Mitigating Implicit Bias

In January 2019, Jade Alburo, librarian for Southeast Asian and Pacific Island studies at UCLA, wrote a Twitter thread that recounted a patron’s experience searching a large academic archive. When the patron could not find materials on Vietnamese or South Vietnamese subjects, archives staffers suggested that he search with a pejorative term generally used to describe East and Southeast Asians, particularly Vietnamese.

Staffers defended the decision to use the racist term because the donors, mostly US servicemen, used it in the materials. Alburo points out several important things about this choice. First, it is a choice made by people. The archives staffers chose to center the experiences of US servicemen, rather than the Vietnamese people represented in the materials. This gives more authority to those voices. Second, it impeded the patron from finding the materials he needed to do his research. Third, it resulted in negative experiences and impressions for other UCLA staffers, researchers, and potential donors.

Bias in library systems directly affects patrons’ abilities to locate materials and experiences in the library. Librarianship is 83% white, according to a 2019 US Census Bureau survey. If diversity is a core value of the profession, why are librarians in the US less diverse than the general population? It may be that institutional and personal biases, including implicit bias, produce this difference.

What is implicit or unconscious bias? According to the Kirwan Institute for the Study of Race and Ethnicity at Ohio State University, “implicit bias refers to the attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner. These biases, which encompass both favorable and unfavorable assessments, are activated involuntarily and without an individual’s awareness or intentional control. Residing deep in the subconscious, these biases are different from known biases that individuals may choose to conceal for the purposes of social and/or political correctness. Rather, implicit biases are not accessible through introspection.”

Look at the publishing industry, for example. White professionals are overrepresented in the field, directly affecting the information resources available to libraries. The overrepresentation of white professionals in publishing is a cycle that reinforces an overarching narrative and deprives people of access to information by and for people of color because of ingroup bias—a tendency to favor a group you identify with over others. Ingroup bias is a natural cognitive bias that, if unchecked, leads to a cycle in which white professionals continue to hire other white professionals who also tend to favor white authors and white characters. This practice values some stories over others.

What about the effects of implicit bias on systems? That’s less clear. Without understanding how bias operates in the systems in which we work, our individual efforts can be overtaken by how bias acts on librarians and library patrons. For example, the Dewey Decimal Classification has been criticized for reinforcing bias through its structure, its treatment of queer subjects, and its treatment of race. Like other knowledge-organization systems, the Dewey Decimal Classification reflects the biases of the people who created it. Now entrenched in the system’s structure and history, these biases toward a white, male, Christian, heterosexual worldview have proven difficult to dislodge.

How to address implicit bias

Libraries, including health sciences libraries, are developing materials to address implicit bias. The Association of College and Research Libraries has a web page with strategies and resources for minimizing its effects. Library organizations—including the American Library Association, Medical Libraries Association, and Rochester (N.Y.) Regional Library Council—have offered continuing education classes, teaching participants how to recognize and address implicit bias in interpersonal interactions.

On an interpersonal level, implicit bias interventions include replacing negative biases with positive ones and seeking opportunities to engage with diverse groups. Bias-replacement strategies include: stereotype replacement, counter-stereotype imaging, individuation, perspective taking, and increasing opportunities for contact.

In stereotype replacement, a nonstereotypical response replaces a stereotypical response. Librarians must first recognize that the negative stereotype exists in their minds, then work on replacing that stereotype with a positive label.

Counter-stereotype imaging builds on stereotype replacement and requires imagining an alternative description. Once librarians recognize that the stereotype itself is bad, they should actively recall someone who proves that negative stereotype to be false.

Individuation requires librarians to obtain personal examples of the negative stereotype and to recall multiple occasions during which the negative stereotype was proven false by multiple people.

In perspective taking, librarians consider and empathically understand the first-person experience of a member of the stereotyped group. It is not possible to fully understand the experiences of any individual or group but, by using empathy to better understand their perspectives, librarians can start to break down biases.

Increasing opportunities for contact with the stereotyped groups is important in all these strategies, because through contact librarians can disprove the negative stereotypes in their minds.

Librarians can also teach patrons to mitigate bias within existing systems. In reference services, for example, critical reference literature positions the reference interview as a critical conversation in which both librarians and patrons examine the assumptions within research questions and information sources and address them by adjusting their own research approaches. After acknowledging that the systems in use have biases, librarians can guide patrons toward recognizing where the holes in the literature exist and where systems make literature difficult to find. Librarians can determine what information exists on a topic and who created that information, figure out how the information is arranged and described, and encourage their patrons to ask the right questions.

A curriculum for reducing bias

To enhance the understanding of implicit bias in health sciences literature for library and information professionals, we created “Working on Ourselves: Mitigating Unconscious Bias in Literature Searching,” a curriculum to help other information professionals better understand how implicit bias affects interpersonal interactions, health science literature, and information systems, and how they can address these biases in their work. Participants can adapt the curriculum to their own institutions without specialized materials. To encourage reuse and adaptation, it is freely available under a Creative Commons license. Our curriculum uses health sciences research to illustrate the effects of bias and how it can be detrimental to the patrons we serve and the populations that they serve in turn.

