1
|
Shen J, Clinton AJ, Penka J, Gregory ME, Sova L, Pfeil S, Patterson J, Maa T. Smartphone-Based Virtual and Augmented Reality Implicit Association Training (VARIAT) for Reducing Implicit Biases Toward Patients Among Health Care Providers: App Development and Pilot Testing. JMIR Serious Games 2024; 12:e51310. [PMID: 38488662 PMCID: PMC11004623 DOI: 10.2196/51310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 10/24/2023] [Accepted: 12/12/2023] [Indexed: 04/12/2024] Open
Abstract
Background Implicit bias is as prevalent among health care professionals as among the wider population and is significantly associated with lower health care quality. Objective The study goal was to develop and evaluate the preliminary efficacy of an innovative mobile app, VARIAT (Virtual and Augmented Reality Implicit Association Training), to reduce implicit biases among Medicaid providers. Methods An interdisciplinary team developed 2 interactive case-based training modules for Medicaid providers focused on implicit bias related to race and socioeconomic status (SES) and sexual orientation and gender identity (SOGI), respectively. The simulations combine experiential learning, facilitated debriefing, and game-based educational strategies. Medicaid providers (n=18) participated in this pilot study. Outcomes were measured on 3 domains: training reactions, affective knowledge, and skill-based knowledge related to implicit biases in race/SES or SOGI. Results Participants reported high relevance of training to their job for both the race/SES module (mean score 4.75, SD 0.45) and SOGI module (mean score 4.67, SD 0.50). Significant improvement in skill-based knowledge for minimizing health disparities for lesbian, gay, bisexual, transgender, and queer patients was found after training (Cohen d=0.72; 95% CI -1.38 to -0.04). Conclusions This study developed an innovative smartphone-based implicit bias training program for Medicaid providers and conducted a pilot evaluation on the user experience and preliminary efficacy. Preliminary evidence showed positive satisfaction and preliminary efficacy of the intervention.
Collapse
Affiliation(s)
- Jiabin Shen
- Department of Psychology, University of Massachusetts Lowell, Lowell, MA, United States
| | - Alex J Clinton
- Department of Psychology, University of Massachusetts Lowell, Lowell, MA, United States
| | | | - Megan E Gregory
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Lindsey Sova
- Center for Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, Ohio State University, Columbus, OH, United States
| | - Sheryl Pfeil
- College of Medicine, Ohio State University, Columbus, OH, United States
| | - Jeremy Patterson
- Advanced Computing Center for Arts and Design, Ohio State University, Columbus, OH, United States
| | - Tensing Maa
- Center for Clinical Excellence, Nationwide Children’s Hospital, Columbus, OH, United States
| |
Collapse
|
2
|
Ware AD, Wake LM, Fedoriw Y. Lymphomas and Amyloid in the Gastrointestinal Tract. Surg Pathol Clin 2023; 16:719-743. [PMID: 37863562 DOI: 10.1016/j.path.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
Lymphoproliferative disorders are a heterogeneous group of neoplasms with varying clinical, morphologic, immunophenotypic, and genetic characteristics. A subset of lymphomas have a proclivity for the gastrointestinal tract, although this region may also be involved by systemic lymphomas. In addition, a number of indolent lymphoproliferative disorders of the gastrointestinal tract have been defined over the past decade, and it is important to accurately differentiate these neoplasms to ensure that patients receive the proper management. Here, the authors review lymphoid neoplasms that show frequent gastrointestinal involvement and provide updates from the recent hematolymphoid neoplasm classification systems.
Collapse
Affiliation(s)
- Alisha D Ware
- Department of Pathology & Laboratory Medicine, University of North Carolina School of Medicine, 160 Medical Drive, Brinkhous-Bullitt Building, CB#7525, Chapel Hill, NC 27599, USA
| | - Laura M Wake
- Department of Pathology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Pathology Building, Room 401, Baltimore, MD 21287, USA
| | - Yuri Fedoriw
- Department of Pathology & Laboratory Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, 160 Medical Drive, Brinkhous-Bullitt Building, CB#7525, Chapel Hill, NC 27599, USA.
| |
Collapse
|
3
|
Burns J, Kusztos V. Behavioral Economics in Radiology Training: Overcoming Irrational Behavior. J Am Coll Radiol 2023; 20:1168-1176. [PMID: 37634796 DOI: 10.1016/j.jacr.2023.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/06/2023] [Accepted: 06/03/2023] [Indexed: 08/29/2023]
Abstract
Behavioral economics studies how external influences subconsciously affect decision making. Everyone is subject to a range of cognitive biases, which can affect the radiology training environment and can impact resident selection, resident education, feedback, workflow, and report composition. Understanding the cognitive sources of error and patterns of deviation can help faculty and trainees better engage in an optimal learning environment. This review focuses on the role of cognitive biases as they impact multiple facets of radiology education and training environments.
