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And then, “What should I teach myself and the medical students?” ’Cause at the time it was just—medical students was my audience.
那“我应该学到什么，又该教给医学生什么呢？”因为当时我的听众只有——医学生。
And they, they said, “Just apologize.” And I was like, “I’m sorry, what?” They were like, “Just apologize.” And I was like, “Oh—I can teach that! I can do that,” right?
然后他们说，“道个歉就行了。”我说，“不好意思，你说什么？”他们说，“道个歉吧。”我当时想，“哦——我可以教人们这么做！我可以做到的，对吧？”
And so it, it, of course, evolved from there, but we did a, a focus group study with Black and Hispanic patients in English and Spanish across New York City, across the socioeconomic spectrum, and over and over again they were so generous with us.
一切就是从这里开始的，但我们确实进行了一项焦点小组研究，研究对象是纽约市的黑人和西班牙裔患者，他们使用英语和西班牙语，各种经济背景的人都有，他们一次又一次地对我们非常包容。
They said, “We know you’re human; we don’t need the encounter to be perfect and no bias, etcetera, but once it happens we can’t have it ignored,” ’cause that second insult was a real attack on their, like, their, their core, their dignity.
他们说：“我们知道你也是人；我们不奢求相遇是完美的，没有偏见，等等，但一旦它发生了，我们就不能忽视它，”因为第二次侮辱是对他们的核心，他们的尊严的真正攻击。
And sometimes we may also—they may also perceive bias—we, too, when we’re patients—we also may perceive bias when actually it’s a routine question ... Sure.
有时他们也可能察觉到偏见——我们也是，当我们是病人时——我们也可能察觉到偏见，其实这是一个很常见的问题……确定。
But based on our lived experiences, right—being followed around in stores, being accused of wrongdoing, being questioned about our identity, etcetera—we may take it as bias.
但是根据我们的生活经历，比如在商店里被跟踪、被指控做错事、被质疑身份等等，我们可能会认为这是偏见。
And that can be hard as a physician or a medical student, being like, “I’m supposed to ask you this.”
作为一名医生或医科学生，这可能很难，“我应该问你这个问题。”
And so we teach skills to step back and depersonalize it so that you can, again, partner, apologize if necessary or explain why and be able to move forward together.
所以我们会教一些技巧，让你退后一步，去人格化，这样你就可以，再说一次，在必要时道歉，或者解释原因，然后继续下一步。
But it’s the ignoring part that was really, really hard for patients. Sure.
但是，对患者来说，真正非常困难的是被忽视。当然。
Well, and I think a, a lot of folks who are familiar with implicit bias, you know, thanks to a great surge in research over the last few years, they might think that most of the battle is just becoming aware that we all have implicit bias because that’s really revelatory and difficult for a lot of people ... Sure.
我想，很多熟悉隐性偏见的人，由于过去几年研究的激增，他们可能会认为，大部分的斗争只是意识到我们都有内隐偏见，因为这对很多人来说真的很有启发性，也困难……确定。
But it sounds like that is very much just the first step in actually mitigating it. Would you say that’s right?
但这听起来像是真正缓解它的第一步。你觉得是这样吗？
Absolutely. And so there’s been a lot of talk in the literature, and in the lay press as well, about awareness being enough, right?
是的。在文献中，以及在非专业媒体中，有很多关于意识是否足够的讨论，对吧？
Because if we become aware, then our good intentions will prevail.
因为一旦我们意识到了，我们的善意就会占上风。
If it were that easy, I would happily be studying something else, right?
如果真有这么容易，那我早就开开心心地改行了，是吧？
And so I think that, for us, it’s becoming aware, and then—but it’s not fair to have people be aware and then say, “Go be better,” you know, because, of course, they were trying to be their best at the very beginning.
我觉得，对我们来说，是要意识到，但让人们意识到之后就要求他们“以后要做得更好”是不公平的，因为他们一开始就想要做到最好的。
And so that’s where the skill comes in.
这时候就需要用到技能了。
But what happens when someone is resistant to the idea that this is something they need training for?
但是，如果有人抵制这种想法，觉得并不需要为此接受培训，会发生什么呢？
For implicit bias, I think that you have to have safe places to fail.
对于隐性偏见，我认为必须有安全的失败空间。
And in the educational literature that’s called a critical incident, and in a critical incident you may practice something and then have that internal aha! moment, and internal aha! moments happen in private–that you get this reaction that you don’t like when your actions don’t match your values.
在教育文献中，这被称为关键事件，在关键事件中，你可能会实践一些东西，然后内心会有那种“啊哈”的感觉！而这种顿悟会在私下里发生——当你的行为与你的价值观不匹配时，你会有这种不喜欢的反应。
If you could have that privately, right—maybe with a interactive computer case, for example—then you’re more likely to change your actions to match your values.
如果你能在私下里拥有这种感觉，比如跟一个交互式的电脑，那你就更有可能改变行为去匹配你的价值观。
If you have it publicly, you’re actually at risk of changing your values to match your actions ’cause you feel the need to save face.
如果你公开表明了立场，实际上就有可能为了保全面子而改变自己的价值观，使其与你的行为相匹配。
How do you go about measuring implicit bias in, in a clinical setting? Is there a way for you to see how much work there is to do?
在临床环境中，您如何衡量隐性偏见？有没有办法能让你知道还有多少工作需要做？
There are tests, like the Implicit Association Test; it’s a free and publicly available test.
有一些测试，比如隐性联想测试；这是一个免费的、公开可用的测试。
There are other tests, and they’re what’s—what are called latency response tests, meaning they see how quickly you react to two opposite concepts—joy, evil; male, female; just thinking about possibilities—down to the millisecond.
还有其他测试，被称为潜伏期反应测试，是指它们会观察你对两个相反概念的反应速度——快乐、邪恶；男性、女性；各种反义词——时间会精确到毫秒。
So see how quickly you react to different concepts. And that is supposed to measure your implicit bias.
看你对不同概念的反应有多快。这可以用来衡量你的隐性偏见。
They’re interesting, and I don’t use ’em diagnostically.
这些测试很有趣，但我不会用它们来做诊断。
They tend to mirror what we would expect in terms of the way we’re socialized. Sure.
它们往往反映了我们对社交方式的期望。嗯嗯。
