Development and testing of study tools and methods to examine ethnic bias and clinical decision-making among medical students in New Zealand: The Bias and Decision-Making in Medicine (BDMM) study

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dc.contributor.author Harris, Ricci en
dc.contributor.author Cormack, Donna en
dc.contributor.author Curtis, Elana en
dc.contributor.author Jones, Rhys en
dc.contributor.author Stanley, J en
dc.contributor.author Lacey, C en
dc.date.accessioned 2016-08-23T23:36:58Z en
dc.date.issued 2016 en
dc.identifier.citation BMC Medical Education, 16 (1): 173, pp. 1 - 14 en
dc.identifier.issn 1472-6920 en
dc.identifier.uri http://hdl.handle.net/2292/30122 en
dc.description.abstract Background: Health provider racial/ethnic bias and its relationship to clinical decision-making is an emerging area of research focus in understanding and addressing ethnic health inequities. Examining potential racial/ethnic bias among medical students may provide important information to inform medical education and training. This paper describes the development, pretesting and piloting of study content, tools and processes for an online study of racial/ethnic bias (comparing Māori and New Zealand European) and clinical decision-making among final year medical students in New Zealand (NZ). Methods: The study was developed, pretested and piloted using a staged process (eight stages within five phases). Phase 1 included three stages: 1) scoping and conceptual framework development; 2) literature review and identification of potential measures and items; and, 3) development and adaptation of study content. Three main components were identified to assess different aspects of racial/ethnic bias: (1) implicit racial/ethnic bias using NZ-specific Implicit Association Tests (IATs); (2) explicit racial/ethnic bias using direct questions; and, (3) clinical decision-making, using chronic disease vignettes. Phase 2 (stage 4) comprised expert review and refinement. Formal pretesting (Phase 3) included construct testing using sorting and rating tasks (stage 5) and cognitive interviewing (stage 6). Phase 4 (stage 7) involved content revision and building of the web-based study, followed by pilot testing in Phase 5 (stage 8). Results: Materials identified for potential inclusion performed well in construct testing among six participants. This assisted in the prioritisation and selection of measures that worked best in the New Zealand context and aligned with constructs of interest. Findings from the cognitive interviewing (nine participants) on the clarity, meaning, and acceptability of measures led to changes in the final wording of items and ordering of questions. Piloting (18 participants) confirmed the overall functionality of the web-based questionnaire, with a few minor revisions made to the final study. Conclusions: Robust processes are required in the development of study content to assess racial/ethnic bias in order to optimise the validity of specific measures, ensure acceptability and minimise potential problems. This paper has utility for other researchers in this area by informing potential development approaches and identifying possible measurement tools. en
dc.description.uri http://bmcmededuc.biomedcentral.com/ en
dc.publisher BioMed Central en
dc.relation.ispartofseries BMC Medical Education en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://www.sherpa.ac.uk/romeo/issn/1472-6920/ en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.title Development and testing of study tools and methods to examine ethnic bias and clinical decision-making among medical students in New Zealand: The Bias and Decision-Making in Medicine (BDMM) study en
dc.type Journal Article en
dc.identifier.doi 10.1186/s12909-016-0701-6 en
pubs.issue 1 en
pubs.begin-page 1 en
pubs.volume 16 en
dc.description.version VoR – Version of Record en
dc.rights.holder Copyright: The Authors en
dc.identifier.pmid 27401206 en
pubs.author-url http://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-016-0701-6 en
pubs.end-page 14 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype Article en
pubs.elements-id 535962 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Te Kupenga Hauora Maori en
pubs.org-id Office of Tumuaki en
pubs.org-id TKHM Teaching en
dc.identifier.eissn 1472-6920 en
pubs.number 173 en
pubs.record-created-at-source-date 2016-08-24 en
pubs.dimensions-id 27401206 en


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