Project lead: Nancy Waite
Project members: Jonathan Blay, Martin Cooke and Michael Beazely
Project coordinator: Richard Violette.
PhD candidate: Fahad Alzahrani

Full project name: Understanding the relationship between pharmacists’ implicit and explicit bias and perceptions of pharmaceutical care services among Arab and black patients 


pharmacist bias and pharmaceutical careA strong relationship between patients and their healthcare providers can improve patient satisfaction with care and clinical outcomes. Racial and ethnic minorities, however, may experience more difficulty establishing relationships with their healthcare providers. Along with cultural and linguistic barriers are concerns that provider bias may contribute to healthcare disparities.

Canada’s population of visible minorities is growing and within them disparities continue to exist, including in the quality and delivery of healthcare. In recent years considerable attention has been paid to the possibility that provider bias toward racial and ethnic groups, even unknowingly, plays a significant role in creating and perpetuating healthcare disparities.

Some recent studies have found that implicit and explicit bias toward ethnic and racial groups exists among physicians, but it is unknown whether pharmacists are similarly biased and whether their biases are associated with their patient’s perceptions of pharmaceutical care services.

Research goals

The purpose of this sequential exploratory study is to understand the relationship between pharmacists’ implicit and explicit bias toward black and Arab patients and their patients’ perception of pharmaceutical care services. The study has five primary objectives:

  1. To measure and compare the degree of explicit (self-reported) and implicit (unconscious) bias among pharmacists toward visible minorities.
  2. To assess pharmacists’ characteristics associated with explicit and implicit bias.
  3. To describe black and Arab individuals’ perceptions, opinions and beliefs of bias in pharmaceutical care services.
  4. To describe the experiences of black and Arab patients when interacting with pharmacists.

The study is conducting both quantitative and qualitative research.

In study 1, a quantitative approach will be used to determine whether pharmacists are implicitly and explicitly biased toward black and Arab patients. Ontario pharmacists will be invited by e-mail to participate in the implicit association test via a secure website to assess whether bias exists. In study 2, a qualitative survey will be conducted to assess whether black and Arab patients living in Ontario perceive bias in pharmaceutical care services.


As Canada becomes a more diverse nation it is important that healthcare providers strive to eliminate healthcare disparities stemming from racial and ethnic bias by developing interventions and specific strategies to reduce them and their effects on pharmacy care. To our knowledge, this is the first study to use the implicit association test in pharmacy practice research, so it will also provide data and a methodological cornerstone for future studies on pharmacist bias.