Unconscious Bias: The Thoughts You Don’t Have

Lauren Adizas
Independent Research
Ms. Dungey
May 2023
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Abstract

Unconscious bias creates untrue perceptions and ideas about different groups, which
impacts daily life for many. Literature shows that various types of individuals and groups are
targeted by unconscious bias, which can cause discriminatory behavior, as well as unequal
opportunities and treatment. The goal of this study was to determine the effectiveness of
unconscious bias training in mitigating bias and fostering a diverse and inclusive atmosphere. A
total of five studies were chosen which evaluated unconscious bias training: both methods and
successfulness. It was revealed that training is both effective and ineffective at times, producing
either positive effects or no effects at all. To conclude, this study displays how unconscious bias,
despite having substantial impact on groups of people and society in general, may not be able to
be mitigated through critical tactics like unconscious bias training. In future endeavors, more
research should be conducted on unconscious bias training in order to improve its effectiveness.

Word count: 155

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Literature Review

Cafeterias are often places where people can gather, eat, and recuperate. However, if

these groups were closely observed, it is likely that many convene with those who look and act

similarly to them. This divide can be influenced by unconscious bias, thoughts that occur outside

the conscious mind that can create often untrue perceptions about a particular individual or

group. Many are liable to discriminatory behavior or general disparities in their experiences due

to this. Unconscious bias affects many underrepresented groups by leading to discriminatory

perceptions of a certain group, a decrease of opportunities, and unequal treatment in healthcare.

Unconscious bias creates discriminatory and untrue perceptions of minority groups and

other groups that are often underrepresented in several areas. Certain races or ethnic backgrounds

cause unconscious beliefs to activate in the brain of those who see them, negatively affecting

how the group in question is viewed. First, a journal article from Psychological Science describes

a study using fMRI scanning and the Implicit Association Test where participants were shown

both Black and White faces in 30 millisecond intervals. In one series of trials, they pressed a

computer key for Black faces and positive words, and another for White faces and negative

words. The next series would be the opposite. The study found that caucasian subjects’

amygdalas, typically activated in stressful situations, were more activated when the Black faces

were shown. In addition, the response times for pairing Black faces to negative words were

significantly shorter than pairing Black faces to positive words (Cunningham et al., 2004). This

heightened emotional response only occurred when Black faces were shown, and a large part of

participants correlated White and Good with Black and Bad based on shortened response times.

These decisions were made in a split second, which demonstrates how unconscious bias is so

embedded in the participants’ ideas that it did not require forethought to correlate Black people
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with negative words. This study displays how even upon first glance, certain races can

experience discriminatory behavior and perceptions from other people. Second, in one study

found in the Journal of Personality and Social Psychology, participating students were shown

photos of black or white men—flashed so quickly that they were unable to consciously pick up

what was in the photo. They were then asked to push a button when they identified objects in

subsequent blurry pictures that gradually became more clear. The experiment concluded that

those who were originally shown Black men identified objects related to violence quicker than

those shown white men (Eberhardt et al., 2019). The rapid correlation between objects and Black

faces exemplifies racial bias as those who were shown the white faces did not identify the objects

as quickly as those shown the Black faces did. The objects swiftly identified correlated to

violence, so racial bias had to be present as participants unconsciously connected violence to

only Black faces.

Gender plays a part as well, as women are often looked down upon and not offered equal

opportunities for jobs or education when compared to their male counterparts who are

unconsciously identified as superior. Starting off, a Yale University study had science faculty rate

identical applications of students applying for a manager assistant—each was randomly assigned

either a male or female name. The study found that although the resumes were identical, the male

applicants were rated more competent and hireable, received a higher starting salary, and were

offered more mentoring as opposed to female counterparts (Moss-Racusin et al., 2012). This

study leads to the underrepresentation of women because the evaluators had unconsciously taken

the gender of the applicant into account, which was the only variable that was different in the

applications. Male applicants were deemed more worthy than women applicants for increased

pay and opportunities. These disparities continue to be prevalent in the hiring process. An article
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from Clear Law Institute that includes information about the impact of implicit bias for

employees describes a study conducted in 2020 that found that hiring managers were inclined to

hire those similar to them. Men hire men, as women are seen as less competent (Johnson, 2021).

Men are typically given authoritative positions, and by seeking out men to hire because women

are regarded as incapable of doing the job, this exhibits unequal opportunities between the

genders and a cynical or systemic issue with who has the power to hire.. Unconscious bias is

prevalent in multiple fields and areas, which creates disparities and fosters discrimination for

underrepresented groups.

Lastly, physical attributes, such as weight, can create negative perceptions about the

individual. In a study from the journal of Academic Emergency Medicine, participating

physicians filled out a survey that had adaptations of the Implicit Association Test and Crandall

Anti-fat Attitudes Questionnaire. Participants paired silhouette images of average weight and

obese individuals with either positive or negative words, and were also asked to fill out a

questionnaire on how much they agree with statements regarding the abilities of obese people.

