Immigration bias among medical students: a randomized controlled trial
Jürgen Grafeneder, Andjela Baewert, Henri Katz, Anita Holzinger, Jan Niederdoeckl, Dominik Roth- Emergency Medicine
Background and importance
Racial bias is found in both physicians and medical students. Immigrants in many parts of the world face challenges similar to racial minorities. Identification of immigrants might however be more subtle than identification by race, and currently, no data are available on a possible bias against the large minority group of migrants in Europe.
Design
Randomized control trial.
Settings and participants
Second-year medical students were randomized into four groups to watch a video of either a male or female patient with pain, with or without immigrant status.
Intervention
Students were asked whether they would administer pain medication (primary outcome).
Outcome measures and analysis
Immigrant status, patient’s gender, student’s gender, age, and language skills were covariates in a logistic regression model. Secondary outcomes included pain medication potency and the student’s rating of the patient’s pain intensity.
Main results
We recruited 607 students [337 females (56%), 387 (64%) between 18 and 22 years old]. Analgesia was administered in 95% (n = 576). Immigrant status was not associated with the probability of receiving pain medication [95 vs. 95%, odds ratio (OR) 0.81, 95% confidence interval (CI) 0.39–1.70,
Conclusion
Medical students showed no immigration bias with regard to administering pain medication but were less likely to choose high-potency analgesia in immigrants. We also found a gender difference in pain management. These results demonstrate the importance of including knowledge about immigration bias in medical training.