Exploring Awareness of Implicit Bias Within New Zealand's Chronic Pain Management Healthcare Workforce: Is Current Regulation Serving Them Best?

Abstract

Objective: To explore the knowledge and beliefs about implicit bias in chronic pain management healthcare practitioners in New Zealand and analyse the current Regulatory Authority competence documents and guidelines, regarding the topic of implicit bias. Additionally, provide recommendations for Regulatory Authorities regarding implicit bias messaging, training and competence framework implementation. Setting: Interviews were carried out with members of both public and private Chronic Pain Management Services across New Zealand from February 2025 to May 2025. Relevant Regulatory Authority documents were analysed during February 2025 to March 2025. Study Design: The research study was an exploratory mixed-methods approach. The qualitative portion involved semi-structured healthcare practitioner interviews. The Regulatory Authority documents were analysed independently for words and narrative. Data was then combined and analysed to obtain detailed insights for making recommendations. Data collection: Microsoft teams was used to audio record and transcribe interviews with 15 healthcare practitioners. Interviews were coded using NVivo to identify themes. Regulatory Authority documents were accessed online and explored manually as well as word searched electronically. Principal Findings: Several themes emerged from participant interviews regarding sources of perceived knowledge, associated emotions and actions and the perceived effects of implicit bias. A varied understanding of the concept exists within the cohort and few healthcare practitioners get their information about implicit bias from their Regulatory Authority: An impression of lack of agency regarding change was observed in all interviews. Even though competence and code of ethics documents are extensive, they lack definition, measurement or suggested training options for their members regarding implicit bias. Discussion: This study is the first in New Zealand to qualitatively explore the beliefs and knowledge of any healthcare workforce cohort about implicit bias. Current levels of knowledge are being impacted by a lack of guidance and definition from Regulatory Authorities as well as overall support and access to relevant evidence-based training options. Conclusion: Simple changes within Regulatory Authority documentation, as well as cross-authority collaboration, could positively impact levels of implicit bias knowledge alongside training uptake. These easily implemented changes are needed to promote movement towards the healthcare service goal of patient-centred care.