Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2022


Doctor of Nursing Practice (DNP)

Primary Advisor

Linda Cassar, DNP, RNC-OB, CNE; Carol Chwal, DNP, MBA, RN, NEA-BC; Autum Shingler-Nace, DNP, MBA, RN, NEA-BC


Implicit Bias; Maternal Care; Racial and ethnic disparities


Background: Racial and ethnic disparities persist in the United States leading to adverse maternal outcomes. Nationally, the maternal mortality rates in black women are two to three times higher than white women. Implementing implicit bias training, recommended by the Council on Patient Safety in Women’s Health, is a key intervention that may help to reduce these disparities.

Objectives: This quasi-experimental/mixed methods project evaluated the effectiveness of training on implicit bias to increase awareness of implicit bias among a convenience sample of registered nurses in labor and delivery and postpartum units at two community hospitals.

Methods: Quantitative data was analyzed with IBM SPSS Statistics software and the Wilcoxon signed-rank test used. Compared were pre and post training results of the free, online race Implicit Association Test. A two-question post training survey assessed what was learned and how it will be used in practice. Demographic data of age, gender and race was analyzed with descriptive statistics.

Results: Completing the study were thirteen white, female participants; their mean age 49.83 years. Results of the Implicit Association Test showed that an educational session on implicit bias did not elicit a statistically significant change in participants’ association between concepts involving race and bias. (Z = -.137, p = 0.891).

Conclusion/Implications: The lack of statistical significance in the results can be attributed to the small sample size which did not generate enough power to detect changes in associations between concepts. This may lay the groundwork for a replicative study with a larger sample size. One implication for practice is that respondents overwhelmingly indicated they will endeavor to be more consciously aware of their biases while recognizing that we all have biases.

Open Access


Included in

Nursing Commons



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