Collapse
Affiliation(s)
- Judah Burns
- Vice Chair of Radiology Education, Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; Chair, ACR Subcommittee on Methodology, Committee on Imaging Appropriateness.
| | | |
Collapse
|
4
|
Maru JA, Wang J, Knight OJ, Tsou BC, Oatts JT, Ross DA, Moore EZ, Zhang AY, Ramanathan S, Woreta FA. Barriers in Ophthalmology Residency Applications for Students Identifying as Underrepresented in Medicine: A San Francisco Match Analysis. JOURNAL OF SURGICAL EDUCATION 2023; 80:971-980. [PMID: 37217381 PMCID: PMC10330680 DOI: 10.1016/j.jsurg.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 03/14/2023] [Accepted: 04/13/2023] [Indexed: 05/24/2023]
Abstract
OBJECTIVE There is a significant lack of ophthalmologists who self-identify as underrepresented in medicine (URiM) in the physician workforce. Prior literature has revealed bias in traditional metrics for selection relied on by resident programs such as United States Medical Licensing Examination (USMLE) scores, letters of recommendation (LOR), and induction into medical honors societies such as Alpha Omega Alpha (AOA). The purpose of this study was to elucidate race-based differences in word usage within ophthalmology residency letters of recommendation that may disproportionately affect URiM applicants. DESIGN This was a retrospective, cohort study. SETTING This was a multicenter study across the Wilmer Eye Institute at Johns Hopkins, the University of California San Francisco, and the University of North Carolina at Chapel Hill. PARTICIPANTS San Francisco (SF) Match applications submitted to three ophthalmology residency programs between 2018 and 2020 were reviewed. URiM status, USMLE Step 1 score, and AOA membership were recorded. Letters of recommendation were analyzed using text analysis software. T-tests and chi-squared or Fisher's exact tests were used to compare continuous and categorical variables, respectively. Frequency of word/summary term usage in letters of recommendation were the main outcome measures. RESULTS Relative to non-URiM applicants, URiM applicants had lower USMLE Step 1 scores (mean difference=7.0; p<0.001). Non-URiM letters of recommendation were more likely to describe applicants as "dependable" (p=0.009) and highlight "research" (p=0.046). URiM letters were more likely to describe applicants as "warm" (p=0.02) and "caring" (p=0.02). CONCLUSIONS This study identified potential barriers for URiM ophthalmology residency applicants which can help guide future interventions to increase workforce diversity.
Collapse
Affiliation(s)
- Johsias A Maru
- School of Medicine, University of California San Francisco, San Francisco, California
| | - Jiangxia Wang
- Johns Hopkins Biostatistics Center, Johns Hopkins University, Baltimore, Maryland
| | - O'Rese J Knight
- Department of Ophthalmology, University of California San Francisco, San Francisco, California
| | - Brittany C Tsou
- Department of Ophthalmology, Albany Medical College, Albany, New York
| | - Julius T Oatts
- Department of Ophthalmology, University of California San Francisco, San Francisco, California
| | - David A Ross
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Edward Z Moore
- Department of Engineering, Central Connecticut State University, New Britain, Connecticut
| | - Alice Yang Zhang
- Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Saras Ramanathan
- Department of Ophthalmology, University of California San Francisco, San Francisco, California
| | - Fasika A Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
| |
Collapse
|
5
|
Hovey SW, Arif SA, Khan AM, Hyderi AF, Varughese C, Peksa GD, Flint N. More than a buzz word: Building diversity, equity, and inclusion into pharmacy residency recruitment. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2023. [DOI: 10.1002/jac5.1716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Sara W. Hovey
- Department of Pharmacy Rush University Medical Center Chicago Illinois USA
| | - Sally A. Arif
- Department of Pharmacy Rush University Medical Center Chicago Illinois USA
- College of Pharmacy Midwestern University Downers Grove Illinois USA
| | - Ayesha M. Khan
- Department of Pharmacy Rush University Medical Center Chicago Illinois USA
| | - Alifiya F. Hyderi
- Department of Pharmacy Rush University Medical Center Chicago Illinois USA
| | - Christy Varughese
- Department of Pharmacy Rush University Medical Center Chicago Illinois USA
| | - Gary D. Peksa
- Department of Pharmacy Rush University Medical Center Chicago Illinois USA
| | - Nora Flint
- Department of Pharmacy Rush University Medical Center Chicago Illinois USA
| |
Collapse
|
6
|
Pei KY, Klingensmith ME. Ethical challenges in education research during high stakes events - can participants truly "opt-out?". Am J Surg 2023; 225:258-259. [PMID: 35773039 DOI: 10.1016/j.amjsurg.2022.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/17/2022] [Accepted: 06/18/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Kevin Y Pei
- Parkview Health Graduate Medical Education, Fort Wayne, IN, USA.
| | | |
Collapse
|
7
|
Ash TL, Helminen EC, Yamashita S, Felver JC. Teachers' anti-black biases in disciplinary decisions: The role of mindfulness. J Sch Psychol 2023; 96:75-87. [PMID: 36641226 DOI: 10.1016/j.jsp.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/13/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022]
Abstract
Research suggests that disparities in exclusionary discipline can be explained, in part, by teachers' anti-Black biases in disciplinary decision-making. An emerging body of literature also speaks to the benefits of cultivating mindfulness for bias reduction. The present study adds to the literature by assessing whether mindfulness is associated with differences in teachers' responses to student disciplinary infractions as a function of student signaled race, which was manipulated as a between-subjects factor. We predicted that teachers with lower levels of mindfulness, as measured via self-report, would demonstrate greater anti-Black bias in response to students' disciplinary files than teachers with higher levels of mindfulness. Teachers (N = 179) completed the study via an online research participant platform. Consistent with hypothesis, we found that participants' self-reported mindfulness in teaching moderated their responses to a disciplinary file as a function of student signaled race, b = -1.05, F(1, 175) = 4.50, p = 0.035, ηp2 = 0.03, 95% CI [-2.03, -0.07]. Specifically, participants with lower levels of mindfulness rated the disciplinary infraction as more severe if it was enacted by a Black boy compared to a White boy. At higher levels of mindfulness, however, the opposite pattern emerged; participants demonstrated more leniency if the infraction was perpetrated by a Black boy, relative to a White boy. Our research adds to the literature and suggests that improving teachers' ability to remain present in the classroom may improve their ability to make more equitable decisions in managing students' misbehavior.
