Date of this Version

12-5-2022

Document Type

DNP Project

Abstract

Background: Inequality and disparities in healthcare is not an unfamiliar phenomenon as it was developed centuries ago during slavery. The longstanding beliefs that blacks and whites are biologically different date back centuries, as physicians, scientists, and slave owners proposed these beliefs as validation of the acts of slavery.1 Additionally, blacks have been exposed to unethical experiments for years. Three examples of unethical experiments that influenced fictitious notions of blacks include: (1) the experiment conducted by the US Public Health Services known as the Tuskegee Study of Untreated Syphilis in the Negro Male1 (2) the 1793 yellow fever epidemic in Philadelphia where it was assumed due to their race, black people were immune to the viral disease1 and (3) James Marion Sims known as the “father of modern gynecology” who performed unconsented vesicovaginal fistula repairs on enslaved black women without anesthesia.2

Objectives: The objective of this project is to shed light and provide knowledge to providers on cultural competence to influence a change in perceptions of blacks, decrease disparities that lead to misdiagnosis and unequal treatment, as well as repair quality care and health outcomes in black patients. A literature review including six research studies address the PICO question, “In perioperative healthcare providers, does an educational module on pain perception in black patients, compared to no education, improve provider knowledge and treatment of pain perception in the black community?” The literature review was used as the basis for this study and served as the educational framework to increase perioperative healthcare provider knowledge.

Methodology: An online presentation in an educational format was the primary methodology used for the proposed project. An initial survey was created to assess perioperative provider knowledge of racial bias and inequality in healthcare towards the black community.

Results: A total of 10 individuals consented to participate in which 8 actually completed the survey. The survey consists of only CRNAs, 7 female participants and 1 male. The mean age of participants was 34. The participant’s ethnicity involved 3 Hispanics, 1 White, 4 African American/Blacks. Three of the participants possess Masters’ while the remaining 5 hold Doctorate degrees. Five of the participants have been in practice 1-2 years, 2 between 2-5 years, and 1 between 5-10 years. When asked the pre-survey questions, the results varied among the categories. The post-survey questions following the educational module revealed more consistency.

Conclusions: In conclusion, all participants were extremely likely to self-evaluate subconscious prejudices. Four participants feel race does not factor into patient care often, 1 not as often, 1 often, and 2 very often. Six of the participants are extremely likely there will be a change in their practice while equally one believed somewhat likely and the other is indifferent with neither likely or unlikely.

Keywords: Black people, black patients, black community, blacks, healthcare providers, perioperative providers, provider perception, pain perception, pain in black patients, pain management in blacks, healthcare inequalities, healthcare disparities, racial bias in healthcare.

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