Teaching resident physicians the power of implicit bias and how it impacts patient care utilizing patients who have experienced incarceration as a model

Abstract

Over 2 million adults in the United States are incarcerated and over 650,000 return to the community each year. This disparate population is known to have an elevated burden of chronic disease and lower socioeconomic status. Medical residency training about care of incarcerated or previously incarcerated patients is significantly lacking in the United States. Curriculum can be developed and implemented in residency programs to help physicians learn how to work with this population, be sensitive to their unique needs, and achieve positive health outcomes. This article describes a method for “educating the educators” based on a workshop presented at a peer-reviewed national conference during the fall of 2016. Attendees participated in exercises addressing assumptions, expectations, bias, and worldview and increased their ability for self-reflection when interacting with patients who are or have experienced incarceration. In this session, strategies were identified that engaged the patient with the goal to aid in patient retention and compliance. Future steps include development of a formal curriculum for training in this area, incorporation into existing community medicine rotations or electives, and establishment of structured transition clinics where residents can be exposed to this population on a more regular basis and improve their overall health outcomes.