Achieving Inclusive Organizations:...
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Study Rationale and Literature Review
Understanding unconscious biases is critically important to the delivery of inclusive health care because no matter how many laws are enacted or how much anti-discrimination training is received, decisions will align with a person's unconsciously generated biases (Clements, 2014).
Malcolm Gladwell (2005) defines biases as the instantaneous impressions and conclusions that arise in our minds and influence our decisions. Clark's 1954 (Abagond, 2009) classic doll study, replicated in 2006 with the same results, reinforces the power of these ingrained, unconscious biases. After being handed two dolls and asked by the researcher to respond to the question "Can you show me the doll that looks bad?" (para: 7), the black child described the black doll as looking bad and the white as looking nice. Furthermore, when one receives information that contradicts one's deeply held unconscious biases, the brain simplifies the understanding process and relies on stereotypes and heuristics to inform decision making – rightly or wrongly. Information incongruent with one's beliefs is quickly separated, labeled as information that doesn't fit and discarded (Moule, 2005). When asked if they are biased against blacks, many egalitarians respond that they have black friends. This reduces the dissonance with their unconscious black stereotypical beliefs by convincing them that their black friends are exceptions. Dovidio and Gaertner (2005) label this equalizing thinking as absolution – I am not a racist because I have black friends (p. 2). The evolution of racism from open hostility to unknowingly making decisions based on one's biased perceptions is aversive racism (Dovidio & Gaertner, 2005). Aversive racism systematically disadvantages marginalized peoples by influencing how qualifications are perceived and weighed. Aversive racism resulting from unconscious biases may account for why résumés with typically white names receive 50% more callbacks than those with highly skilled typically black named candidates (Ross, 2005). More importantly, the literature provides no reason to believe that the aversive racism found in the study of blacks is not applicable to other marginalized populations.
Lawrence Kohlberg (Schwind, Das, Wagar, Fssina & Bulmash, 2013) theorized that people move through six stages of moral development. Stage one behaviors are prescribed – do or be punished (i.e., Nuremberg defence of following orders). Stage two behaviour is reciprocal - an understanding that if I act one way you will reciprocate another way. With stage three, interpersonal conformity, one acts in a socially acceptable manner. Stage four is doing what is legally binding. Stage five practices distributive justice (greatest good for the most people). Stage six views people as being inherently good and should be treated justly. Understanding one's level of moral development provides cues to understanding the underpinning of decisions.
The Personal Beliefs About Diversity Scale (Pohan & Aguilar, 2001) is a 15-item scale that focuses on the diversity issues of race/ethnicity, gender, social class, sexual orientation, disabilities, language, and immigration from the participant's personal sphere of relationships, raising children, treatment by others, living conditions and collective stereotypes. The Professional Beliefs About Diversity Scale, a 25-item scale, focuses on the same diversity items as the Personal Beliefs Scale to which are added religion, instruction, staffing, segregation/integration, ability tracking, curriculum materials and multicultural versus monoculture education. A number of survey questions were negatively worded to indicate a more accepting response to the various issues. While awareness is the first step to self-regulation, reflection is a powerful tool to identify strategies for self-correction.
A digital e-portfolio is an electronic repository of one's reflections. It provides a structured environment where users document their deep-seated beliefs and self-understanding. Portfolio users report reflection, allows them to gain a more comprehensive understanding of their actual thought processes (Whitworth, Deering, Hardy & Jones, 2011). After administration of the diversity scales, four e-portfolios were distributed to the study participants, one per week. Each e-portfolio consisted of a scenario that described the equity problems of sexual orientation, physical or mental abuse, ageism, and marital/family status. Standardizing the reflective questions across each portfolio allowed for themes to be combined. A post-study survey was conducted with a randomly selected sub-group of participants to assess the level of usefulness of the e-portfolio.
Sixty percent of the respondents responded with the most socially desired response (agree and strongly agree) for all the items on the Personal Beliefs Scale. The question that elicited the highest level of disagreement, however, was Question (Q)14 "It is as important for immigrants to maintain their first language, as it is to learn English" (62%). As for Q10 "Many women in our society continue to live in poverty because males still dominate most of the major social systems in Canada", the respondents were almost equally split between all three responses (disagree, neutral, agree).
Forty-four percent of the respondents selected the most culturally diverse response (agree and strongly agree) on the Professional Beliefs scale. Q16 "Whenever possible, second language learners should receive instruction in their first language until they are proficient enough to learn via English instruction" elicited the least culturally diverse response (strongly disagree and disagree)(68%). Q17 "Teachers often expect less of students from the lower socio-economic class" was almost equally distributed between all three responses. Q20 "Large numbers of students of colour are improperly placed in special education classes by school personnel" elicited a higher number of neutral responses (62%).