Explore personal bias. Harvard’s Implicit Association Test uses images and keyboard strokes to assess unconscious biases. By taking the test, librarians can explore their personal biases and reflect on their own experiences as individuals and within a group setting. Librarians might ask themselves what expectations they have before taking the test and whether they are surprised by their results. Describing how different kinds of biases may affect results, such as ingroup bias or halo-and-horns bias—the tendency to let one positive or negative trait overshadow others—may also be useful.

To create a personal connection with the topic, linking personal experiences with the experiences of larger groups and societal patterns can be useful, especially with individuals who do not identify as people of color. One way to do this is by connecting microaggressions (lived experiences) with implicit bias (unseen motivations that can create larger patterns).

Microaggressions are brief, seemingly innocuous interactions that communicate hostile, derogatory, or prejudicial stereotypes about a group. They can be intentional or unintentional, but when they are unintentional, they are manifestations of unconscious bias. They vary from insensitive comments about minority groups to, say, subtle disparagements of librarians’ looks or abilities to feelings of isolation working in predominantly white institutions. Microaggressions occur everywhere.

In a workshop setting, participants can identify microaggressions they have experienced by writing them on sticky notes and placing the notes somewhere in the room, such as on a table or on a wall. These do not have to be racial microaggressions but can relate to gender, age, accent, socioeconomic status, education level, and ability/disability. Workshop facilitators can ask participants to walk around, read the notes, and draw checkmarks on the ones that describe a situation they have experienced or have seen a coworker experience.

After a brief discussion, participants should revisit the notes and draw an “X” on those that detail situations they have seen a patron experience. Discuss the patterns, similarities, and differences that appeared in the two rounds of marking sticky notes. This shifts the conversation from librarians’ experiences to those of the patrons and builds empathy.

Discuss medical literature. Reading and discussing disparities in health care connects implicit bias to medical literature and health sciences libraries through concrete examples. Workshop facilitators can discuss one article or several on a common theme. Research articles can illustrate how individuals’ unconscious bias creates harmful patterns when a large population of professionals hold similar biases. Or, in the case of the underrepresentation of people of color in clinical trials, participants might discuss whether they think unconscious bias influenced doctors’ decisions to continue prescribing a medication, or drug companies’ decisions to continue promoting a medication despite evidence it did not work. Non–health sciences librarians can use other discipline-specific literature. For example, children’s literature has traditionally suffered from a lack of representation of characters of color and could be used in place of medical literature.

Model the reference interview. In our workshops, we model reference interview and literature search strategies that mitigate implicit bias. One presenter acts as an example patient, similar to the way standardized patients (trained professionals who act as patients in classes to teach students how to interact with and diagnose them) are used in medical education. In our example, the “patient” is looking for information on managing diabetes, while the “librarian” conducts a reference interview. Participants are encouraged to ask the example patient questions they think will help in their literature search. As a group, we discuss which questions are important—such as language preferences, reading-level preferences, and cultural and dietary habits—and how to ask potentially personal questions in appropriate and respectful ways. Providing participants with opportunities to practice their new and adapted skills is important for helping them negate bias in their daily life.

Perform a literature search. Workshop participants may split into groups and conduct a literature search together. Sometimes groups find no information specific to a patient’s demographics and cultural preferences because so much medical research focuses on healthy, white, adult men without comorbidities. This illustrates the lack of health sciences literature and patient-education materials that focus on people of color, health disparities, and linguistic and culturally specific needs. Even when such information exists, it may be difficult to find within mainstream databases.

The role that health sciences librarians often play in developing search strategies creates opportunities for addressing unconscious bias in their work with patrons. Other librarians can also find these opportunities—whether teaching in a school, instructing university students, or working with the public—by being aware of and connecting their patrons to resources that they might not otherwise consider during their search.

Improving outcomes for everyone

Once they understand that implicit bias affects their work, librarians must learn to combat it. Our curriculum helps librarians understand how unconscious bias upholds unspoken, systematic structures of power that confine the library profession and encourages librarians to use their knowledge and experiences to help make the field more equitable for information professionals and our patrons.

Health science librarians have the power to help medical and allied health professionals and patients find the information they need and encourage researchers to be more inclusive. We encourage our patrons to consider and use materials that move beyond the typical (white and male) subjects who define most clinical trials and research. As academic and research librarians, we ask patrons to consider how unconscious biases might affect library patrons when they consult with librarians and when they design and execute their searches.

Ultimately, reducing implicit bias is a job for all librarians because it exists in all parts of librarianship. It is there when we:

• teach patrons in formal sessions and through reference interviews
• catalog materials and design search algorithms
• choose what materials to promote
• recruit and hire new librarians and make decisions about tenure and promotion

In all these situations, librarians are choosing—consciously or unconsciously—which stories to center and which members of our communities to welcome. Librarians from all types of institutions can encourage library patrons and stakeholders to consider how bias might be affecting their work by asking questions, being aware of biases in the information they use, and encouraging everyone who uses the library to reflect on unconscious bias. Whether through this program or through other forms of outreach and engagement, librarians can train one another and enhance their practices, improving outcomes for everyone.