Racial Bias Among Doctor of Physical Therapy Students and its Impact on Managing Patients in Pain

Purpose/HypothesisThe purpose of this study was to determine 1) the prevalence of false beliefs about biological differences between Blacks and Whites among Doctor of Physical Therapy (DPT) students, and 2) if DPT students evaluate and approach the management of pain differently based on the race of a hypothetical patient. MethodsDPT program directors across the United States were emailed and asked to distribute the survey to students currently enrolled in their respective DPT programs. The survey consisted of 15 questions on beliefs of biological differences between races, as well as questions on the estimated pain intensity and treatment parameters for gender-matched patient cases (one with an ankle sprain and another with low back pain) with randomized race. ResultsOf 457 respondents, 72% were female and 80% were White non-Hispanic. Respondents came from 47 states, and 27% of respondents reported growing up in rural, 63% in suburban, and 10% in urban communities. 71% of respondents held at least one false belief about biological differences between Black and White people. Students appraised the hypothetical Black patients with slightly higher pain and recommended more treatment for the Black patients (p<0.05). There were no differences in pain appraisal between students who did and did not hold false beliefs. ConclusionsThe majority of students had misconceptions regarding biological differences between Black and White races. However, these misconceptions did not result in meaningful differences between how DPT students appraised or proposed to manage hypothetical Black and White patients. Clinical relevanceLess than 5% of physical therapists in the United States are Black, and racial bias among physical therapists has not been widely studied. By improving understanding of bias and false beliefs in DPT students, this study provides valuable information on the readiness and barriers for our future workforce to provide equitable care.