Session Design Submission Review

Yes

• Assessment, Curriculum, and Evaluation
• Diversity, Equity and Inclusion (DEI)
• Graduate Surgical Education

Evidence suggests significant attrition (or a leaky pipeline) for trainees under-represented in medicine who have an interest in or pursue a career in surgery. As studies have investigated the pathway from undergraduate degrees to medical school, residency, fellowship, and academic medicine they have demonstrated that, at each step forward, there are fewer and fewer physicians who are women or with races/ethnicities that are under-represented in medicine. While the causes of these disparities are multifactorial, an underappreciated and correctable cause may be unconscious bias in assessment at all levels of medical and surgical training.

Implicit bias in standardized testing has long been discussed. Further, the recent transition of the USMLE Step 1 exam to pass/fail represents a highly publicized attempt to mitigate this bias. More recent evidence suggests that bias likely occurs in nearly all stages of medical assessment. Additionally, this bias may worsen feelings of imposter phenomenon and worsen stereotype threat – both of which may negatively impact the performance of women and trainees underrepresented in medicine, further perpetuating disparities in grading and academic recognitions. Therefore, the DEI, ACE, and GSE Committees propose a workshop to provide a framework for understanding bias in assessment and to train surgical educators to mitigate the impact of implicit bias by redesigning individual assessments and overall evaluation programs.

During this workshop, we will explain how the amplification of small disparities in trainee performance evaluation secondary to implicit bias can, over time, lead to significant differences in achievements and awards, contributing to role strain, stereotype threat, and imposter syndrome. Participants will practice redesigning a currently used trainee assessment to mitigate the likelihood of bias within that assessment. We will conclude by using a framework of components of equity in assessment (contextual, intrinsic, and instrumental equity) and the impact of bias at individual, interpersonal, and structural levels to frame a conversation about creating and redesigning trainee assessment.

45-minute workshop

Yes

Yes

Evaluate frequently used assessment methods in UME and GME for the impact of bias

Appreciate how through the reinforcing effect even small differences in assessment can lead to large differences in achievement

Understand how to implement effective strategies to mitigate bias in assessment