Implicit-Bias Remedies: Treating Discriminatory Bias as a Public-Health Problem

Greenwald, Anthony G.; Dasgupta, Nilanjana; Dovidio, John F.; Kang, Jerry; Moss‐Racusin, Corinne A.; Teachman, Bethany A.

doi:10.1177/15291006211070781

Cited by 54 publications

(39 citation statements)

References 121 publications

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“…40 In addition, the numeric scale used to demarcate Milestones may provide evaluators with undue discretion, rendering the tool vulnerable to rater bias. 41 Mastery grading systems, in which mastery standards are defined and assessments are made along a binary scale (mastered vs not mastered), may alleviate some of the racial and ethnic disparities in assessment described in this study. 42,43 This recommendation is supported by our finding that Asian and URiM residents were no more likely to receive a critical deficiency than White residents.…”

Section: Discussionmentioning

confidence: 97%

Racial and Ethnic Differences in Internal Medicine Residency Assessments

et al. 2022

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ImportancePrevious studies have demonstrated racial and ethnic inequities in medical student assessments, awards, and faculty promotions at academic medical centers. Few data exist about similar racial and ethnic disparities at the level of graduate medical education.ObjectiveTo examine the association between race and ethnicity and performance assessments among a national cohort of internal medicine residents.Design, Setting, and ParticipantsThis retrospective cohort study evaluated assessments of performance for 9026 internal medicine residents from the graduating classes of 2016 and 2017 at Accreditation Council of Graduate Medical Education (ACGME)–accredited internal medicine residency programs in the US. Analyses were conducted between July 1, 2020, and June 31, 2022.Main Outcomes and MeasuresThe primary outcome was midyear and year-end total ACGME Milestone scores for underrepresented in medicine (URiM [Hispanic only; non-Hispanic American Indian, Alaska Native, or Native Hawaiian/Pacific Islander only; or non-Hispanic Black/African American]) and Asian residents compared with White residents as determined by their Clinical Competency Committees and residency program directors. Differences in scores between Asian and URiM residents compared with White residents were also compared for each of the 6 competency domains as supportive outcomes.ResultsThe study cohort included 9026 residents from 305 internal medicine residency programs. Of these residents, 3994 (44.2%) were female, 3258 (36.1%) were Asian, 1216 (13.5%) were URiM, and 4552 (50.4%) were White. In the fully adjusted model, no difference was found in the initial midyear total Milestone scores between URiM and White residents, but there was a difference between Asian and White residents, which favored White residents (mean [SD] difference in scores for Asian residents: −1.27 [0.38]; P &lt; .001). In the second year of training, White residents received increasingly higher scores relative to URiM and Asian residents. These racial disparities peaked in postgraduate year (PGY) 2 (mean [SD] difference in scores for URiM residents, −2.54 [0.38]; P &lt; .001; mean [SD] difference in scores for Asian residents, −1.9 [0.27]; P &lt; .001). By the final year 3 assessment, the gap between White and Asian and URiM residents’ scores narrowed, and no racial or ethnic differences were found. Trends in racial and ethnic differences among the 6 competency domains mirrored total Milestone scores, with differences peaking in PGY2 and then decreasing in PGY3 such that parity in assessment was reached in all competency domains by the end of training.Conclusions and RelevanceIn this cohort study, URiM and Asian internal medicine residents received lower ratings on performance assessments than their White peers during the first and second years of training, which may reflect racial bias in assessment. This disparity in assessment may limit opportunities for physicians from minoritized racial and ethnic groups and hinder physician workforce diversity.

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Section: Discussionmentioning

confidence: 97%

Racial and Ethnic Differences in Internal Medicine Residency Assessments

et al. 2022

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“…To ensure data quality, the scoring algorithm described in Greenwald et al (2003) was used, resulting in the exclusion of data from 9.8% of participants. While there have been controversies surrounding what the IAT measures (e.g., individual differences vs. situational associations), there is considerable evidence for its good psychometric properties, particularly when aggregated across groups (for a fuller discussion of critiques of the IAT and the evidence for its use and interpretation, see Greenwald et al, in press).…”

Section: Methodsmentioning

confidence: 99%

Effects of Mass Shootings on Mental Illness Stigma in the United States

Beltzer

Moulder

Baker

et al. 2022

Pers Soc Psychol Bull

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Although the vast majority of people with mental illness (PWMI) are not violent, Americans tend to think they are more dangerous than the general population. Because negative media portrayals may contribute to stigma, we used time-series analyses to examine changes in the public’s perceived dangerousness of PWMI around six mass shootings whose perpetrators were reported to have a mental illness. From 2011 to 2019, 38,094 U.S. participants completed an online study assessing implicit and explicit perceived dangerousness of PWMI. There were large, upward spikes in perceived dangerousness the week of the Sandy Hook mass shooting that were relatively short-lived. However, there was not a consistent pattern of effects for other events analyzed, and any other spikes observed were smaller. Effects tended to be larger for explicit versus implicit perceived dangerousness. Sandy Hook seemed to temporarily worsen perceived dangerousness of PWMI, but this pattern was not observed for other mass shootings.

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“…Such learning plays an important role in our skills, perceptions, attitudes and overall behaviour, such as biases towards age, socioeconomic status, gender, race, etc. (in this context, see for example Greenwald et al, 2022).…”

Section: Evans (2019) Default Interventionist Model-revisedmentioning

confidence: 99%

Heuristics, Biases and the Psychology of Reasoning: State of the Art

Martin¹,

Valiña²

2023

PSYCH

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Investigations on heuristics and biases have had a great impact on the study of reasoning and related higher cognitive processes, such as judgment and decision making. Specifically, the research in cognitive psychology of reasoning has revealed that people frequently activate mental shortcuts, or heuristics, to make inferences. These are non-logical strategies and could lead subjects to commit systematic deviations from the tenets of normative principles, that is, cognitive biases. The key objective of this paper is to present some of the most relevant theories on heuristics and biases in reasoning, focusing on the dual process theories of deduction. According to these theories, there are two kinds of thinking. Type 1, automatic, unconscious, implicit, fast and effortless and Type 2, reflective, controlled, conscious, explicit, slow and effortful. Much debate on these theories has emphasized on the relationship between both types of processes and the underlying factors that could triggered one or other. In this regard, different dual-process theories propose distinct answers to these questions. The results in the literature have registered that the likelihood of activation of Type 1 and Type 2 processes has important consequences on reasoning, both in experimental laboratory tasks and in everyday situations. Recent empirical investigations that have studied the critical role that intuitive and deliberative processes play in different professional areas are displayed. It is a key question that future research continues with the study of the underlying procedures that professionals activate for reasoning and decision making.

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Implicit-Bias Remedies: Treating Discriminatory Bias as a Public-Health Problem

Cited by 54 publications

References 121 publications

Racial and Ethnic Differences in Internal Medicine Residency Assessments

Racial and Ethnic Differences in Internal Medicine Residency Assessments

Effects of Mass Shootings on Mental Illness Stigma in the United States

Heuristics, Biases and the Psychology of Reasoning: State of the Art

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