Physical Therapists' Perspectives of Implicit Racial and Ethnic Biases and the Influence on Physical Therapy Practice

Authors

• Michael Blizniak, Pacific Northwest University of Health SciencesFollow
• Mary Shotwell, Rocky Mountain University of Health ProfessionsFollow
• Cheryl Kerfeld, Seattle Public SchoolsFollow
• Shanda Gore, Mays and Associates, LtdFollow

Abstract

Problem: Physical therapy (PT) outcome disparities exist among racial and ethnic minority groups in the United States. Implicit racial and ethnic biases (IREBs) may contribute to these inequities. Understanding IREBs within PT practice is crucial for addressing disparities and helping physical therapists comply with the American Physical Therapy Association Code of Ethics Principles. Purpose: This study examines the role of IREBs in PT by exploring physical therapists' awareness of them and their potential influence on PT practice. Methods: A virtual explanatory sequential mixed-methods design was employed, integrating quantitative surveys and qualitative interviews. Fifty-one United States physical therapists participated in the survey phase, with a subset of these participants engaging in qualitative interviews (n = 16). All participants completed the Bias Awareness (BAS), Bias Experience and Actions (BEAS), and demographic surveys. Interview participants completed a semi-structured qualitative interview to explore the perspectives and experiences of their IREBs. The primary outcomes were participants' levels of bias awareness and their perspectives on how IREBs influence clinical practice. Measures included BAS and BEAS scores. Qualitative interviews used an interpretive phenomenological analysis. Results: The survey results indicated moderate to high levels of bias awareness, with differences in awareness across personal, societal, and healthcare domains. Qualitative data revealed that participants’ awareness of IREBs varied by experience, education, and clinical exposure. Participants identified multiple ways IREBs influenced PT practice, including client interactions and treatment decisions. Conclusions: Participants acknowledged the existence of IREBs and identified multiple ways in which IREBs adversely influence PT practice. Recommendation: Future research focusing on intersecting social identities could clarify the effects of IREBs in physical therapy practice.

Author Bio(s)

Michael Blizniak attended Ithaca College, earning an undergraduate degree in clinical science and a Doctor of Physical Therapy degree. Dr. Blizniak completed his PhD in Health Sciences at Rocky Mountain University of Health Professions and is now an assistant professor at Pacific Northwest University’s School of Physical Therapy.

Mary Shotwell earned her undergraduate in occupational therapy from Temple University, master’s in health professions education from the Medical University in South Carolina, and PhD in Adult Education from the University of Georgia. She is a faculty member in the Health Sciences PhD Program at Rocky Mountain University of Health Professions.

Cheryl Kerfeld earned a Bachelor of Science from St. Cloud State University, Certificate in Physical Therapy from the Mayo Clinic School of Health Sciences, and MS in Rehabilitation Medicine and PhD in Rehabilitation Science from the University of Washington. Dr. Kerfeld currently works as a physical therapist for Seattle Public Schools.

Shanda Gore received her bachelor's and a master’s degree in communications from Bowling Green State University and an Ed.D. in Leadership Studies. Dr. Gore is the founder and President of Mays and Associates, Ltd., a full-service leadership development, strategic planning, and culture-building consulting firm.

Recommended Citation

Blizniak M, Shotwell M, Kerfeld C, Gore S. Physical Therapists' Perspectives of Implicit Racial and Ethnic Biases and the Influence on Physical Therapy Practice. The Internet Journal of Allied Health Sciences and Practice. 2026 Jun 01;24(2), Article 10.