Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland.
Oregon Health & Science University, Portland State University School of Public Health, Portland.
JAMA Ophthalmol. 2024 May 1;142(5):429-435. doi: 10.1001/jamaophthalmol.2024.0394.
Best recruitment practices for increasing diversity are well established, but the adoption and impact of these practices in ophthalmology residency recruitment are unknown.
To describe the adoption of bias reduction practices in groups underrepresented in ophthalmology (URiO) residency recruitment and determine which practices are effective for increasing URiO residents.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional survey study used an 18-item questionnaire included in the online survey of the Association of University Professors in Ophthalmology (AUPO) Residency Program Directors. Data collection occurred from July 2022 to December 2022. The data were initially analyzed on January 16, 2023. Participants included residency program directors (PDs) in the AUPO PD listserv database.
Descriptive analysis of resident selection committee approaches, evaluation of applicant traits, and use of bias reduction tools. Primary outcome was diversity assessed by presence of at least 1 resident in the last 5 classes who identified as URiO, including those underrepresented in medicine (URiM), lesbian, gay, bisexual, transgender, queer, intersex, and asexual plus, or another disadvantaged background (eg, low socioeconomic status). Multivariate analyses of recruitment practices were conducted to determine which practices were associated with increased URiO and URiM.
Among 106 PDs, 65 completed the survey (61.3%). Thirty-nine PDs used an interview rubric (60.0%), 28 used interview standardization (43.0%), 56 provided at least 1 bias reduction tool to their selection committee (86.2%), and 44 used postinterview metrics to assess diversity, equity, and inclusion efforts (67.7%). Application filters, interview standardization, and postinterview metrics were not associated with increased URiO. Multivariate logistic regression analysis showed larger residency class (odds ratio [OR], 1.34; 95% CI, 1.09-1.65; P = .01) and use of multiple selection committee bias reduction tools (OR, 1.47; 95% CI, 1.13-1.92; P = .01) were positively associated with increased URiO, whereas use of interview rubrics (OR, 0.72; 95% CI, 0.59-0.87; P = .001) and placing higher importance of applicant interest in a program (OR, 0.83; 95% CI, 0.75-0.92; P = .02) were negatively associated. URiM analyses showed similar associations.
Ophthalmology residency interviews are variably standardized. In this study, providing multiple bias reduction tools to selection committees was associated with increased URiO and URiM residents. Prioritizing applicant interest in a program may reduce resident diversity. Interview rubrics, while intended to reduce bias, may inadvertently increase inequity.
增加多样性的最佳招聘实践已经确立，但这些实践在眼科住院医师招聘中的采用和影响尚不清楚。
描述在眼科住院医师招聘中代表性不足群体（URiO）中减少偏见的实践的采用情况，并确定哪些实践对增加 URiO 住院医师有效。
设计、设置和参与者：本横断面调查研究使用了包含在眼科大学教授协会（AUPO）住院医师项目主任在线调查中的 18 项问卷。数据收集于 2022 年 7 月至 2022 年 12 月进行。数据最初于 2023 年 1 月 16 日进行分析。参与者包括 AUPO PD 名单数据库中的住院医师项目主任（PD）。
对居民选拔委员会方法、申请人特质评估以及使用偏见减少工具的描述性分析。主要结果是通过过去 5 个班级中至少有 1 名自认为是 URiO 的居民（包括在医学中代表性不足的居民、女同性恋、男同性恋、双性恋、跨性别者、酷儿、双性人或无性恋者，以及其他弱势群体（例如，低社会经济地位）来评估多样性。对招聘实践进行多变量分析，以确定哪些实践与增加 URiO 和 URiM 相关。
在 106 名 PD 中，有 65 名完成了调查（61.3%）。39 名 PD 使用了面试评分表（60.0%），28 名 PD 使用了面试标准化（43.0%），56 名 PD 向他们的选拔委员会提供了至少 1 种偏见减少工具（86.2%），并且 44 名 PD 使用了面试后指标来评估多样性、公平性和包容性工作（67.7%）。应用程序筛选器、面试标准化和面试后指标与增加 URiO 无关。多变量逻辑回归分析表明，更大的住院医师班级（优势比[OR]，1.34；95%置信区间，1.09-1.65；P=0.01）和使用多个选拔委员会偏见减少工具（OR，1.47；95%置信区间，1.13-1.92；P=0.01）与增加 URiO 呈正相关，而使用面试评分表（OR，0.72；95%置信区间，0.59-0.87；P=0.001）和更重视申请人对项目的兴趣（OR，0.83；95%置信区间，0.75-0.92；P=0.02）与减少 URiO 呈负相关。URiM 分析显示出类似的关联。
眼科住院医师面试的标准化程度不同。在这项研究中，向选拔委员会提供多种偏见减少工具与增加 URiO 和 URiM 住院医师相关。优先考虑申请人对项目的兴趣可能会降低居民的多样性。面试评分表虽然旨在减少偏见，但可能会无意中增加不公平。