Collapse
Affiliation(s)
- Tory L Ash
- Department of Psychology, Syracuse University, United States of America; Department of Educational Psychology, University of Wisconsin-Madison, United States of America.
| | - Emily C Helminen
- Department of Psychology, Syracuse University, United States of America
| | - Shiharu Yamashita
- Department of Psychology, Syracuse University, United States of America
| | | |
Collapse
|
8
|
Berman L, Renaud E, Pace D, Downard CD, Nwomeh BC, Huang EY, Weatherall YZ, Gadepalli SK, Mollen KP, Mak GZ, Newman E. Inclusion and representation in the pediatric surgery workforce: Strategies to mitigate bias in the fellowship application process. J Pediatr Surg 2022; 57:592-597. [PMID: 35065807 DOI: 10.1016/j.jpedsurg.2021.12.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 10/31/2022]
Abstract
Diverse perspectives are critical components of effective teams in every industry. Underrepresentation of minorities in medicine leads to worse outcomes for minority patients, and efforts to increase diversity in the health care workforce are critical. Presently, about 70% of the pediatric surgery workforce is white, and pediatric surgeons at large do not reflect the racial or ethnic diversity of the populations they serve. Pediatric surgery fellowship training programs are the gateway to the field, and fellow selection processes should be optimized to support diversity and inclusion. The Association of Pediatric Surgery Training Program Directors (APSTPD) Diversity Equity and Inclusion subcommittee compiled best practices for bias mitigation during fellow selection, drawing from published literature and personal experiences in our own programs. A list of concrete recommendations was compiled, which can be implemented in every phase from applicant screening to rank list creation. We present these as a position statement that has been endorsed by the executive committee of the APSTPD. Pediatric surgery fellowship programs can utilize this focused review of best practices to mitigate bias and support diverse applicants.
Collapse
Affiliation(s)
- Loren Berman
- Department of Surgery Nemours Children's Health, Wilmington, DE, USA, and Sidney Kimmel Medical College at Thomas Jefferson University, 1600 Rockland Road, Philadelphia, PA 19803, USA.
| | - Elizabeth Renaud
- Hasbro Children's Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Devon Pace
- Department of Surgery Nemours Children's Health, Wilmington, DE, USA, and Sidney Kimmel Medical College at Thomas Jefferson University, 1600 Rockland Road, Philadelphia, PA 19803, USA
| | - Cynthia D Downard
- Division of Pediatric Surgery, Hiram C. Polk, Jr., MD, Department of Surgery, University of Louisville, Louisville, KY, USA
| | | | - Eunice Y Huang
- Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ying Z Weatherall
- Division of Pediatric Surgery, Department of Surgery, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Samir K Gadepalli
- Section of Pediatric Surgery, Department of Surgery, C.S. Mott Children's Hospital, The University of Michigan, Ann Arbor, MI, USA
| | - Kevin P Mollen
- Division of Pediatric General and Thoracic Surgery, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Grace Z Mak
- Section of Pediatric Surgery, Department of Surgery, Comer Children's Hospital, The University of Chicago, Chicago, IL, USA
| | - Erika Newman
- Section of Pediatric Surgery, Department of Surgery, C.S. Mott Children's Hospital, The University of Michigan, Ann Arbor, MI, USA
| | | |
Collapse
|
9
|
Kidd VD, Spisak JM, Vanderlinden S, Kayingo G. A survey of implicit bias training in physician assistant and nurse practitioner postgraduate fellowship/residency programs. BMC MEDICAL EDUCATION 2022; 22:598. [PMID: 35922854 PMCID: PMC9351247 DOI: 10.1186/s12909-022-03664-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There has been renewed focus on advancing inclusivity within organized medicine to reduce health disparities and achieve health equity by addressing the deleterious effects of implicit bias in healthcare and clinical outcomes. It is well documented that negative implicit attitudes and stereotypes perpetuate inequity in healthcare. The aim of this study is to investigate implicit bias training in postgraduate physician assistant (PA) and nurse practitioner (NP) education; describe delivery of content to trainees; and detail program directors' attitudes toward this type of training. Although there is research examining implicit bias training in physician residency education, there are no published studies on implicit bias training in postgraduate PA and NP postgraduate residency/fellowship programs. METHOD A non-experimental, descriptive study was designed to obtain information via survey from members of the Association of Postgraduate Physician Assistant Programs (APPAP). RESULTS The response rate was 41%. The majority of respondents (76%) felt that PA and NP postgraduate programs should include implicit bias instruction. Educational strategies used by PA and joint PA/NP postgraduate programs or their sponsoring institution to deliver implicit bias content to trainees include: implicit bias training modules (50%), facilitated group discussions (36%), invited speaker on implicit bias (33%), case studies on implicit bias (16%), and implicit association test (10%); however, 30% of postgraduate programs do not provide implicit bias training to PA and/or NP trainees. Barriers to implementing implicit bias training expressed by some postgraduate programs include: uncertainty in how to incorporate implicit bias training (16%); lack of strategic alignment with training program or sponsoring institution (13%); time constraints (10%); financial constraints (6%); lack of access to content experts (6%); and unfamiliarity with evidence supporting implicit bias training (6%). CONCLUSION The present study sheds some light on the current state of implicit bias training in PA and joint PA/NP postgraduate residency/fellowship programs. While the majority of programs offer some sort of implicit bias training, there is a need to standardize this training in PA and joint PA/NP postgraduate education curricula using an actionable framework.
