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Shifting Perspectives

Nursing students are learning how to recognize and reduce weight bias when treating patients

By Jennifer Meininger Wolfe

In health care settings across the nation, one form of bias continues to undermine patient care and perpetuate health disparities: weight bias, which refers to negative attitudes, beliefs and stereotypes directed at individuals with obesity. This bias can lead providers to make assumptions about a patient’s lifestyle, provide substandard care or dismiss health concerns. As a result, patients who experience bias may avoid seeking medical care.

Faculty and staff at the M. Louise Fitzpatrick College of Nursing and the MacDonald Center for Nutrition Education and Research (MCNER) have been taking a proactive approach to reduce the harm of weight bias through research and curricular enhancements.

The endeavor, now in its eighth year, began with a ����ֱ�� Institute of Teaching and Learning grant focused on embedding interventions into the junior-year curriculum. This weight sensitivity training developed by MCNER has been showcased by the Strategies to Overcome and Prevent Obesity Alliance as a model for incorporating weight bias reduction education in the undergraduate Nursing curriculum.

Reducing weight bias can begin with thoughtful and compassionate gestures. “If a blood pressure cuff is the incorrect size, the nurse shouldn’t insinuate that the cuff is too small or the patient is too big,” says Associate Professor Tracy Oliver, PhD, RDN, LDN. In addition to having the correct sizes in gowns and equipment, providers should ask patients if they consent to being weighed.

In recent years, the interdisciplinary research team studied whether awareness and education translated to improved behaviors in clinical practice. Dr. Oliver and her colleagues—including MCNER’s director, Rebecca Shenkman, MPH, RDN, LDN, and associate director, Lisa Diewald, MS, RDN, LDN; and Clinical Professor Gail Furman, PhD, RN, CHSE-A, who is the executive director of the Simulation and Learning Resource Center (SLRC)—turned to Nurse Practitioner (NP) students.

To measure impact, standardized patients (SPs) living with obesity were hired for weight-based simulation encounters in the SLRC. Encounters occurred over three semesters and were accompanied by a debriefing session and didactic weight bias lesson. Each time, faculty observed the NPs in action, and the SPs evaluated each encounter.

The team wants to set the standard. “Our goal is to equip nurses and nurse practitioners with skills needed to promote sensitive, weight-related conversations as part of clinical practice. By disseminating our research findings, we hope that practical weight bias education programs like these can be implemented in other schools and applied more broadly to other health care disciplines,” says Shenkman. “We want to be a hub for this type of research.”