While respondents personally believed that retaining one's mother tongue is as important as learning English (Q14), professionally the majority agreed that English should be the language of instruction (Q16). The cognitive dissonance created between the personal belief that retaining one's mother tongue is important and the professional belief that English is the language of instruction may account for the delays in translating documents and accessing translators. The professional belief that expectations are less for poor children (Q17) and the strong neutral response that minorities should be segregated in the classroom (Q20), suggests a large number of the respondents may be struggling to manage their personal bias, whereby they discriminate on the basis of socioeconomic status. This bias potentially hinders supervisors from offering professional development, training and promotional opportunities to minority employees. The post-survey statement that "I will do nothing differently" may be evidence of absolution (Dovidio & Gaertner, 2005), as respondents try to rationalize their unconscious beliefs between what is legally binding and what they personally believe. The stronger reaction of the HIM respondents may be attributed to the fact that information management (formally health records) was female dominated and viewed as a lower status health care job.
Minimizing the influence of unconscious biases falls into two categories: strategies that assist learners to become aware of their biases and strategies to help learners reduce the impact of their biases on their decisions (Teal, Gill, Green & Crandall, 2012). These strategies aim to gauge the influence of unconscious biases, while the purpose of the reflective activities is to raise awareness and initiate resolution and amelioration of biases. Encouraging interactions with diverse groups forces the person to face their biases and take immediate and sustainable steps to curb their covert influence on decisions.
Potential Application of the Study
This study indicates that unconscious biases existed in the study group. The next step is to conduct a focused, generalized study using the diversity scales to assess the degree to which our health leaders, mentors and educators exhibit unconscious biases.
While generalizations from case studies are limited and this study's low response rate makes any conclusions based on the inferential statistics suspect, this study indicated unconscious biases exist and influence the thinking of students. This exploratory research provided insights into why aversive racism may contribute to continued workplace disparities. Composite continuous indices were calculated for each scale by averaging the respondents' answers together. The Personal Beliefs index had a score of 4.05 out of a possible 5.0. The Professional Beliefs index had a score of 3.59 out of a possible 5.0. Overall, these index scores denote that the respondents reported moderately high levels of agreement on the diversity issues, assuming an absolute average value of 3.0. Using these indices in an Analysis of Variance (ANOVA) was performed as a confirmatory test of the levels of significance amongst the collapsed demographic variables. There were no statistically significant differences between group means, as determined by a One-way ANOVA. While the X2 identified possible differences in the program groups, the ANOVA demonstrated that these differences might have been the artifacts of the size differentials among the groups.
As Ryerson's mission is to address societal needs by providing students with curricula that balance theory and application, and prepare them for global careers, diversity must be taught from a sustainable perspective. McShane and Steen (2012) are clear that most institutions of higher education teach diversity from a surface perspective: observable demographic physiological differences such as race, ethnicity, and physical capabilities. Surfacing one's deep seated beliefs through personal reflection is the most effective way to begin to understand how these enduring traits influence decision making and the social order of what one perceives is socially, economically and environmentally acceptable. This study has the potential to positively impact how diversity is taught at Ryerson.
Banks and Banks (1993) argue that multicultural and awareness training materials are ineffective in the hands of leaders who have negative attitudes and beliefs toward culturally diverse people. Instructors minimize the influence of unconscious biases by designing in-class exercises that expose their biases (Teal, Gill, Green & Crandall, 2012). These strategies aim to gauge the influence of unconscious biases while the reflective activities raise awareness and initiate resolution and amelioration of biases. Encouraging interactions with diverse groups forces the person to face their biases and take immediate and sustainable steps to curb their covert influence on decisions.
Media or Publication
This research was presented at the Ryerson Learning and Teaching Conference in May 2014.
Information and a resource for this study is posted on Ryerson's Learning and Teaching Office Website and on Ryecast.
The teaching tool is posted on YouTube. http://www.youtube.com/watch?v=Eic9mI_n9WU
This research was supported by a 2013 Teaching About Diversity Grant from Ryerson University Teaching and Learning Office.
Banks, J. & Banks, C. (1993). Multicultural education: Issues and perspectives (2nd ed). Boston, MA: Allyn & Bacon Inc. Retrieved from http://books.google.ca/books?hl=en&lr=&id=e1ITbOA2jhQC&oi=fnd&pg=PA1&dq=multicultural+education:+issues+and+perspectives
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Retrieved from http://www.cookross.com/docs/UnconsciousBias.pdf
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Whitworth, J., Deeing, T., Hardy, S. & Jones, S. (2011). Perceptions regarding the efficacy and use of professional portfolios in the employment of teachers. International Journal of ePortfolio, 1(1), 95-106.
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