Their study found that those taking the IAT responded quicker to compatible words and images,

such as negative words to obese silhouettes, and 87% of participants had a degree of implicit

weight bias, with 34% categorized as severe bias (McLean et al., 2021). The rapidity of the

participants’ responses demonstrated unconscious bias as they correlated negative associations

with obese people impulsively. In addition, a significant majority of the participants exhibited

weight bias based on their response. Furthermore, in a journal titled Obesity, the authors describe

a study where health professionals filled out the Implicit Association Test, during which subjects

were asked to categorize certain words between “fat people'' and “thin people”. It was split up

into four categories: bad-good, lazy-motivated, stupid-smart, and worthless-valuable. Next, they
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were given a scale, ranging from “Very Bad” to “Very Good”, where they were asked to rate

their feelings about fat and thin people. Finally, they filled out a questionnaire that included

attributes, degrees, personal experiences, and political beliefs of themselves. The study found

that each category on the IAT and the “Very Bad” to “Very Good” scale had significant implicit

weight bias, such as fat people being linked to laziness and worthlessness (Schwartz et al., 2003).

This study demonstrates unconscious bias as the participants had correlated these negative traits

based solely on the fact that the silhouettes appeared to be overweight. The stereotype that has

been created for obese people, such as being lazy or worthless, had been ingrained into the minds

of the participants, which is exhibited in this study.

Furthermore, those with certain characteristics related to factors such as gender and race

are often given fewer opportunities due to unconscious bias. In interviews for chances regarding

employment and education, the Black interviewees can experience discriminatory behavior from

the evaluator. In an article from the Association of American Medical Colleges, the author

describes an instance where an interviewee, Jamal, a dark-skinned African American male,

perceived that his interviewer during a medical school interview was biased against him. The

interviewer, a professor at the school, seemed uncomfortable around Jamal, interrupting his

answers and making less eye contact. Any small talk was also excluded, and their conversation

was mechanical (Capers IV, 2019). Through Jamal’s perspective, the interviewer was exhibiting

discriminatory behavior towards him as he was African American. This could lead to Jamal not

being hired just because of the interviewer’s unconscious bias, demonstrating a loss of

opportunities as the interviewer decides if Jamal is accepted. Second, in the Journal of Nursing

Education, researchers cite a survey where 347 participants described their experiences when

applying to medical school. 21% of participants had experienced discrimination in the behavior
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and attitude of the interviewer regarding gender, age, race, sexual orientation, and physical

attributes. A Latinx background was a striking factor when experiencing this discrimination

(Noone & Najjar, 2021). This study displays fewer opportunities because Latinx interviewees

seemed to be a target in discrimination from the interviewer. Despite having other qualities,

Latinx applicants experienced discrimination based on their ethnic background and had less

opportunity because of the evaluator’s unconscious perception of them.

Additionally, when choosing people for opportunities, particular attributes such as ethnic

names and appearance are unconsciously considered in the process. These qualities act as

hindrances and decrease the chances of being called back. First, Dr. Pragya Agarwal (2019) self

conducted a study where she applied to 12 places similar in departments: six with her double

barreled European sounding surname, and six with her Indian sounding maiden surname. All six

places that she applied to using the European sounding name led to callbacks, but only one she

applied to using the Indian sounding name was called back (Agarwal, 2019). This self-conducted

study exemplifies a decrease in opportunities as the non-ethnic name was called back 100% of

the time in the six places it was used to apply as opposed to the ethnic name that was only called

back once despite applying in six places. She had an 83% greater chance of being called back

simply for having a white sounding name. When compared, the non-ethnic sounding name had

more opportunities than the ethnic-sounding name, despite it being the same person who applied

each time. Next, in one study that simulated an application review process for radiology

residents, faculty members assessed applications given to them that included a photo of the

resident. Residents who were considered unattractive and obese were more likely to get a

negative rating (Noone & Najjar, 2021). The included picture in the application indicates that

physical attributes/attractiveness were considered as the application was evaluated; since obese
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applicants were likely to be negatively rated, this is an example of a decrease of opportunities as

those who deemed unattractive are less likely to be rated high and ultimately accepted into the

program.

