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Eliminate Implicit Bias From Patient Interactions by Practicing the ‘5Rs of Cultural Humility’

Every now and then, we all need a bias check. From the teenager in the psychiatric unit to the mother of four waiting for surgery, healthcare providers are constantly interacting with patients from all walks of life. And across the board, trusted patient-provider relationships are rooted in fair, culturally sensitive treatment.

For HCPs to be sure they’re meeting this standard of care regardless of a patient’s gender, sexual orientation or citizenship, they must acknowledge their implicit biases. A recent article in the Journal of General Internal Medicine provides a framework for doing so. Called the 5Rs, the practice relies on mindful interactions with patients and constant self-evaluation.

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The 5Rs are as follows:


Clinicians will approach every encounter with humility and understanding that there is always something to learn from everyone. Even if you’re an expert in your field, remind yourself that you’re not an expert in how your patient lives his or her life, at least not right away. Reflection will help you navigate challenging patient interactions and confront moments of detachment.

Ask yourself: What did I learn from each person in that encountered?


Clinicians will treat every person with the utmost respect and strive to preserve dignity at all times. Respect is about acknowledging another person’s dignity, regardless of their culture or life experiences. In a healthcare setting, you can show respect by incorporating a patient’s needs and boundaries into your evidence-based treatment. Or in situations where it’s not possible to act on patient preferences, demonstrate that you still care about their wishes.

Ask yourself: Did I treat everyone involved in that encounter respectfully?


Clinicians will hold every person in their highest regard, be aware of, and not allow unconscious biases to interfere in any interactions. The goal of regard is to build trust and rapport with a new patient as quickly as possible. To do so, you must understand and refuse to act on your personal biases toward groups of people different from you. Patients are more likely to trust clinicians who seem them as individuals.

Ask yourself: Did unconscious biases drive this interaction?

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Clinicians will expect cultural humility to be relevant and apply this practice to every encounter. Prioritizing cultural humility in every patient interaction teaches HCPs how to advocate for patients in a way that takes their individual perspective into consideration. After all patients have a right to voice their treatment preferences.

Ask yourself: How was cultural humility relevant in this encounter?


Clinicians will embody the practice of cultural humility to enhance personal resiliency and global compassion. As clinician burnout reaches epidemic numbers, resiliency is a tool for clinicians to find meaning in their work, which can help minimize burnout. Be aware of how your own mental state affects your patients and the care you provide — as well as how practicing cultural humility benefits your patients.

Ask yourself: How was my personal resiliency affected by this interaction?

There is no definitive solution to mitigating the effects of implicit bias. But by implementing these 5Rs into your practice, you might be one step closer to ensuring your patient’s satisfaction, as well as your own.

Addressing Biases in Patient Care with The 5Rs of Cultural Humility, a Clinician Coaching Tool, Journal of General Internal Medicine.

Last updated on 10/2/19.

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