Questioning Children: Interactional Evidence of Implicit Bias in Medical Interviews

chologists has shown that implicit race bias can influence an individual’s behavior (Amodio and Devine 2006; Dovidio, Kawakami, and Gaertner 2002; Fazio and Olson 2003). Implicit bias has been suggested to be more prevalent but also less subject to cognitive control than explicit racism (Amodio, Harmon-Jones, and Devine 2003; Dovidio et al. 1997). However, relatively little is known about how implicit bias is manifest in naturally occurring social interaction. This article investigates factors associated with pediatricians selecting children, rather than their parents, to answer questions during medical visits for routine childhood illnesses. Examining the relationships between interactional conduct and sociodemographic characteristics of children and their parents, we propose that physicians’ questioning behavior reflects an implicit bias in the competence physicians attribute to children of different racial and socioeconomic backgrounds. We examine question asking because in the present data we observed that when interacting with pediatricians and their parents, young to middle-age children rarely participate through their own initiative (by offering comments or asking questions).1 Physicians’ questions to child patients therefore represent the primary opportunities for children to both participate in their medical visits and to be appropriately socialized into the role of autonomous accountable patient. However, there is a great deal of variation in whether and how physicians ask children questions in their health-care encounters. We can thus ask what sorts of factors are associated with micro-interactional behaviors that involve, or exclude, children in the visit. Here we investigate one element of interactional conduct—who physicians select to answer their questions—and examine the relationships between this selection and the child’s Social Psychology Quarterly 2007, Vol. 70, No. 4, 424–441