Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Susan Dean-Baar


Susan Dean-Baar

Cathy Koetting

Samantha Kohler


Problem: Maternal and fetal morbidity and mortality is a rising health care crisis in the United States. Black women are disproportionately affected. Clinician implicit bias and medical racism have been named as factors in this crisis. Recommendations to address this public health peril include; educating and raising awareness among front-line perinatal nursing staff on implicit bias and its consequences for Black women. The purpose of this project is to evaluate the impact of implicit bias training on nurses’ awareness of implicit bias, attitudes, and beliefs about disparities, and the likelihood to engage in behaviors to reduce or address racial bias and promote health equity.

Methods: A descriptive cohort design with a convenience sample of nurses employed on a women’s services unit in a midwestern urban hospital was utilized. Participants were administered a pre-education Implicit Association Test (IAT), to establish baseline awareness of their own biases and a pre-education survey. Educational modules on implicit bias in perinatal care were assigned to participants. A post-education IAT and survey were administered. An analysis of participants' survey results was performed. The primary outcome of interest was the level of implicit bias awareness among staff nurses as determined by pre-and post-training surveys.

Results: A total of 31 pre-education surveys and 28 post-education surveys were returned. 30 participants engaged in the implicit bias education modules. On the questions related to the engagement behaviors of nurse participants, all results indicated statistical significance based on an alpha value of .05. No significant difference was found on the other items. Participants indicated a mean of 4.37 (SD=0.74) on the post-education question “I feel more aware of implicit bias and its effects on perinatal outcomes.”

Implications for practice: This quality improvement project resulted in mixed results. However, the questions related to the engagement behaviors of the individual nurse all resulted in statistical differences when comparing the pre-and post-survey results. Participants' mean scores indicate they feel more aware of implicit bias and its effects on perinatal outcomes after having participated in the education. This reflects a positive response to the training and suggests the training achieved its overall intended result.