Opportunities for Mitigating Bias in the Process and Priorities for Pediatric Chief Resident Selection

Gustafson, Sarah; Poitevien, Patricia; Acholonu, Rhonda Graves; Blankenburg, Rebecca; Fromme, H. Barrett

doi:10.1016/j.acap.2021.12.004

Cited by 4 publications

(11 citation statements)

References 12 publications

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“…Some programs consider examination scores in the CR selection process; however, this introduces another known source of bias, as standardized test scores may be influenced by family income level and access to educational resources, and therefore disadvantage those from lower socioeconomic strata. [1,9]. In addition, test scores do not necessarily translate to excellence in the clinical competencies desired of a CR [2,10].…”

Section: Introductionmentioning

confidence: 99%

“…Chief residency is a considered an honor, and may facilitate a future career in academia and/or professional leadership positions for those selected [1][2][3][4][5][6]. At the same time, the selection process for the chief resident (CR) role varies across programs, is often opaque to the stakeholders and can be vulnerable to various types of biases, which may include affinity or in-group bias, gender bias, and racial and ethnicity biases, among others [1][2][3]7]. Efforts to increase diversity in academic medicine and physician leadership may be aided by an inclusive process that facilitates the selection of a diverse pool of CRs [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“…At the same time, the selection process for the chief resident (CR) role varies across programs, is often opaque to the stakeholders and can be vulnerable to various types of biases, which may include affinity or in-group bias, gender bias, and racial and ethnicity biases, among others [1][2][3]7]. Efforts to increase diversity in academic medicine and physician leadership may be aided by an inclusive process that facilitates the selection of a diverse pool of CRs [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Those most influential in CR selection include program directors and associate program directors, current chiefs, coordinators, and the departmental chair [1,8]. CRs are often chosen for their "fit" with each other and with departmental leadership, which may lead to in-group bias, with influencers unconsciously favoring candidates most similar to themselves [1]. Some programs consider examination scores in the CR selection process; however, this introduces another known source of bias, as standardized test scores may be influenced by family income level and access to educational resources, and therefore disadvantage those from lower socioeconomic strata.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Implementation of a Chief Resident Selection Process Designed to Mitigate Bias: Lessons Learned

Katz-Sidlow,

Roberts,

Elliott

et al. 2023

Cureus

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Background: Chief residency selection processes are often opaque and beset by bias, which can result in disparities in who is selected for this important role. As a chief residency can lead to future academic and/or leadership positions, efforts to increase diversity in academic medicine and physician leadership may be aided by an inclusive chief resident (CR) selection process designed to mitigate bias.Objective: To implement and evaluate the acceptability of a CR selection process that is inclusive and designed to mitigate bias.Methods: In the 2021-2022 academic year, we designed and implemented a CR selection process aligned with published strategies known to mitigate bias in academic recruitment. The four-step opt-out CR selection process included a nomination survey, structured interviews, a clinical review, and a holistic review of each candidate. Each step was clearly delineated, assigned a specific number of points, and scored on a designated rubric. The candidates with the highest and second-highest number of points were awarded the two CR positions. Our selection process excluded examination scores and precluded consideration of "fit" between the selected CRs, as these are known sources of potential bias. In January 2023, we surveyed our department to obtain post-implementation feedback and to assess satisfaction with the process, before repeating the process for 2022-2023.Results: Survey response rates were 47% (14/30) for residents and 29% (18/63) for departmental faculty. The majority of responding residents (64%) and faculty (100%) were satisfied with the CR selection process, finding it fair and inclusive. Nearly 80% of residents and 100% of faculty wished to repeat the process in 2022-2023.Conclusions: An inclusive CR selection process utilizing strategies to mitigate bias was feasible, and acceptable to residents and faculty. We recommend that residency training programs make efforts to implement CR selection practices that are inclusive and aim to mitigate bias.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Implementation of a Chief Resident Selection Process Designed to Mitigate Bias: Lessons Learned

Katz-Sidlow,

Roberts,

Elliott

et al. 2023

Cureus

View full text Add to dashboard Cite

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The Chief Residency in U.S. and Canadian Graduate Medical Education: A Scoping Review

McDaniel,

Molloy,

Blanck

et al. 2024

Teaching and Learning in Medicine

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The selection of chief residents across residency programs at a large academic medical center

Mirabal,

Wright,

O’Rourke

2023

BMC Med Educ

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Background Chief residents have a unique role in graduate medical education (GME). They not only connect residents with program and hospital leadership, but also advocate for the wellbeing and educational priorities of trainees. Previous studies have focused on describing the characteristics of chief residents (CRs), however little is known about how CRs are selected across GME programs. Methods One-on-one semi-structured interviews with all (n = 21) GME program directors at the Johns Hopkins University School of Medicine were conducted from January to March 2022. Investigators independently coded the transcripts using an inductive approach to categorize meaningful segments of text; this culminated in the identification of explanatory themes. Results From discussions with 21 program directors, four themes were identified: (1) identifying candidates: timing, recruitment, nominations, as well as desirable attributes and data considered; (2) applications: expression of intent and participation in interviews; (3) selections: voting, discussions leading to consensus, and program director intimately involved in the choice(s); and (4) confidence in processes and outcomes. Conclusions Our results provide a deeper understanding of the nuances associated with the selection of CRs. It is hoped that the descriptions of the similarities and differences across GME programs will prompt reflection about what is done at one institution such that all programs can consider what are the best practices to serve their individual goals and needs.

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Opportunities for Mitigating Bias in the Process and Priorities for Pediatric Chief Resident Selection

Cited by 4 publications

References 12 publications

Implementation of a Chief Resident Selection Process Designed to Mitigate Bias: Lessons Learned

Implementation of a Chief Resident Selection Process Designed to Mitigate Bias: Lessons Learned

The Chief Residency in U.S. and Canadian Graduate Medical Education: A Scoping Review

The selection of chief residents across residency programs at a large academic medical center

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