Exploring Implicit Bias Training in Nursing: An Integrative Review

BACKGROUND: Implicit bias refers to unconscious attitudes and beliefs about a person that can influence decisions without awareness. Nurses may hold biases that lead to lower quality care and contribute to health care disparities, such as higher maternal mortality rates and unequal pain management for black women. Efforts to address this issue have generated interest in implicit bias training (IBT), which aims to increase awareness and reduce biased behavior. PURPOSE: We aimed to explore and describe the existing research interventions related to IBT that have been used in nursing. METHODS: We conducted an integrative review using Whittemore and Knafl's integrative review approach. Database searches were conducted in spring 2025. Database included Cumulative Index to Nursing and Allied Health Literature, PubMed, and PsycINFO. The Johns Hopkins Evidence-Based Practice Model was adopted to evaluate the level and quality of the studies. RESULTS: Fourteen studies were included. IBT led to positive experiences among nursing professionals and an immediate improvement in implicit bias awareness and knowledge. The studies employed diverse methods of delivery and educational strategies. Limitations of the studies include a lack of long-term follow-up on awareness, knowledge, and mitigation practice behaviors. Other significant limitations involve small sample sizes and a lack of methodological rigor. CONCLUSIONS: While IBT appears to positively impact nursing practice, additional research is needed. Significant gaps remain in demonstrating robust evidence, long-term effectiveness, and impact on patient outcomes.