Collapse
Affiliation(s)
- Vasco Deon Kidd
- School of Medicine, Department of Orthopaedic Surgery, University of California Irvine (UCI Health), 101 The City Dr S, Orange, CA, 92868, USA.
| | - Jennifer M Spisak
- Ronald O. Perelman Department of Emergency Medicine, NYU Langone Health, 545 First Avenue, Greenberg Hall Suite 6B, New York, NY, 10016, USA
| | - Sarah Vanderlinden
- Department of Surgery, Trauma and Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Gerald Kayingo
- Graduate School, University of Maryland Baltimore, Baltimore, MD, USA
| |
Collapse
|
10
|
Guzek R, Goodbody CM, Jia L, Sabatini CS, Sankar WN, Williams BA, Shah AS. Implicit Racial Bias in Pediatric Orthopaedic Surgery. J Pediatr Orthop 2022; 42:393-399. [PMID: 35522848 DOI: 10.1097/bpo.0000000000002170] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Racial and ethnic minority patients continue to experience disparities in health care. It is important to understand provider-level factors that may contribute to these inequities. This study aims to evaluate the presence of implicit racial bias among pediatric orthopaedic surgeons and determine the relationship between bias and clinical decision making. METHODS A web-based survey was distributed to 415 pediatric orthopaedic surgeons. One section measured for potential implicit racial bias using a child-race implicit association test (IAT). IAT scores were compared with US physicians and the US general population using publicly available data. Another section consisted of clinical vignettes with associated questions. For each vignette, surgeons were randomly assigned a single race-version, White or Black. Vignette questions were grouped into an opioid recommendation, management decision, or patient perception category for analysis based on subject tested. Vignette answers from surgeons with IAT scores that were concordant with their randomized vignette race-version (ie, surgeon with pro-White score assigned White vignette version) were compared with those that were discordant. RESULTS IAT results were obtained from 119 surveyed surgeons (29% response rate). Overall, respondents showed a minor pro-White implicit bias ( P <0.001). Implicit bias of any strength toward either race was present among 103/119 (87%) surgeons. The proportion of pediatric orthopaedic surgeons with a strong pro-White implicit bias (29%) was greater than that of US physicians overall (21%, P =0.032) and the US general population (19%, P =0.004). No differences were found in overall opioid recommendations, management decisions, or patient perceptions between concordant and discordant groups. CONCLUSION Most of the pediatric orthopaedic surgeons surveyed demonstrated implicit racial bias on IAT testing, with a large proportion demonstrating strong pro-White bias. Despite an association between implicit bias and clinical decision making in the literature, this study observed no evidence that implicit racial bias affected the management of pediatric fractures. LEVEL OF EVIDENCE Level IV.
Collapse
Affiliation(s)
- Ryan Guzek
- Division of Orthopaedic Surgery, Children's Hospital of Philadelphia
| | | | - Lori Jia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Coleen S Sabatini
- Department of Orthopaedic Surgery, University of California San Francisco and UCSF Benioff Children's Hospital Oakland, Oakland, CA
| | - Wudbhav N Sankar
- Division of Orthopaedic Surgery, Children's Hospital of Philadelphia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Brendan A Williams
- Division of Orthopaedic Surgery, Children's Hospital of Philadelphia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Apurva S Shah
- Division of Orthopaedic Surgery, Children's Hospital of Philadelphia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
11
|
Bias and discrimination in surgery: Where are we and what can we do about it? J Pediatr Surg 2022; 57:1315-1320. [PMID: 35307193 DOI: 10.1016/j.jpedsurg.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/07/2022] [Accepted: 02/15/2022] [Indexed: 11/24/2022]
Abstract
Bias is an inclination or preconceived outlook that favors toward or against an idea, person, or group. It manifests in implicit and explicit ways throughout all aspects and institutions of society. These cognitive shortcuts are often based on stereotypes and can lead to prejudice and discrimination in medicine as they mediate interactions with patients, between providers, and at the institutional level. It is important to understand the drivers and consequences of bias in order to overcome barriers to representation, equity, and inclusion. This paper provides definitions of bias; discusses its manifestations across academic medicine at the institutional and individual levels; and concludes by examining techniques to reduce bias and measure progress. Equity for patients, families, and members of the broader surgical community cannot be achieved without reducing bias and discrimination. We call for action to increase intentional efforts that reduce the influences of bias in healthcare, research, and education, particularly in the field of pediatric surgery.