Finally, disparities are also often present in treatment where a provider’s unconscious bias

can lead to worse treatment to certain demographics relating to appearance or race. Firstly, in an

article from the journal of Obesity, the authors include the results of two studies. The first study,

which compared the attitudes of US nurses and Canadian nurses towards their obese patients,

resulted in 35% to 48% of nurses feeling uncomfortable when treating obese patients and 31% to

42% preferring not to treat obese patients at all. In the second study, patients who went through

weight loss surgery rated their satisfaction with the treatment they received and the equipment

being used. This study found that the equipment and facilities given to obese patients were

mostly insufficient (Schwartz et al., 2003). A portion of the nurses in the study felt somewhat or

fully disturbed regarding the treatment of obese patients, which could lead to lesser quality

treatment based on the nurses’ attitudes toward the patient’s weight. Obese patients who

underwent weight loss surgery also did not have adequate equipment, due to the unconscious

weight bias of their healthcare provider. Secondly, in the Journal of General Internal Medicine,

the authors cite a study that reviewed physicians’ ability to determine pain in Hispanic patients

compared to non-Hispanic patients. The study found that physicians were able to evaluate

patients’ pain despite their ethnicity, but gave less analgesia to Hispanic patients with severe pain

or injuries. The authors state that this data shows how physicians make treatment decisions based

on race or ethnicity (Chapman et al., 2013). The physicians in this study, despite being able to

recognize pain levels in patients, decided to provide less relief to a racial minority: Hispanic

patients. Racial background played a part in the physicians’ decision making when determining
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what treatment to provide, demonstrating unproportionate treatment. Many patients are often

given lower quality treatment because of unconscious bias, and this treatment can be often

inadequate for the person’s needs.

As unconscious bias continues to foster in different fields, individuals and groups

simultaneously suffer from inequality ranging from fewer opportunities to outright

discrimination. There are several disparities surrounding those with certain attributes, which can

nurture various disadvantages. One example is underrepresentation, either due to race, gender, or

their physical appearance. The loss of being appreciated in the spotlight removes the possibility

of gaining traction and opportunities with employers. These employers would only focus on the

person’s name and appearance in relation to ethnicity. Even more so, due to these inferences,

many people are unwilling to help or care for minorities. This is all due to an unnoticeable

thought; it is time to put an end to this unconscious inequality.

Data Collection and Methods

Meta-analysis was used to assess the effectiveness of unconscious bias training in

mitigating bias in several fields, and whether it was successful in fostering a diverse and

inclusive atmosphere. Five studies were chosen, all of which evaluated methods of training such

as workshops, seminars, and interactive presentations on unconscious bias and the impact they

made on the participants. The first source used was titled “Using Implicit Bias Training to

Improve Attitudes Toward Women in STEM”, which investigated both men’s and women’s

attitudes toward women in the STEM field, finding that diversity training sessions were

significantly more effective than a regular faculty meeting. The second source, titled

“Addressing Implicit Bias in First-Year Medical Students: a Longitudinal, Multidisciplinary

Training Program,” described a training method conducted with various methods- lectures,
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discussions, and trips to different areas regarding healthcare disparities that stem from

unconscious bias- and found that participants leaned more toward a decrease of bias subsequent

to the training. The next source, “Longitudinal Outcomes One Year Following Implicit Bias

Training in Medical Students”, assessed how well participants could retain information

immediately and a year after attending unconscious bias workshops, resulting in a significant

difference between the pre and post tests, and a small difference between the post and one year

post tests. The fourth source was named “Defeating Unconscious Bias: The Role of a Structured,

Reflective, and Interactive Workshop,” and it investigated participants’ pre and post awareness

of unconscious bias after a 90-minute workshop; it found that there was a large increase in

knowledge of bias after the trial. Finally, the fifth source, named “Reducing Mental Illness

Stigma through Unconscious Bias-Informed Education,” evaluated the effectiveness of a seminar

on stigma surrounding psychiatric illness in participating medical students, discovering a

statistically significant impact on participants’ attitudes towards psychiatric illness following the

seminar.

Results and Analysis

Figure 1: Positive outcomes of unconscious bias training

Article Title Positive results of unconscious bias training

workshops, seminars, etc.

“Using Implicit Bias Training to Improve
Attitudes Toward Women in STEM”
- Women’s implicit attitudes toward women in
STEM were primarily positive and stayed
positive
- Men’s implicit attitudes positively increased
toward women in STEM

“Addressing Implicit Bias in First-Year - Participants leaned more toward a decrease

Medical Students: a Longitudinal, of bias following the sessions, and in their
Multidisciplinary Training Program” reflection, they described more detailed
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records of implicit bias in healthcare after the

study

“Longitudinal Outcomes One Year Following - Significant increase of awareness between

Implicit Bias Training in Medical Students”
the pre session and post session training (to
compare implicit attitudes before and after
training)
- Biggest difference was found between the
pre and post tests
- Small difference was between the post and
one year post test

“Defeating Unconscious Bias: The Role of a - There was a large increase in knowledge of
Structured, Reflective, and Interactive unconscious bias for the participants after the
Workshop” trial (increased awareness)

“Reducing Mental Illness Stigma through - Seminar had a statistically significant impact
Unconscious Bias-Informed Education” on participants’ attitudes towards patients and
towards traits of individuals with psychiatric
illness

In Figure 1, all five articles reveal the results of unconscious bias training through multiple

methods such as seminars, workshops, and discussions. Each article demonstrates both

increasing positive or decreasing negative attitudes in participants, due to the training. More

specifically, article three and four both noted a significant increase of awareness of unconscious

bias, signaling that the training was effective, which was expected in the hypothesis.

