Types of Bias

by Angela Richard-Eaglin, DNP, MSN, FNP-BC, CNE, FAANP, CDE

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    00:06 So what is bias? You see, there are intentional or unintentional assumptions and those influence how we think about our attitudes, behaviors, towards other people.

    00:17 And those biases are based on our lived experiences and how we're conditioned.

    00:21 Remember, we talked about cultural influences.

    00:25 Whatever those are, those determine what type of human we are at this point in our lives, but then we talked about when you know better, do better from that Maya Angelou quote.

    00:37 So, we get to where we are based on the things we were exposed to.

    00:43 So, if all I know is what's inside my box and now I have the opportunity to look outside my box, I need to do what I can do. I can read, so I need to look up things that are factual.

    00:55 And we'll talk later on in this series about making sure that whatever we read is a fact and that we use our intellectual capacity to make accurate judgments.

    01:07 Because bias, whether it is intentional or unintentional, it results in this unfair and inaccurate judgments about people.

    01:16 We overlook talent, we discriminate against people, and in terms of health, it converts into poor detrimental health outcomes and continues to perpetuate these health disparities that nothing has changed over these, what is it, 30, 40 something years with the healthy people that's taught it 2010, now we're up to 2030 and I really do, highly encourage you, to look at that and see how those goals and how these action items we took in the past which weren't accurately done, mostly because it wasn't in partnership but see how there's been minimal to no change.

    01:53 So let's talk about some specific types of bias.

    01:57 Affinity bias is when you unconsciously prefer people who have the same qualities with you as somebody you really like.

    02:06 Now, we're all human, so of course, we all have a certain degree of affinity bias and that's not bad in isolation.

    02:13 It's only bad, you're going to hear me say this like a broken record; if you use that bias to advantage someone unfairly or disadvantage someone unfairly, so the keyword is if it's unearned on either side, then we need to stop and take a look at it and evaluate it from a more objective perspective.

    02:32 Attribution bias is another common one and which is we're going through the most common.

    02:37 And it's how you perceive your actions and those of others.

    02:41 So I'm going to attribute something based on whatever is in the back of my mind, whatever I was taught, inaccurate or not, myth, that I'm right and they're wrong.

    02:50 So I'm perceiving my preference right as what's right, somebody else's is wrong.

    02:56 So and I'm going to attribute my own preferences onto someone else.

    03:01 Beauty bias. Unconscious preference for people we view as attractive.

    03:06 So, when- a lot of times this shows up in searches for employees.

    03:13 And so two people, maybe equally qualified, but I think someone else is more attractive than the other person and I may hire that person just because I think they're more attractive not necessarily based on qualifications.

    03:27 So being aware of that as well.

    03:29 Conformity bias. This is one of those things when we talked about bias standards and up-standards that you have to be really conscious of because some of us and maybe we've done it and it may not be who you always are, how you always choose, but sometimes we're swayed too much by other people's opinions and views.

    03:49 So you come into it with your own, but then, you are persuaded to start thinking of something else and that can happen. If you're the only person in the group that's thinking one way and everybody else is thinking another way of doing something, and you buy into that, that's conformity bias.

    04:05 You're conforming to what the majority is saying, so be very careful of that.

    04:10 Confirmation bias. This is another very common thing.

    04:15 So you form an opinion about somebody based on whatever the reason is.

    04:20 It could be you had a negative interaction the first time you met them and you let that cloud everything.

    04:26 You're not willing to look deeper and see, wait a minute, maybe that's not who this person are, is, rather.

    04:32 Instead, what you're looking for is something to confirm that this person is bad.

    04:37 They said a curse word this time, oh, my, god, they are horrible, potty-mouth person.

    04:42 Something could have happened then that slipped, but my point is, you don't want to look for some way to validate whatever it is you're feeling about a person even if it's good, because it happens in terms of good too.

    04:53 Oh, they're a great person, well, great people make mistakes, right? We're all human. Like I would say that a lot throughout this series, too.

    05:02 So, just look at the context and have a conversation and look for clarity so that before you make a judgment, so that, you can be more accurate in terms of your interpretation of someone, and that usually involves having a conversation in seeking clarification for whatever it is.

    05:20 So another type of bias is contrast effect.

    05:26 And that happens when you assess two or more similar things and compare them with each other versus looking at each one of those based on their own merits.

    05:35 We could think about that if we - I don't know, I'll just pick - I'll go with gender now.

    05:39 So, let's think about all men are XYZ, all women are XYZ.

    05:44 Because they share the same gender, it doesn't mean that the thought processes and the actions are the same.

    05:52 So we need to look at each individual and judge them based on their own merits.

    05:57 Gender bias, we obviously know that that's preferring one gender over the other, that will get you into trouble. Again, we're thinking about qualifications and merit.

    06:07 The Halo effect is so common. It's when you focus on one great thing about a person.

    06:14 So the person could be really, really, consistently bad, but then they did this one great thing and because of that I'm going to excuse all the bad behavior.

    06:26 No, absolutely not. We need to focus on as a whole, what's happening, and then situational too, because if a person is usually great, it doesn't mean that they're not human.

    06:39 They're going to make a mistake it doesn't make them not great.

    06:42 They're still a great person, but that great person made a mistake and I don't want to minimize or invalidate the fact that that mistake may have caused harm to someone else.

    06:53 The Horns effect is the opposite of the Halo effect. So, same thing.

    06:57 The person does one negative thing, then we want to say, oh, they're horrible.

    07:03 Just overall, in general, this person is a horrible human being.

    07:07 We don't think about why they may have done that one thing, we just label that person as a horrible person. Well, absolutely, not.

    07:15 It was just that particular situation and again, you always want to try to dig deeper and find out what happened.

    07:21 Especially in those situations where we developed these negative opinions about people.

    07:26 Typically, behaviors are manifestations of something deeper.

    07:30 So we always, especially, as healthcare providers, want to dig down and try to figure out what was it.

    07:37 And when you're in a leadership role, what caused this situation to happen versus rather labeling a person, we want to talk about the issue and how we can resolve the issue.

    07:48 Bias is one of those things that has so many [core layers 07:47] and they impact so many different things so I think about it in terms of a funnel.

    07:58 We have bias up here and out of bias, multiple different things are born.

    08:03 And we'll talk about these individually but marginalizing and stereotyping people is one of the things that happens as a result of bias.

    08:13 And then once we marginalized people and put them in the less than category with other people and we stereotype people, then oftentimes, remember, I just talked about those manifested behaviors in the form of micro and macroaggressions.

    08:28 Sometimes in the middle but definitely subtle or just outright macroaggressions.

    08:33 We stigmatize people based on these biased beliefs we have and then as a result our actions turn into inequities across the board, not just in health, but inequity period and in equality and all of those result in negative outcomes, that's what the inflow, if we're looking at what's filtering through that funnel, negative outcomes is what we get from all of that which is why we should care.

    About the Lecture

    The lecture Types of Bias by Angela Richard-Eaglin, DNP, MSN, FNP-BC, CNE, FAANP, CDE is from the course Bias in Healthcare.

    Author of lecture Types of Bias

     Angela Richard-Eaglin, DNP, MSN, FNP-BC, CNE, FAANP, CDE

    Angela Richard-Eaglin, DNP, MSN, FNP-BC, CNE, FAANP, CDE

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