Examination of family medicine residents' explicit (conscious) and implicit (unconscious) attitudes toward pediatric patients

Introduction and Aim: This study aimed to simultaneously evaluate the explicit (conscious) and implicit (unconscious) attitudes of family medicine residents toward pediatric patients and to determine their relationship with demographic, professional, and educational variables. Materials and Methods: This descriptive–cross-sectional study was conducted with family medicine residents working in three institutions in Antalya (n=150). Explicit attitudes were assessed using a 9-item Likert-scale questionnaire, while implicit attitudes were evaluated with a computer-based Implicit Association Test (IAT). Associations with participants' sociodemographic data were examined. Results: The mean explicit attitude score was 2.78±0.62, indicating a moderate low level. The mean IAT score was –0.24±0.43, showing an implicit bias in favor of adult patients in 76% of participants. No significant correlation was found between explicit and implicit attitudes (p=0.484). Explicit attitude scores were significantly associated with age, residency duration, having children, and year of graduation. Higher explicit attitude scores were observed in married residents, those in the Contracted Family Medicine Residency Program (Ministry of Health cadre), and those with children. According to institution, "approach to pediatric patients" scores were higher at Akdeniz University Faculty of Medicine, whereas "perception of education" scores were higher at Antalya Training and Research Hospital. Pediatric rotation did not affect either explicit or implicit attitudes. Implicit attitude scores were not associated with any demographic or professional variables. Conclusion: Family medicine residents demonstrated moderate explicit attitudes and an implicit bias favoring adult patients toward pediatric care. While explicit attitudes tended to improve with demographic and professional factors, implicit attitudes remained resistant and independent. Emphasizing practice- and awareness-based content in educational programs may strengthen explicit attitudes and promote recognition of implicit biases. Keywords: Family medicine, pediatric patient attitudes, implicit attitudes.