Collapse
|
12
|
Webber CRJ, Davie R, Herzwurm Z, Whitehead J, Paré DW, Homlar KC. Is There Unconscious Bias in the Orthopaedic Residency Interview Selection Process? JOURNAL OF SURGICAL EDUCATION 2022; 79:1055-1062. [PMID: 35241397 DOI: 10.1016/j.jsurg.2022.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 09/28/2021] [Accepted: 02/06/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Orthopaedic surgery has historically been a white male-dominated field. Given the diverse patient population presenting to providers with musculoskeletal pathology, it is thought that it would be beneficial for the orthopaedic workforce to more closely mirror this patient population. This study aims to elucidate whether unconscious bias may have an effect on the scoring of applications for residency interview selection. DESIGN Applications for the 2019-2020 residency match cycle were initially reviewed and scored by faculty members. Applications were then redacted of all information suggestive of race or gender and returned to evaluators for rescoring after at least 6 months. The pre and post-redaction data was compared using ANOVA and student's two-tailed t tests. SETTING Department of Orthopaedic Surgery, Medical College of Georgia at Augusta University. PARTICIPANTS Thirteen attending surgeons scored 320 2019-2020 Electronic Residency Application System (ERAS) applications, unblinded and blinded of applicant identifying information. RESULTS Interviewed applicants were similar to the non-interviewed group in all measured variables except for higher pre-redaction scores (8.73-7.81; p = 0.02) which was expected (Table 2). Minority applicants had significant differences in Step 1 scores (243 vs 247; p < 0.01), Step 2 scores (251 vs 254; p = 0.01), articles (5.9 vs 3.8; p < 0.01), posters (5.9 vs 3.5; p < 0.01), and pre-redaction scores (7.44 vs 8.07; p = 0.01) compared to white applicants (Table 4). There was no relationship noted between step score and number or type of research items (Table 5). Pre-redaction and post-redaction scores were significantly different in white applicants who experienced a negative change (8.07-7.88; p = 0.03 (Table 6)). Males had statistically significant differences compared to females in Step 1 score (246 vs 243; p = 0.01) (Table 7). CONCLUSIONS This study was unable to prove unconscious bias based on a lack of statistically significant change of score when blinded, however the direction in change of scores was unlikely to be accounted for exclusively by objective differences between applicants, suggesting a trend toward unconscious bias. It remains unclear how influential subjective portions of the ERAS application such as personal statements, Letters of Recommendation, hobbies, and activities are on the overall assessment of an applicant and whether or not unconscious bias manifests in these subjective portions. Further investigation is needed in this area. Until then, residency programs should take immediate measures to mitigate potential implicit bias in the residency interview selection process. Actions can include implicit bias training for all faculty members involved in resident selection, standardization of application scoring and possibly redacting all or portions of the ERAS application so that only objective academic markers are presented to evaluators. Gaining a better understanding of these barriers is not only essential for their removal, but also allows for better preparation of applicants for success in the match with the ultimate goal being to correct the persistent disparity in the field of orthopaedic surgery.
Collapse
Affiliation(s)
- Colton R J Webber
- Department of Orthopaedic Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia.
| | - Ryann Davie
- Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Zachary Herzwurm
- Department of Orthopaedic Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Jonathon Whitehead
- Department of Orthopaedic Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Daniel W Paré
- Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Kelly C Homlar
- Department of Orthopaedic Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia
| |
Collapse
|
13
|
Diversifying Medical School and Residency Programs: a Practical Guide for Gatekeepers. CURRENT TRAUMA REPORTS 2022. [DOI: 10.1007/s40719-022-00230-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
14
|
Calderon Y, Beeson MS, Johnston MM, Joldersma KB, Reisdorff EJ. Emergency Medicine Residency Does Not Reduce a Racial Minority-Based Test Performance Gap. J Emerg Med 2022; 62:793-799. [PMID: 35781370 DOI: 10.1016/j.jemermed.2022.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Health care inequity is corrected more readily when safe, high-quality care is provided by physicians who reflect the gender, race, and ethnicity of patient communities. It is important to train and evaluate racially diverse physicians involved in residency training. OBJECTIVE This study sought to determine any test-taking differences for black Emergency Medicine (EM) residents and whether any such differences would narrow as residency progressed. METHODS This was an observational, cross-sectional study that reviewed performance (scaled scores) on the American Board of Emergency Medicine (ABEM) In-Training Examination (ITE) for 2018, 2019, and 2020. The study included EM residents in 3-year programs who took the ITE. A linear regression model was used for the variables of race, which included black physicians and white physicians (reference group), and level of training (EM resident year 1 [EM1] as the reference group). RESULTS There were 9591 residents included; 539 were black and 9052 were white. Mean scaled scores were higher as a function of training level. Regression showed a scaled score intercept of 73.51. The ITE score increased for all groups as a function of training level (EM2 β = +5.45, p < 0.0001; EM3 β = +8.09, p < 0.0001). The regression coefficient for black residents was -5.87 (p < 0.0001). There was relative improvement by training level compared with improvement in the reference group, but this difference was not materially or statistically significant. CONCLUSION In this study of the ABEM ITE, a test-taking performance gap identified early in residency for black physicians persisted into late residency.
