Implicit bias in health care settings can contribute to inequitable treatment — and worsen health disparities. A newly developed virtual reality training series aims to help obstetricians better recognize, understand and address implicit bias toward Black mothers.
Participants say the training is helping them communicate better with these patients, said Charee Thompson, a communications researcher at the University of Illinois Urbana-Champaign and one of the lead authors of a 2024 study that describes the series and the outcomes.
“The goal was to be more educational and to say, ‘Can we show you a postpartum visit with a Black mother and a physician and where it demonstrates [how] implicit bias manifests through communication?” she said. “‘Can we tell you why it’s problematic? Because it’s a stereotype, because it’s a microaggression, and because it’s an appropriation.’”
The first module in a series of three focuses on implicit bias and how it can negatively affect a patient at a doctor’s appointment. In the VR training, participants — who are medical students and physicians — observe an interaction between a Black patient and a white male doctor at a postpartum checkup.
During the appointment, the physician dismisses the woman’s symptoms and makes comments about her family life based on negative stereotypes about Black people. After participants see the interaction, they are asked to pay attention to how the patient reacted to the comments made toward her.
To test the module, the researchers recruited 30 participants for a lab study that included a pretest, VR training and a posttest.
Once the training was completed, the participants reported an improvement in their attitude toward implicit bias and a greater understanding of the importance of effective communication. Participants said they would be attentive to patients’ verbal and nonverbal cues in future interactions, Thompson said. Additionally, medical student participants said they would prioritize their patients’ feelings.
Mardia Bishop, a communications professor at the U of I involved in the study, said VR allows physicians to see the possible impacts of bias.
“A lecture format is not good for this because a lot of times you have to make people feel, or you have to see what’s going on. You have to see what is said and how what is said affects the patient,” she said.
Sara Babu, a communications doctoral student who has experience researching bias in health care, was not involved in this study. She said she is excited about this approach because using VR is an innovative way to tackle the issue of implicit bias.
“Trainings that get created using PowerPoint slides, for example, may not hold people’s attention quite the same way as something like a virtual reality training that constructs an online learning environment,” Babu said.
Even though the VR modules allow medical students and physicians to gain experience with real-world scenarios, Babu said, the technology may be inaccessible to some because of its high cost.
In addition to addressing implicit bias, Babu hopes future training modules also teach students about disparities associated with class, sexual orientation or citizenship. She said it is important to recognize that some people face discrimination in maternal health care because of these, and other, factors.
The second and third modules of the training are currently under development, Thompson said. They aim to help medical students identify and address their own implicit biases and enable them to practice their communication skills with virtual patients.
Thompson said if the VR training modules are approved by the National Institutes of Health, they will receive funding to complete the project and go on to test the modules in six medical schools across the country.