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Let’s start with a basic question: What is implicit bias?
我们先来问一个最基本的问题：什么是隐性偏见？
So implicit bias refers to the unconscious and unintentional mental associations that we make about others, often along lines of personal identity factors like race or religion or gender.
内隐偏见指的是我们对他人无意识或无意的心理联想，这些联想通常是基于个人身份因素，如种族、宗教或性别。
But they’re unconscious and unintentional.
但它们是无意识和无意的。
How much does that tend to come up in a clinical setting, and why does it matter?
在临床环境中，这种情况出现的频率有多高，为什么它很重要？
It’s more likely to come up when we’re pressed for time; when we’re fatigued; probably when we’re hungry, although that doesn’t exist in the literature, to my knowledge, anyway; when we’re not really knowing the person in front of us very well and we may have incomplete data—honestly kind of every day at work, right, at different times of the day, different time pressures, etcetera.
据我所知，人们赶时间的时候，疲劳的时候，饥饿的时候，更容易出现隐性偏见，虽然并没有文献提出这种说法；当我们不太了解面前的人，而且可能掌握的数据不完整时——老实说，这种情况工作中每天都有，对吧，在不同时间，面临不同压力的时候都会出现。
And the reason why it matters is because it can actually influence our communication behaviors with patients.
而它之所以重要，是因为它实际上可以影响我们与患者的沟通行为。
And so I wanna be clear that implicit bias isn’t, like, a moral indictment.
所以我想明确的是，隐性偏见并不是一种道德指控。
It’s a coincidence of our lived experiences, how our unconscious mental associations go, but because it can influence our behaviors, we wanna—we work on that in, in our lab.
它只是我们生活经历的巧合，是我们无意识的心理联想，但因为它会影响我们的行为，所以我们想——在实验室里研究它。
What do we know about how implicit bias in a clinical setting can impact patients?
关于临床环境中的隐性偏见对患者有何影响，我们了解多少？
How do you know when implicit bias has impacted the encounter, right?
隐性偏见影响到见面时，你要怎么知道？
I know it’s because the vibe—I and others—that the vibe has changed, the nonverbals have changed, the patient may get a little more curt in their answers or shorter, you know?
我知道是因为氛围，我和其他人之间的氛围已经变了，非语言的东西已经改变了，病人可能在回答问题时很简短之类的。
And we do this in real life. And I keep getting people who say, “How do we, how do we teach that?”
我们在现实生活中会这样做。我不断听到有人说，“我们如何教授这个？”
And, and I keep consulting other people. I’m like, “How do you teach it? Like, I don’t know.”
我一直在咨询其他人。问他们，“你是怎么教的？我不知道。”
And so I think we could talk about that as a challenge in case anybody writes in and gives us the answer. I would love it so much.
我们可以把它当作挑战来讨论，万一有人写信来告诉我们答案呢。我不胜感激。
Yeah, maybe, maybe there’s, like, a, a body language coach out there ... Yes! An acting or movement coach who thinks about micro facial expressions.
嗯，也许，比如，有个肢体语言教练在收听……是的！一位思考微表情的表演或动作教练。
Like, somebody’s, somebody’s gotta be able to help with that. Yes—yes, yes, yes and yes.
肯定有人能帮忙解决这个问题的。是的——是的，是的，是的，是的。
If we stay focused on communication behaviors and communication skills, there’s the concept that’s called verbal dominance, meaning that if we have a 15-minute encounter, and if we are gonna center the conversation on racial bias, then if you have higher unconscious—implicit racial bias, more pro-white as a coincidence of your lived experience, then you’re likely to talk more in those 15 minutes when you’re seeing a Black patient compared to a white patient.
如果我们专注于沟通行为和沟通技巧，有一个被称为语言主导的概念，这意味着如果我们有15分钟的相遇，如果我们将谈话集中在种族偏见上，那么如果你有更高的无意识——隐性种族偏见，根据你的生活经验，你更亲白人一些，那么与白人患者相比，在这15分钟里，你看到黑人患者时可能会说的更多。
When you’re talking more, that means they’re talking less. Right.
你说得更多，意味着他们说得更少。是的。
That means we’re likely to be asking their opinion less; we’re likely to be doing less shared decision-making, meaning getting their input on what the, what the treatment plan is, is it acceptable to them; asking if they have questions.
这意味着我们可能会更少地询问他们的意见；更少地进行共同决策，也就是在治疗计划、他们是否可以接受等方面征求他们的意见；询问他们是否有问题。
Patients perceive less patient-centeredness.
患者感受到的以患者为中心的程度较低。
They perceive, in essence, a colder affect or vibe, if you will, in the encounter.
本质上，在这次相遇中，他们察觉到的是一种更冷淡的情感或氛围，如果你愿意这么说的话。
And, and we also end up using more words that relay anxiety.
而且，我们最终也会使用更多传递焦虑的词汇。
It’s the way we’re socialized and our unconscious ... Sure. Mental associations. So it’s just humans. Yeah.
这是我们的社交方式和我们的潜意识……当然。心理联想。这就是人类。是的。
So let’s talk about what you’re doing at your lab.
那我们来谈谈你正在实验室里做的事情。
What interventions have you been working on, and what’s been working?
你一直在从事哪些干预措施，哪些措施是有效的？
So we’re interventionalists, right? But instead of needles or devices or pills, we use education.
我们是介入治疗专家，对吧？但是，我们使用的是教育，而不是针具、设备或药片。
So we recognize when implicit bias may have impacted the patient encounter, right?
我们要认识到隐性偏见可能会对医患接触产生影响，对吧？
And then we teach people skills to be able to manage that negative influence, negative impact—partner with the patient and then restore rapport, you know, discuss ways of moving forward, etcetera—to be able to have the positive outcomes we wanted in the first place.
然后我们会教给人们一些技能，让他们能够应对这种负面影响，与患者合作，恢复融洽关系，讨论继续的方法等等，以便能够获得我们最初想要的积极结果。
And so a lot of what we talk about is basic “humaning,” to be quite honest.
老实说，我们谈论的很多内容都是基本的“做人”。
And so—but people get nervous when it’s something about race or religion or gender or sexual orientation, and people worry.
所以——但是当涉及到种族、宗教、性别或性取向时，人们会感到紧张，人们会担心。
So if I can take a step back and explain that the—we were the first to study—we weren’t the first to study patient perceptions of bias and discrimination in their encounters, but to our knowledge in the literature, our lab was actually the first to study it and then stop and say, “Okay, great. Not great that it’s happening, but great that we’re talking about it, that you’re talking about it.”
我先退后一步解释一下，我们并不是第一个研究患者对接触中的偏见和歧视的看法的人，但根据我们对文献的了解，我们实验室确实是第一个研究它，并提出，“太好了，这种情况并不好，但好在我们正在谈论它，大家正在谈论它。”