Collapse
Affiliation(s)
- Yvette Calderon
- Department of Emergency Medicine, Albert Einstein College of Medicine, New York, New York
| | | | - Mary M Johnston
- American Board of Emergency Medicine, East Lansing, Michigan
| | | | | |
Collapse
|
15
|
Towaij C, Gawad N, Alibhai K, Doan D, Raîche I. Trust Me, I Know Them: Assessing Interpersonal Bias in Surgery Residency Interviews. J Grad Med Educ 2022; 14:289-294. [PMID: 35754644 PMCID: PMC9200259 DOI: 10.4300/jgme-d-21-00882.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/24/2022] [Accepted: 02/28/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Residency selection integrates objective and subjective data sources. Interviews help assess characteristics like insight and communication but have the potential for bias. Structured multiple mini-interviews may mitigate some elements of bias; however, a halo effect is described in assessments of medical trainees, and degree of familiarity with applicants may remain a source of bias in interviews. OBJECTIVE To investigate the extent of interviewer bias that results from pre-interview knowledge of the applicant by comparing file review and interview scores for known versus unknown applicants. METHODS File review and interview scores of applicants to the University of Ottawa General Surgery Residency Training Program from 2019 to 2021 were gathered retrospectively. Applicants were categorized as "home" if from the institution, "known" if they completed an elective at the institution, or "unknown." The Kruskal-Wallis H test was used to compare median interview scores between groups and Spearman's rank-order correlation (rs) to determine the correlation between file review and interview scores. RESULTS Over a 3-year period, 169 applicants were interviewed; 62% were unknown, 31% were known, and 6% were home applicants. There was a statistically significant difference (P=.01) between the median interview scores of home, known, and unknown applicants. Comparison of groups demonstrated higher positive correlations between file review and interview scores (rs=0.15 vs 0.36 vs 0.55 in unknown, known, and home applicants) with increasing applicant familiarity. CONCLUSIONS There is an increased positive correlation between file review and interview scores with applicant familiarity. The interview process may carry inherent bias insufficiently mitigated by the current structure.
Collapse
Affiliation(s)
- Chelsea Towaij
- Chelsea Towaij, MD, is a Postgraduate Year 5 Resident, Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
| | - Nada Gawad
- Nada Gawad, MD, MAEd, is a Surgical Fellow, Division of General Surgery, Department of Surgery, Faculty of Medicine, Department of Innovation in Medical Education (DIME), University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
| | - Kameela Alibhai
- Kameela Alibhai, BSc, is a Third-Year Medical Student, Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Danielle Doan
- Danielle Doan, MAEd, is a Program Administrator, Division of General Surgery, Department of Surgery, Faculty of Medicine, Eric Poulin Office of Education, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
| | - Isabelle Raîche
- Isabelle Raîche, MD, MAEd, is an Assistant Professor of Surgery, Division of General Surgery, Department of Surgery, Faculty of Medicine, DIME, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
| |
Collapse
|
16
|
The Radiology Resident Education Research Alliance: The Evolution of a Multi-Institutional Research Cooperative. J Am Coll Radiol 2022; 19:586-589. [PMID: 35216944 DOI: 10.1016/j.jacr.2021.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/23/2021] [Accepted: 12/27/2021] [Indexed: 11/21/2022]
|
17
|
Haag J, Sanders B, Walker Keach J, Lefkowits C, Sheeder J, Behbakht K. Impact of blinding interviewers to written applications on ranking of Gynecologic Oncology fellowship applicants from groups underrepresented in medicine. Gynecol Oncol Rep 2022; 39:100935. [PMID: 35141387 PMCID: PMC8814661 DOI: 10.1016/j.gore.2022.100935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/16/2022] [Accepted: 01/23/2022] [Indexed: 11/25/2022] Open
Abstract
Despite attempts to improve diversity in healthcare, many populations continue to be underrepresented in medicine (URM) Blinded interviews, which de-emphasize the written application, may reduce bias in application review. We found that blinded interviewers were more likely to rank URM applicants more highly. Other techniques to limit bias, such as standardized questions and implicit bias training, should be considered.
Biases in application review may limit access of applicants who are underrepresented in medicine (URM) to graduate medical training opportunities. We aimed to evaluate the association between blinding interviewers to written applications and final ranking of all applicants and URM applicants for Gynecologic Oncology fellowship. During 2020 virtual Gynecologic Oncology fellowship interviews, we blinded one group of interviewers to written applications, including self-reported URM status. Interviewers visually interacted with the applicants but did not review their application. Interviewers submitted independent rank lists. We compared pooled rankings of blinded and non-blinded interviewers for all applicants and for URM applicants using appropriate bivariate statistics. We received 94 applications for two positions through the National Resident Matching Program, of which 18 (19%) self-identified as URM. We invited 40 applicants to interview and interviewed 30 applicants over six sessions. Ten interviewees (33%) self-identified as URM. Of 12 or 13 faculty interviewers during each interview session, 3 or 4 were blinded to the written application. There was no statistically significant difference in rank order when comparing blinded to non-blinded interviewers overall. However, blinded interviewers ranked URM applicants higher than non-blinded interviewers (p = 0.04). Blinding of written application metrics may allow for higher ranking of URM individuals.
