Genetic Counselors' Implicit Racial Bias and Cognitive, Emotional, and Informational Exchange in Simulated Sessions

Objectives: Implicit racial bias has been shown to negatively affect several communication processes (Schaa et al., 2015), suggesting that bias is detrimental to the genetic counselor-client relationship and therefore impedes progress toward client-centered goals. This study extends previous research in the domains of implicit bias and interpersonal communication to identify possible directions for communication training and practice intervention. Methods: Secondary analysis of a nationally representative sample of genetic counseling sessions with white and minority (Black and Latino) simulated clients (SCs) was conducted. A subset of the genetic counselors (GCs, n=60) completed a Race Implicit Association Test (IAT). The Roter Interaction Analysis System (RIAS) was used to characterize and code GC and SC communication behaviors and Linguistic Inquiry Word Count (LIWC) was applied to session transcripts to analyze SC talk. Main outcomes were SC cognitive and emotional processing, GC facilitation of cognitive and emotional processing, and GC’s provision of personalized clinical information. Multiple linear regression analyses were performed to relate these outcomes to GCs’ IAT scores, SC race, and statistical interaction between GCs’ IAT scores and SC race. Results: GCs’ implicit racial bias had different effects on GCs’ provision of information depending on SC race (p