Eric Holmboe¹
Dowin Boatright²
1 ACGME
2 New York University

Assessment is essential to professional development. Assessment provides the information needed to give feedback, support coaching and the creation of individualized learning plans, inform progress decisions, determine appropriate supervision levels, and, most importantly, help ensure patients and families receive high-quality, safe care in the training environment. 

Yet, one of the most significant challenges in assessment is the ongoing and pernicious effects of bias. Learners from diverse backgrounds, including those from racial/ethnic groups typically underrepresented in medicine (URiM) and other groups often marginalized by bias in assessment (e.g., women, people who identify as sexual and gender minorities, people living with disabilities, and more), face additional and unwarranted obstacles in their professional development. Studies from around the globe have documented significant assessment biases in health professions education (HPE), from selection for training programs to assessment of clinical competence. This body of research highlights the urgent need for the HPE community to develop methods and tools training programs should use to identify, address, and reduce bias in their own assessment programs. 

When learners experience bias, it results in suboptimal learning environments and compromises learners’ well-being and ability to function at the top of their abilities. For example, multiple studies show learners from historically URiM groups receive lower assessment ratings of clinical competence from faculty. Assessment bias can lead to and reinforce stereotype threat and impostor syndrome. These effects are cumulative and even small differences in assessment can translate to disparities in future opportunities, including training and employment, a phenomenon described as the amplification cascade. 

The session will contain three sections. The introduction will provide a synopsis of key findings from the latest research on bias in assessment, including studies and data from a U.S. assessment system using competencies. The second section will provide participants an opportunity to reflect on their own program’s potential sources of bias and how they can identify sources of bias in their assessments. The final section will involve sharing and discussing with participants techniques that can be used to help faculty identify and reduce bias in their program, using recommendations from communication science and psychology. 

Who should participate?
All - 50 maximum Level of workshop: Beginner/Intermediate


Take-home messages:
To ensure assessment in HPE is fair, equitable, and supports all learners, deliberate attention must be directed at reducing bias for groups who have and continue to experience assessment bias in their training programs. 

References (maximum three)