menu’ in the top left corner of the screen.

This document collates the journal entries in relation to the individual activities for this course.

Introduction

Equity & Anti-Racism in Global Healthcare

Objective

Explore the impact of implicit bias on global healthcare

Goals

Identify implicit bias
Recognize the impact of implicit bias on patient outcomes
Practice strategies to mitigate personal bias
Navigate difficult but important conversations about bias

Topic 1: Identifying implicit bias

Good intentions with unintended consequences

Weighing up the good with the bad

While global healthcare initiatives can have a positive impact, they can also have unintended consequences.

Perpetuating colonial dynamics

Well-meaning heroism perpetuates notions that the ‘natural order’ of things is for ‘primitive people’ in resource-poor countries to rely on ‘superior’, resource-rich countries for aid. In reality, such reliance is brought about by global inequities, not lack of ability.

Subjugating local expertise

Global healthcare provision is often given on our own terms. The knowledge of local, often more experienced, doctors can be dismissed or overruled by visiting clinicians keen to share their knowledge and ‘more advanced’ ways - undermining their greater expertise on the local spectrum of diseases and effective treatments.

The right care, the right way

To ensure that your visit has a positive impact, it’s important to exercise cultural humility to learn more about the countries we visit and provide the right care, in the right way. This involves looking at the bigger picture; considering both your own culture and the culture in the country you’re visiting, and where they fit into a world that’s full of inequalities.

Topic 2: Camila’s consultation

Common types of biased behaviour

Exhibiting bias about poverty
Assuming patients have low intelligence
Lack of cultural humility
Speaking to the interpreter
Speaking loudly to patients where there is a language barrier
Disparaging local medical practices
Assuming patients have limited capability
Giving an inappropriate diagnosis based on bias

Topic 3: Identify and challenge your own bias

Strategies for identifying and challenging bias

Step 1 - REFLECT - when have I acted with bias in a patient interview?
Step 2 – STOP – was I thinking fast or slow?
Step 3 – SWITCH – try to see it from the other person’s perspective
Step 4 – CHALLENGE – attributes or situation
Step 5 – COUNTER – say something that contradicts your bias

Implicit Association Test

The Implicit Association Test (IAT) was created by Project Implicit.

It measures attitudes and beliefs that people may be unwilling or unable to say out loud. The IAT may be especially interesting if it shows that you have an implicit attitude that you didn’t know about.

For example, you may believe that women and men should be equally associated with science, but your automatic associations could show that you (like many others) associate men with science more than you associate women with science.

Implicit Association Test

Topic 4: Challenging bias in others

Helping others to recognise and challenge their own bias

Gain trust – speak their name, make gentle eye contact
Withhold judgment – “I know you don’t mean to offend, but…”
Mirror – “When you said…”
Challenge – “Your meaning could be interpreted as…”
Reposition – “How would you feel if someone suggested that…”