Unconscious bias influences the selection of candidates in all types of organizations. This is no different in medical school admissions, where bias often results in the exclusion of talented candidates whose backgrounds and experiences may differ from those of selectors. Bias in admissions perpetuates inequities within medical education, the healthcare workforce, and in health outcomes. Many academic institutions have implemented training to raise awareness of unconscious bias. However, these trainings typically do not teach skills for addressing and mitigating bias that stems from individual and structural sources. Read More
In addition, such programs are often passively delivered without opportunities for engagement to emphasize not just recognition, but also language, skills, and techniques for prevention, mitigation, and correction.
Dr. Sunny Nakae at California University of Science and Medicine argues that, to achieve more equitable admissions outcomes, an active culture of bias recognition and mitigation is key. She and her colleagues have developed an interactive training, which uses real committee comments, reflections, and audience responses to improve the recognition and mitigation of bias in admissions processes, with attention to structural practices that may reduce bias up front.
The Bias Breakers workshop created by Nakae’s team leverages reflection and application by identifying over 23 structural and interpersonal biases that often go unseen and unchecked in existing admissions and selection practices.
In the workshop, these biases are illuminated through examples of comments and behaviors of committees. For instance, ‘name bias’ may lead to candidates with more familiar names receiving greater consideration, while ‘zero risk’ may cause committee members to apply a more stringent standard to candidates who have disclosed challenges related to identity or background. ‘Blind spot’ bias may encourage fixation on one outstanding strength while limiting discussion on limitations. Learning to look for – and challenge – ‘coded language’ can help committee members re-focus on mission alignment.
Vitally, the workshop provides specific mitigation strategies to change frameworks, practices, and policies in the admissions and selection process. Committee members are encouraged to utilize continuous learning tools to consistently cultivate a culture of bias prevention, recognition, and mitigation.
Nakae’s team measured the effectiveness of Bias Breakers using assessments before and after the training sessions. These showed the workshop to be highly effective in building skills to recognize and mitigate bias to achieve more equitable selection outcomes; a stronger, more diverse healthcare workforce representative of the population; and ultimately, improved health equity in patient outcomes.
