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应对医疗住院医师选拔中有害偏见影响的策略。

Strategies to Counteract Impact of Harmful Bias in Selection of Medical Residents.

机构信息

L. Edje is associate dean of graduate medical education, designated institutional official, and professor of medical education and family and community medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio; ORCID: https://orcid.org/0000-0002-9125-7180 .

C. Casillas is a fellow in pediatric hospital medicine, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio; ORCID: https://orcid.org/0000-0001-5789-0620 .

出版信息

Acad Med. 2023 Aug 1;98(8S):S75-S85. doi: 10.1097/ACM.0000000000005258. Epub 2023 Jul 21.

Abstract

Human biases impact medical care in ways that perpetuate health disparities. Research has demonstrated that biases negatively affect patient outcomes and stifle diversity across the physician workforce, further compounding health disparities by worsening patient-physician concordance. Taken as one, the application, interview, recruitment, and selection processes employed by residency programs has been one of the critical junctures where bias has exacerbated inequities among future physicians. In this article, the authors define diversity and bias, review the history of bias in residency programs' processes for selecting residents, explore the impact of this history on workforce demographics, and discuss ways to optimize and work toward equity in the practices used by residency programs to select residents.

摘要

人为偏见以延续健康差异的方式影响着医疗服务。研究表明,偏见会对患者的预后产生负面影响,并抑制医生队伍的多样性,从而通过加剧医患一致性问题进一步加剧健康差异。从整体来看,住院医师培训计划所采用的应用、面试、招聘和选拔过程是人为偏见加剧未来医生之间不平等的关键阶段之一。在本文中,作者定义了多样性和偏见,回顾了住院医师培训计划在选择住院医师的过程中存在偏见的历史,探讨了这一历史对劳动力人口统计数据的影响,并讨论了优化和努力实现住院医师培训计划选拔住院医师实践公平的方法。

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