Medical Student Evaluations Applied Differently Depending on Gender, Minority Status

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The following is a transcript of a recent Research That Matters piece on implicit bias. Listen to this segment and the rest of the show “Working Together to Improve the Care of an Aging Population.”

Dr. Adam Goldstein: This very first one is perhaps one that perhaps I have fallen victim to and can really strive to do better. And it’s the terms that we use to describe our mentees. We’re going to be talking about mentorship in the conversations with our senior adults, but this is about our mentees, the learners, and particularly let’s say medical students. When they do rotations with us they’re frequently coming with us for a rotation 4-6 weeks; they may be with us every day; they may be shadowing providers; they may be seeing patients with us and presenting to us. And at the very end of that period of time we do evaluations of the students. Some authors from the University of San Francisco, California published an article in the Journal of General Internal Medicine which said, do the evaluations that I, and maybe my colleagues, do differ by the gender and the minority status of the students. So specifically, do I write different things whether or not the medical student is a male or female or African American or non-African American and do I then perhaps implicitly have some bias of how I describe and maybe evaluate them. I don’t know if the research completely answers that. But it’s really quite interesting because they actually looked at over 9 years, from 2006 and 2015 both in California and San Francisco and at Brown University at over 90,000 narrative evaluations of third year students. That alone, I think, is an impressive understanding, the evaluation and collecting it orally and they were really saying is it on the behavior of the student or the competencies, the skills that they show or don’t show that are relevant but that a lot of times people when they were evaluating used a kind of personal description and it was really striking by gender, and it really could impact on their evaluations. So for instance, in 2/3 of the words that the evaluators used differed by gender on the personal attributes, half of which were more likely to be used to describe women, so the word pleasant was associated with getting a passing grade. The word energetic, cheerful, lovely and wonderful and fabulous was associated with honors grades. And those were with women. For men it was respectful and considerate while good was associated with passing grades and humble was more common among those with honors grades. We’re clearly having some bias by the gender there, influencing how we are writing about them. When we were talking about a minority status we also tended to have certain words that we use. So we were more likely to use present, open and nice to describe the minority students with passing grades versus words like enthusiastic, sharp and bright for the non-minority students and mature and sophisticated for honors grades. I think what this shows us is that we tend to have biases of the types of words we use to describe people versus, I wouldn’t use those same words if I didn’t know the gender or the minority status. I’d like to think that I’m not bias. But I think this research suggests that I need to do a better job and we all need to do a better job with how it is we describe what it is we’re witnessing even when it comes by people who we think are being non-biased.

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