Thesis advisor: Sr. Callista Roy / Social Cognition and the Impact of Race and Ethnicity on Clinical Decision Making Most literature reflects the persistent existence of unequal treatment in the care provided to ethnic and racial minorities. Comparatively little about ethnic bias in the literature goes beyond the retrospective study as the most frequently encountered method of inquiry. Access to providers and the ability to pay only provide partial explanation in the known data. A more controversial hypothesis is the one offered in this dissertation. This qualitative research explored the cognitive processes of ethnic bias as a phenomenon in clinical decision making. The method was a simulation that captured events as they occurred with a sample of nurse participants. The racial and ethnically related cognitive content of participants was evoked through the interactive process of playing a board game. Immediately following that activity, a video vignette of an ambiguous pain management situation involving an African American male was viewed by each nurse who was then asked to make a "treat" or "not treat" clinical decision. The dialogues during playing of the board game in addition to the rationale for the treatment decision provided data for analysis. Content analysis is the primary approach for using the data to answer the research question. Themes of latent and manifest content were described for those who made the decision to treat and those who decided not to treat. / Thesis (PhD) — Boston College, 2012. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.