Don't look at my wheelchair! The plasticity of longlasting prejudice

Med Educ. 2015 Dec;49(12):1239-47. doi: 10.1111/medu.12834.


Context: Scientific research has consistently shown that prejudicial behaviour may contribute to discrimination and disparities in social groups. However, little is known about whether and how implicit assumptions and direct contact modulate the interaction and quality of professional interventions in education and health contexts.

Objectives: This study was designed to examine implicit and explicit attitudes towards wheelchair users.

Methods: We investigated implicit and explicit attitudes towards wheelchair users in three different groups: patients with traumatic spinal cord injury (SCI); health professionals with intense contact with wheelchair users, and healthy participants without personal contact with wheelchair users. To assess the short-term plasticity of prejudices, we used a valid intervention that aims to change implicit attitudes through brief direct contact with a patient who uses a wheelchair in an ecologically valid real-life interaction.

Results: We found that: (i) wheelchair users with SCI held positive explicit but negative implicit attitudes towards their novel in-group; (ii) the amount of experience with wheelchair users affected implicit attitudes among health professionals, and (iii) interacting with a patient with SCI who contradicts prejudices modulated implicit negative bias towards wheelchair users in healthy participants.

Conclusions: The use of a wheelchair immediately and profoundly affects how a person is perceived. However, our findings highlight the dynamic nature of perceptions of social identity, which are not only sensitive to personal beliefs, but also highly permeable to intergroup interactions. Having direct contact with people with disabilities might foster positive attitudes in multidisciplinary health care teams. Such interventions could be integrated into medical education programmes to successfully prevent or reduce hidden biases in a new generation of health professionals and to increase the general acceptance of disability in patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude
  • Attitude of Health Personnel*
  • Disabled Persons* / psychology
  • Education, Medical, Undergraduate
  • Female
  • Health Personnel / psychology*
  • Humans
  • Male
  • Middle Aged
  • Physical Therapists / psychology
  • Prejudice / psychology*
  • Professional-Patient Relations
  • Social Identification
  • Spinal Injuries / psychology*
  • Spinal Injuries / rehabilitation
  • Wheelchairs*
  • Young Adult