Collapse
|
18
|
Weisberg EM, Fishman EK. Judging film, not skin: can radiologists combat bias in medicine? Clin Imaging 2021; 81:60-61. [PMID: 34619565 PMCID: PMC8489373 DOI: 10.1016/j.clinimag.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/16/2021] [Accepted: 09/06/2021] [Indexed: 11/03/2022]
Abstract
From the more than 700,000 deaths from COVID-19 in the US and the nearly 5 million worldwide, there emerge even more stories than match the statistics when one considers all of the patients' relations. While the numbers are staggering, when we humanize the stories, we are left with even greater devastation, of course. One of the stories among so many that seemed particularly salient and poignant to us was the death of Dr. Susan Moore. Her plaintive Facebook post, which went viral in December 2020, was made a few weeks before she died at the age of 52 from COVID-19 and claimed that she was a victim of racially biased treatment at a hospital in Indiana. It was Dr. Moore's mentioning of CT scans that led us to reflect on the biases of some health care workers and the role of radiologists. Our initial interface with our patients is actually not with their faces, but with their films. This dynamic does not eliminate any biases we may harbor but shields practitioners and patients from potential glaring racial biases in this first and sometimes only stage of the relationship.
Collapse
Affiliation(s)
- Edmund M Weisberg
- Johns Hopkins University Russell H. Morgan Department of Radiology and Radiological Science, 601 North Caroline Street, JHOC 3262, Baltimore, MD 21287 USA.
| | - Elliot K Fishman
- Johns Hopkins University Russell H. Morgan Department of Radiology and Radiological Science, 601 North Caroline Street, JHOC 3254, USA. https://twitter.com/CTisus
| |
Collapse
|
19
|
Maxfield CM, Montano-Campos JF, Chapman T, Desser TS, Ho CP, Hull NC, Kelly HR, Kennedy TA, Koontz NA, Knippa EE, McLoud TC, Milburn J, Mills MK, Morgan DE, Morgan R, Peterson RB, Salastekar N, Thorpe MP, Zarzour JG, Reed SD, Grimm LJ. Factors Influential in the Selection of Radiology Residents in the Post-Step 1 World: A Discrete Choice Experiment. J Am Coll Radiol 2021; 18:1572-1580. [PMID: 34332914 DOI: 10.1016/j.jacr.2021.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 07/06/2021] [Accepted: 07/09/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Reporting of United States Medical Licensing Examination Step 1 results will transition from a numerical score to a pass or fail result. We sought an objective analysis to determine changes in the relative importance of resident application attributes when numerical Step 1 results are replaced. METHODS A discrete choice experiment was designed to model radiology resident selection and determine the relative weights of various application factors when paired with a numerical or pass or fail Step 1 result. Faculty involved in resident selection at 14 US radiology programs chose between hypothetical pairs of applicant profiles between August and November 2020. A conditional logistic regression model assessed the relative weights of the attributes, and odds ratios (ORs) were calculated. RESULTS There were 212 participants. When a numerical Step 1 score was provided, the most influential attributes were medical school (OR: 2.35, 95% confidence interval [CI]: 2.07-2.67), Black or Hispanic race or ethnicity (OR: 2.04, 95% CI: 1.79-2.38), and Step 1 score (OR: 1.8, 95% CI: 1.69-1.95). When Step 1 was reported as pass, the applicant's medical school grew in influence (OR: 2.78, 95% CI: 2.42-3.18), and there was a significant increase in influence of Step 2 scores (OR: 1.31, 95% CI: 1.23-1.40 versus OR 1.57, 95% CI: 1.46-1.69). There was little change in the relative influence of race or ethnicity, gender, class rank, or clerkship honors. DISCUSSION When Step 1 reporting transitions to pass or fail, medical school prestige gains outsized influence and Step 2 scores partly fill the gap left by Step 1 examination as a single metric of decisive importance in application decisions.
Collapse
Affiliation(s)
- Charles M Maxfield
- Vice-Chair of Education, Department of Radiology, Duke University Medical Center, Durham, North Carolina.
| | - J Felipe Montano-Campos
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Teresa Chapman
- Residency Program Director, Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | - Terry S Desser
- Department of Radiology, Stanford University Medical Center, Stanford, California
| | - Christopher P Ho
- Residency Program Director, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Nathan C Hull
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Hillary R Kelly
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Tabassum A Kennedy
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Nicholas A Koontz
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Emily E Knippa
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Theresa C McLoud
- Vice-Chair of Education, Residency Program Director, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - James Milburn
- Residency Program Director, Department of Radiology, Ochsner Health System, New Orleans, Louisiana
| | - Megan K Mills
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | - Desiree E Morgan
- Vice-Chair of Education, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Rustain Morgan
- Residency Program Director, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Ryan B Peterson
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Ninad Salastekar
- Department of Radiology, SUNY Upstate Medical University, Syracuse, New York
| | | | - Jessica G Zarzour
- Radiology Residency Program Director, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Shelby D Reed
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Lars J Grimm
- Department of Radiology, Duke University Medical Center, Durham, North Carolina
| |
Collapse
|
20
|
Tseng JR, Kang YS, Youm J, Pandit R. Radiology resident selection factors predict resident performance. Clin Imaging 2021; 80:225-228. [PMID: 34352495 DOI: 10.1016/j.clinimag.2021.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/04/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To determine selection factors that predict radiology resident performance. METHODS 59 consecutive radiology residents from 2002 to 2015 were ranked on performance during residency. Correlations and multiple regression analyses were performed to predict resident performance from the following selection factors: United States Medical Licensing Exam (USMLE) Step 1 score, medical school rank, Alpha Omega Alpha (AOA) membership, honors in clinical rotations, Medical Student Performance Evaluation (MSPE), and interview score. Results were compared against predictions from Match rank position. RESULTS Five selection factors showed significant or marginally significant correlations with resident performance (r = 0.2 to 0.3). The interview score was not significantly correlated. A multiple regression model comprised of the USMLE Step 1 score, medical school rank, AOA membership, and interview score predicted resident performance, with an adjusted R2 of 0.19. The interview score was included in the model but did not achieve statistical significance. Match rank did not predict resident performance, with an R2 of 0.01. CONCLUSIONS A multiple regression model comprised of the USMLE Step 1 score, medical school rank, and AOA membership predicted radiology resident performance and may assist with resident selection.
