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Social Dominance Orientation, Dispositional Empathy, and Need for Cognitive Closure Moderate the Impact of Empathy-Skills Training, but Not Patient Contact, on Medical Students' Negative Attitudes toward Higher-Weight Patients.

ABSTRACT: Anti-fat bias in healthcare providers and medical students has serious implications for quality of care of higher-weight patients. Studies of interventions aimed at reducing anti-fat attitudes in medical students have generally been disappointing, with little enduring effect. It is possible that some students may be more receptive to prejudice-reducing influences than others, due to underlying differences in their personal characteristics. It is also possible that attitudes toward patients, specifically, may differ from anti-fat attitudes in general, and prejudice-reduction effectiveness on patient-specific attitudes has not yet been evaluated. The present study explored the effect on general and patient-specific anti-fat attitudes of (1) contact with higher-weight individuals prior to and during medical school; and (2) training designed to increase medical students' empathy toward patients by encouraging them to take the patient's perspective during clinical encounters. The moderating role of individual difference factors on effectiveness of contact and student-reported hours of empathy training on patient-specific attitudes was assessed. A total of 3,576 students enrolled across 49 US medical schools completed an online survey at the start of their first year of medical school and at the end of their fourth year. Favorable contact experience with higher-weight patients predicted improved attitudes toward heavier patients after 4 years of medical school, and appeared sufficient to partially offset the effects of dislike of higher-weight individuals at baseline. The impact of favorable contact on general anti-fat attitudes was less strong, highlighting the importance of using target-specific outcome measures. The positive effects of favorable contact on attitudes toward higher-weight patients did not differ based on students' baseline levels of social dominance orientation, dispositional empathy, or need for cognitive closure. In contrast, the effectiveness of training did vary by student characteristics, generally being more effective in students who were more egalitarian and empathic at baseline, with little effect, or even adverse effects in students low in these traits. Overall, however, perspective-taking training produced only small improvements in attitudes toward higher-weight patients.

SUBMITTER: Meadows A

PROVIDER: S-EPMC5378792 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Social Dominance Orientation, Dispositional Empathy, and Need for Cognitive Closure Moderate the Impact of Empathy-Skills Training, but Not Patient Contact, on Medical Students' Negative Attitudes toward Higher-Weight Patients.

Meadows Angela A Higgs Suzanne S Burke Sara E SE Dovidio John F JF van Ryn Michelle M Phelan Sean M SM

Frontiers in psychology 20170404

Anti-fat bias in healthcare providers and medical students has serious implications for quality of care of higher-weight patients. Studies of interventions aimed at reducing anti-fat attitudes in medical students have generally been disappointing, with little enduring effect. It is possible that some students may be more receptive to prejudice-reducing influences than others, due to underlying differences in their personal characteristics. It is also possible that attitudes toward patients, spec ...[more]

PMID: 28421020

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Project description:Previous research using immersive virtual reality (VR) has shown that after a short period of embodiment by White people in a Black virtual body, their implicit racial bias against Black people diminishes. Here we tested the effects of some socio-cognitive variables that could contribute to enhancing or reducing the implicit racial bias. The first aim of the study was to assess the beneficial effects of cooperation within a VR scenario, the second aim was to provide preliminary testing of the hypothesis that empathy and political attitudes could contribute to implicit bias about race, while the third aim was to explore the relationship between political attitudes and empathy. We had (Caucasian) participants embodied in a Black virtual body and engaged either in a cooperative (Coop group) or in a non-cooperative (Neutral group) activity with a confederate experimenter embodying another Black avatar. Before and after VR, we measured participants' implicit racial bias by means of Implicit Association Test (IAT) and their perceived closeness toward the confederate experimenter. Before VR we also assessed participants' political attitudes and empathy traits. Results revealed that, as compared to the Neutral group, the Coop group showed lower IAT scores after the social interaction. Interestingly, in the Neutral but not the Coop group the perceived closeness toward the confederate experimenter was associated with the initial racial bias: the more the participants reduced their distance, the more they reduced their IAT score. Moreover, reported traits of empathy and political attitudes significantly explained the variance observed in the initial implicit bias, with perspective-taking, empathic concern, and personal distress being significant predictors of the IAT scores. Finally, there was a relationship between political attitudes and empathy: the more participants considered themselves as left-wing voters, the higher their perspective-taking and empathic concern scores. We discuss these findings within the neuroscientific and social cognition field and encourage scholars from different domains to further explore whether and under which conditions a given manipulation for reducing racial bias could be efficiently transposed in VR.

Dataset Information

Social Dominance Orientation, Dispositional Empathy, and Need for Cognitive Closure Moderate the Impact of Empathy-Skills Training, but Not Patient Contact, on Medical Students' Negative Attitudes toward Higher-Weight Patients.

Publications

Social Dominance Orientation, Dispositional Empathy, and Need for Cognitive Closure Moderate the Impact of Empathy-Skills Training, but Not Patient Contact, on Medical Students' Negative Attitudes toward Higher-Weight Patients.

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