Disrupting Implicit Bias in Dental Clinical Decision-Making and Mitigating Its Effect on the Dentist-Scientist Workforce Pathway

PROJECT SUMMARY Bias is a significant contributor to health disparities and health inequities; and rises to the level of a public health problem. Research has consistently shown that implicit bias effects the healthcare system, resulting in differential outcomes: medical treatment care quality; patient-provider communication; and trust in the medical system. Significant research has explored the impact that implicit bias has in medical settings, with studies focused on physicians and nurses. There is, however, a gap in the evidence-base regarding oral health and dentists. Understanding the role that implicit bias plays in clinical dentistry—both in clinician decision-making and in the recruitment/ retention of the oral health workforce—is essential to advancing health equity and closing the gap in health disparities. This project’s objectives are to (1) assess the multi-level impact of implicit bias on oral healthcare: clinician decision-making and the recruitment/retention of a diverse, oral health research workforce; (2) to mitigate the impact of implicit bias and advance oral health equity through the implementation of implicit bias interventions for dentists and psychosocial support for underrepresented trainees. This project is a combination of research approaches and Diversity, Equity, Inclusion and Accessibility (DEIA) activities. The specific aims are to 1) determine the prevalence and impact of treatment planning bias in a national sample of dentists; 2) identify and describe critical facilitators and barriers to effective implicit bias training among dentists; and 3) demonstrate the effects of psychosocial barriers, including implicit bias, on the recruitment of underrepresented groups to the dentist and oral health research workforce. In this mixed methods approach of observational and interventional research design, rigor and reproducibility comes from randomization of dentists to clinical vignettes of Black and white patients and time- sequenced analysis of the impact of implicit bias training. Focus groups with underrepresented undergraduate students participating in research pathway programs at dental schools will provide data to identify critical facilitators and barriers to the recruitment and retention of an oral health workforce that is representative of the U.S. population.