Collapse
Affiliation(s)
- Jeffrey R Tseng
- Santa Clara Valley Medical Center, Department of Radiology, 751 South Bascom Avenue, San Jose, CA 95128, United States of America.
| | - Young S Kang
- Santa Clara Valley Medical Center, Department of Radiology, 751 South Bascom Avenue, San Jose, CA 95128, United States of America
| | - Jiwon Youm
- Santa Clara Valley Medical Center, Department of Radiology, 751 South Bascom Avenue, San Jose, CA 95128, United States of America
| | - Rajul Pandit
- Santa Clara Valley Medical Center, Department of Radiology, 751 South Bascom Avenue, San Jose, CA 95128, United States of America
| |
Collapse
|
21
|
Abstract
BACKGROUND The potential exists for unconscious bias to influence decisions throughout the admission process to nursing school and derail holistic admission review processes. Although little is known about unconscious bias in nursing school admissions, unconscious bias has been demonstrated in nurse educators at levels similar to the general population. METHOD This article examines concepts of unconscious bias, factors that may interfere with accurate and fair assessment of applicants to nursing school, and ways to mitigate unconscious bias in the application and admission decision processes. RESULTS Interventions that have shown success in reducing unconscious bias center on increased awareness of the presence of unconscious bias and cognitive strategies that include motivation and effort to counter the unconscious bias. CONCLUSION Creating structures in the admission process that promote fairness and reduce the risk of relying on automatic judgments can minimize the influence of unconscious bias on admission decisions. [J Nurs Educ. 2021;60(6):317-323.].
Collapse
|
22
|
Ware AD, Flax LW, White MJ. Strategies to Enhance Diversity, Equity, and Inclusion in Pathology Training Programs: A Comprehensive Review of the Literature. Arch Pathol Lab Med 2021; 145:1071-1080. [PMID: 34015822 DOI: 10.5858/arpa.2020-0595-ra] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Like many medical specialties, pathology faces the ongoing challenge of effectively enriching diversity, equity, and inclusion within training programs and the field as a whole. This issue is furthered by a decline in US medical student interest in the field of pathology, possibly attributable to increasingly limited pathology exposure during medical school and medical student perceptions about careers in pathology. OBJECTIVE.— To review the literature to identify the challenges to diversity, equity, and inclusion in pathology, with an emphasis on the pathology trainee pipeline. To evaluate the medical education literature from other medical specialties for diversity and inclusion-focused studies and initiatives, and determine the outcomes and/or approaches relevant for pathology training programs. DATA SOURCES.— A literature review was completed by a search of the PubMed database, as well as a similar general Google search. Additional resources, including the Web sites of the Association of American Medical Colleges, the Electronic Residency Application Service, and the National Resident Matching Program, were used. CONCLUSIONS.— Many strategies exist to increase diversity and encourage an inclusive and equitable training environment, and many of these strategies may be applied to the field of pathology. Interventions such as increasing exposure to the field, using a holistic application review process, and addressing implicit biases have been shown to promote diversity, equity, and inclusion in many medical specialties. In addition, increasing access to elective and pipeline programs may help to bolster medical student interest in careers in pathology.
Collapse
Affiliation(s)
- Alisha D Ware
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (Ware, White)
| | | | - Marissa J White
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (Ware, White)
| |
Collapse
|
23
|
O'Brien EK, Douse DM, Bayan SL, Stokken JK, Van Abel KM. Increasing the Number of Black Otolaryngologists. Otolaryngol Clin North Am 2021; 54:457-470. [PMID: 33743890 DOI: 10.1016/j.otc.2020.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Otolaryngology continues to have one of the lowest percentages of black physicians of any surgical specialty, a number than has not improved in recent years. The history of exclusion of black students in medical education as well as ongoing bias affecting examination scores, clerkship grades and evaluations, and honors society acceptance of black students may factor into the disproportionately low number of black otolaryngology residents. In order to increase the number of black physicians in otolaryngology, intentional steps must be taken to actively recruit, mentor, and train black physicians specializing in otolaryngology.
Collapse
Affiliation(s)
- Erin K O'Brien
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA.
| | - Dontre' M Douse
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA
| | - Semirra L Bayan
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA
| | - Janalee K Stokken
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA
| | - Kathryn M Van Abel
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA
| |
Collapse
|
24
|
Maxfield CM, Thorpe MP, Koontz NA, Grimm LJ. You’re Biased! Deal With It. J Am Coll Radiol 2021; 18:161-165. [DOI: 10.1016/j.jacr.2020.06.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 02/07/2023]
|
25
|
Swipe right for surgical residency: Exploring the unconscious bias in resident selection. Surgery 2020; 168:724-729. [DOI: 10.1016/j.surg.2020.05.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/16/2020] [Accepted: 05/19/2020] [Indexed: 11/19/2022]
|