Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
J Surg Educ. 2021 Sep-Oct;78(5):1524-1534. doi: 10.1016/j.jsurg.2021.02.005. Epub 2021 Feb 24.
Differential use of communal terms (caring/unselfish traits) versus agentic terms (goal-oriented/leadership/achievement traits) may reveal bias and has been extensively reported in letters of recommendation for residency. We evaluated bias in medical student performance evaluations (MSPE) of general surgery residency applicants.
This is a retrospective study evaluating ethnic/race bias, as measured by differential use of agentic and communal terms, in MSPEs of residency applicants. 50% of MSPEs were randomly selected. An ethnic bias calculator derived from an open-source online gender bias calculator was populated with a list of validated agentic and communal terms. Relative frequency of communal and agentic terms was used to estimate bias. Multivariable regression was used to assess the association between the terms and ethnicity/race.
US medical students applying for a categorical surgery residency position at a single academic institution for a single Match cycle.
A total of 339 MSPEs were reviewed from 119 US medical schools. Genders were equally represented (women, 51.6%); most participants were white and Asian applicants (79.1%). Overall, MSPEs were more agency biased (65.2%) than communal biased (16.2%) or neutral (18.6%). MSPEs for Black and Hispanic/Latinx applicants were more likely to contain communal rather than agentic terms (adjusted OR: 3.02, 95% CI: 1.52-6.02) when compared to white and Asian applicants. This finding was independent of MSPE writer's gender or rank.
Surgery residency applicants self-identifying as Black and Hispanic/Latinx were more likely to be described using communal traits compared to white and Asian applicants, suggesting ethnic/racial bias. Such differences in language utilized in MSPEs may impact residency opportunities for applicants who are under-represented in medicine. Educational efforts aimed at MSPE writers may help to reduce bias.
在推荐信中，对被推荐人使用描述关爱/无私特质的 communal terms（共通性特质）与描述目标导向/领导力/成就特质的 agentic terms（独特性特质）可能存在偏见，这一现象已被广泛报道。我们评估了医学专业学生表现评估（MSPE）中对普通外科住院医师申请人的评价存在的偏见。
这是一项回顾性研究，评估了 MSPE 中是否存在种族偏见，通过评估共通性特质和独特性特质的使用差异来衡量。从 MSPE 中随机抽取 50%进行分析。一个基于开源在线性别偏见计算器的种族偏见计算器，其列表中包含了经过验证的共通性和独特性特质。共通性和独特性特质的相对频率用于估计偏见程度。多变量回归用于评估这些术语与种族/民族之间的关联。
在美国一所学术机构申请普通外科住院医师职位的医学生，参加了一个特定的 Match 周期。
共审查了来自 119 所美国医学院的 339 份 MSPE。性别比例均衡（女性占 51.6%）；大多数参与者为白人和亚裔申请人（79.1%）。总体而言，MSPE 更偏向于独特性特质（65.2%），而非共通性特质（16.2%）或中立（18.6%）。与白人和亚裔申请人相比，黑人和西班牙裔/拉丁裔申请人的 MSPE 更有可能使用共通性特质来描述他们（调整后的 OR：3.02，95%CI：1.52-6.02）。这一发现与 MSPE 撰写者的性别或职级无关。
与白人及亚裔申请人相比，自认为是黑人或西班牙裔/拉丁裔的外科住院医师申请人更有可能被描述为具有共通性特质，这表明存在种族偏见。MSPE 中使用的语言差异可能会影响在医学领域代表性不足的申请人获得住院医师机会。针对 MSPE 撰写者的教育工作可能有助于减少偏见。
