{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:20:30Z","timestamp":1788175230755,"version":"build-2803163510"},"reference-count":51,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Department of Defense, the NIH and VA HSR&D","award":["NH170001, R61AT012309, 1R61NS130636, SDR 21-012, I"],"award-info":[{"award-number":["NH170001, R61AT012309, 1R61NS130636, SDR 21-012, I"]}]},{"DOI":"10.13039\/100006545","name":"National Institute for Minority Health and Health Disparities","doi-asserted-by":"crossref","award":["K23MD014178"],"award-info":[{"award-number":["K23MD014178"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Academy of Medicine's Scholars in Diagnostic Excellence"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_dx-2025-0123_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Evidence for the impact of racial implicit bias and clinical reasoning remains conflicting. Our inability to characterize the relationship between racial implicit bias and clinical reasoning (CR) precludes development of comprehensive interventions seeking to address the impact of racial implicit bias on clinical encounters. To address this gap, we conducted a simulation-based investigation with clinical presentations with known health disparities, cognitive stressors common to clinical environments, and Black and White standardized patients (SPs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_dx-2025-0123_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited 75\u00a0early-career generalist physicians from five academic medical centers in New York, NY, USA. Physicians engaged in a three-station simulation. The first was for level-setting, familiarizing physicians with the online platform. The second was a diagnostic dilemma \u2013 an atypical presentation of acute coronary syndrome (ACS). The third tested treatment decision-making in acute pain. Immediately afterward, physicians completed the Race Implicit Association Test (IAT) and Race Medical Cooperativeness (RMC) IAT measuring affective and cognitive implicit biases, respectively. Two investigators assessed CR accuracy by applying a scoring rubric to physicians\u2019 post-encounter\u00a0notes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_dx-2025-0123_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Statistical analyses revealed no significant correlations between physicians\u2019 Race-IAT scores and CR by SP race. However, for ACS, a moderate correlation was suggested between physicians\u2019 RMC-IAT scores and CR accuracy when seeing Black (R=0.36, CI\u00a0\u22120.04 to 0.6), but not White, SPs (R=0.1, CI\u00a0\u22120.44 to\u00a00.24).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_dx-2025-0123_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study expands our understanding of the complex impact of racial implicit bias on clinical encounters. Future, larger studies should explore affective and cognitive implicit biases\u2019 effects on CR across varied clinical scenarios and contexts with diverse\u00a0SPs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/dx-2025-0123","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T16:56:24Z","timestamp":1769273784000},"page":"410-418","source":"Crossref","is-referenced-by-count":0,"title":["Pilot investigation into the influence of racial implicit bias on physician clinical reasoning"],"prefix":"10.1515","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9779-6548","authenticated-orcid":false,"given":"Cristina M.","family":"Gonzalez","sequence":"first","affiliation":[{"name":"Institute for Excellence in Health Equity, New York University Grossman School of Medicine , New York , USA"},{"name":"Departments of Medicine and Population Health , New York University Grossman School of Medicine , New York , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4305-643X","authenticated-orcid":false,"given":"Maria L.","family":"Deno","sequence":"additional","affiliation":[{"name":"Institute for Excellence in Health Equity, New York University Grossman School of Medicine , New York , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2799-1416","authenticated-orcid":false,"given":"Tavinder K.","family":"Ark","sequence":"additional","affiliation":[{"name":"Department of Medical Education , CUNY School of Medicine , New York , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Helft","sequence":"additional","affiliation":[{"name":"Institute for Excellence in Health Equity, New York University Grossman School of Medicine , New York , USA"},{"name":"New York University , New York , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6281-4438","authenticated-orcid":false,"given":"Denise M.","family":"Connor","sequence":"additional","affiliation":[{"name":"University of California San Francisco , San Francisco , CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4855-0223","authenticated-orcid":false,"given":"Adina L.","family":"Kalet","sequence":"additional","affiliation":[{"name":"Department of Medical Education , CUNY School of Medicine , New York , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1139-7739","authenticated-orcid":false,"given":"Diana J.","family":"Burgess","sequence":"additional","affiliation":[{"name":"University of Minnesota , Minneapolis , MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3150-8025","authenticated-orcid":false,"given":"Malika T.","family":"Samuel","sequence":"additional","affiliation":[{"name":"NYU Tisch School of the Arts , New York , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2826-584X","authenticated-orcid":false,"given":"Marla R.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Mount Sinai Morningside-West , New York , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5223-1597","authenticated-orcid":false,"given":"Steven J.","family":"Durning","sequence":"additional","affiliation":[{"name":"Uniformed Services University , Bethesda , MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"2026083110583456638_j_dx-2025-0123_ref_001","doi-asserted-by":"crossref","unstructured":"Holmboe, ES, Durning, SJ. 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