Figure 2: No positive outcomes of unconscious bias training

Article Title Negative results of unconscious bias

training workshops, seminars, etc.

“Using Implicit Bias Training to Improve - No significant changes in the explicit

Attitudes Toward Women in STEM” measures from pre to post training
- Men being more likely to endorse
stereotypes did not change after training

“Addressing Implicit Bias in First-Year - Neither the experimental group nor the
Medical Students: a Longitudinal, control group demonstrated a significant
Multidisciplinary Training Program” change in implicit bias
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“Reducing Mental Illness Stigma through - No significant impact on attitudes towards

Unconscious Bias-Informed Education” society’s responsibility to address psychiatric
illness

In Figure 2, three articles portrayed unchanged results in participants after unconscious bias

training. These articles demonstrate an ineffective training session or a lack of change in the

participants. To be specific, article one and three both state that there were no significant

differences or impact on the attitudes of those who participated, meaning that the training did not

work in that area, which was unexpected based on the hypothesis.

Discussion/Conclusion

The data partially supports the hypothesis that unconscious bias training can

successfully mitigate unconscious bias (Figure 1). However, as shown with Figure 2, there were

no results pertaining to whether or not the effect was positive or negative. This was surprising to

discover because the hypothesis argues that unconscious bias training always produces positive

outcomes. This data somewhat connects to secondary research because Figure 2 states that men

are more likely to endorse stereotypes in regards to women, and in the literature, it states that

men are more likely to seek out men when hiring for positions instead of women (Johnson,

2021). Healthcare disparities are also a trend in both secondary research and the data, as the

literature review describes an instance where physicians made decisions for treatment based on

race or ethnicity (Chapman et al., 2013), and the data suggests that implicit bias in medical

workers creates healthcare disparities. The data consists of only a small sample of studies, which

contributes to the data’s limitations. The studies are also mainly conducted on the same subjects

and fields: medical students and healthcare.


Appendix A
Article Title
“Using Implicit Bias Training to Improve
Attitudes Toward Women in STEM”
“Addressing Implicit Bias in First-Year
Medical Students: a Longitudinal,
Multidisciplinary Training Program”
“Longitudinal Outcomes One Year Following
Implicit Bias Training in Medical Students”
“Defeating Unconscious Bias: The Role of a
Structured, Reflective, and Interactive
Workshop”
“Reducing Mental Illness Stigma through
Unconscious Bias-Informed Education”
Appendix B
Article Title
“Using Implicit Bias Training to Improve
Attitudes Toward Women in STEM”
“Addressing Implicit Bias in First-Year
12
Background
- Women are often underrepresented in the
STEM field due to stereotypes
- Men are more likely to endorse those
stereotypes
Implicit bias in medical workers create
healthcare disparities
- Schools do not provide methods to mitigate
this
Comparison between medical students'
understanding of concepts immediately
following and one-year post participation in
an implicit bias workshop
- Negative implicit bias in clinicians create
disparities and inequities for patients
- Previous studies show bias can be
correctable with training
- Mental illness stigma is detrimental to
families and healthcare organizations
- Direct interventions are often unsuccessful,
unconscious bias training is a more beneficial
alternative
Conditions/methods used
- STEM faculty participated
- Average age of 48, 84.4% Caucasian
- Pre training: filling out a survey and a
categorization task
- Split into two groups: one attended a 30
minute diversity training session, and the
other attended a regular faculty meeting
- 39 first-year medical students participated

Medical Students: a Longitudinal,
Multidisciplinary Training Program”
“Longitudinal Outcomes One Year Following
Implicit Bias Training in Medical Students”
“Defeating Unconscious Bias: The Role of a
Structured, Reflective, and Interactive
Workshop”
“Reducing Mental Illness Stigma through
Unconscious Bias-Informed Education”
13
- Control and experimental group
- Completed Harvard IAT and Attitudes
Toward Implicit Bias Questionnaire
- Session in museum
- Lecture by medical anthropologist
- Video and discussion
- 272 third-year medical students participated
- Attended workshops
- 3 surveys then filled out: pre, post, and one
year post workshop
- Pre and post intervention survey
- Subjects participated in a 90-minute
workshop with an interactive presentation on
implicit bias
- Images of different people shown in a quick
sequence, participants asked to rate how
trustworthy they look as well as guess their
profession
- 146 third-year students from Canadian
Medical School
- Pre and post IAT
- Participated in one-hour seminar on stigma
and psychiatric illness
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