Recognizing and Reckoning With Unconscious Bias: A Workshop for Health Professions Faculty Search Committees
2017; Association of American Medical Colleges; Linguagem: Inglês
10.15766/mep_2374-8265.10544
ISSN2374-8265
Autores Tópico(s)Innovations in Medical Education
ResumoOPEN ACCESSFebruary 16, 2017Recognizing and Reckoning With Unconscious Bias: A Workshop for Health Professions Faculty Search Committees Peter S. Cahn, PhD Peter S. Cahn, PhD Professor, Center for Interprofessional Studies and Innovation and Associate Provost for Academic Affairs, MGH Institute of Health Professions E-mail Address: [email protected] https://doi.org/10.15766/mep_2374-8265.10544 SectionsAboutPDF ToolsDownload Citations ShareFacebookTwitterEmail Abstract Introduction: As part of national efforts to reduce disparities in access to care, health professions schools have committed to increasing the proportion of faculty members from underrepresented minority groups. Responsibility for recruiting and vetting candidates for faculty positions, however, tends to rest in decentralized search committees that may receive no training in the science of human judgment. Simply as a product of living in a stratified culture, we form unthinking stereotypes about certain groups of people. Fortunately, when people become sensitized to their unconscious biases, they can minimize cognitive errors. Methods: This 2-hour workshop is designed to introduce health professions faculty search committee members to the concept of unconscious bias and to spur reflection on how it can influence the decisions they make. In small-group activities, participants create and test materials that can facilitate their efforts to hire qualified candidates. Results: Search committee members who attended the workshop consistently rated it somewhat or very helpful in carrying out their roles. At one institution, the proportion of faculty members from underrepresented minority groups has increased each year that the workshop has been implemented. Discussion: The modules follow the work flow of a typical search process and are generalizable to any health professions department. While the challenge of diversifying the faculty involves many factors external to a university, calling search committee members' attention to unconscious bias is a strategy that faculty affairs officers can control. Educational Objectives By the end of this 2-hour workshop, the learner will be able to: 1.Define unconscious bias and explain its origins.2.Recognize how unconscious bias shapes judgments about candidates for health professions faculty positions.3.Generate ideas about how to minimize the impact of bias at different stages of the health professions faculty search process. Introduction The need for a broadly representative faculty in the health professions has long been recognized as central to the goal of increasing access to quality care.1 The Sullivan Commission on Diversity in the Healthcare Workforce issued a report in 2004 highlighting the key role that minority faculty members play in serving as mentors to students, conducting research on health disparities, and enhancing cultural competency.2 The commission issued a specific recommendation that institutions evaluate their faculty search processes to ensure that qualified members of underrepresented groups apply and are considered for open positions. It is undeniable that the pool of applicants qualified to serve as faculty members in the health professions is a rarefied group. Still, the narrowness of the pipeline to the professoriate cannot be used as an excuse to perpetuate existing hiring practices. One study of nearly 400 minority students with doctorates from elite institutions who had received prestigious fellowships reported that only 11% had been recruited to apply for a faculty position.3 These findings suggest that challenges in faculty hiring reside as much in the internal practices of search committees as they do in the external conditions of available candidates. Indeed, according to the Chronicle of Higher Education, universities that train search committee members to neutralize unconscious bias have demonstrated improvement in their ability to recruit faculty members from underrepresented minority groups.4 Unconscious, or implicit, bias has been popularized by the research of psychologists Mahzarin R. Banaji and Anthony G. Greenwald, who have shown that humans make unthinking assumptions about categories of people that are unrelated to individual performance.5 Several studies have demonstrated how faculty members rate identical candidates differently depending on the candidates' assumed ethnicity or gender.6–8 The MGH Institute of Health Professions identified the attraction and support of a diverse community of faculty as a priority for fulfilling its mission to improve health and health care. Traditionally, at the institute, the search process had been decentralized, with each department following its own customs and schedule. Involvement from the Office of Human Resources was limited to managing transactional steps, and the Office of the Provost signed off only on the final decision. In 2014, the Associate Provost with responsibility for faculty affairs joined with the Director of Human Resources to implement a mandatory workshop for all search committee members at the beginning of their work. The 2-hour session, repeated annually, combines the interest in ensuring compliance with legal requirements with the interest in minimizing unconscious bias that could disadvantage candidates from different backgrounds. The target audience is members of faculty search committees, including staff assistants, who play an integral role in creating a fair, consistent process. Although we conducted the workshop for committees from different departments at the same time to encourage sharing of promising practices, the workshop could be tailored for a single search committee. Similarly, for efficiency's sake in scheduling, we held the workshop in a single session early in the academic year, but the modules could be separated and delivered at the relevant points in a committee's search cycle. Methods Fitting an audience of academics, the workshop takes an evidence-based approach to explaining the concept of unconscious bias. The first part of the workshop addresses the learning objective of defining unconscious bias and its origins through examples from the scientific literature. The examples emphasize that the presence of bias is both natural and ubiquitous rather than a sign of personal failings. The second part of the workshop walks participants sequentially through the stages of the search process, highlighting potential opportunities for bias to cloud judgment and generating ideas to neutralize that bias. Importantly, the hands-on activities result in finished products that a search committee can use in creating the job description, recruitment plan, and candidate-screening criteria. A typical schedule introduces all participants to unconscious bias and asks them to reflect on how it operates in their lives. Then, if participants from different search committees are attending, each search committee breaks into its own working group to tackle discipline-specific projects, with the entire cohort regrouping to share insights. The typical schedule is as follows: •10 minutes: define unconscious bias, its origins, and its consequences (Appendices A & H)—all participants.•20 minutes: gallery walk to elicit different perspectives on unconscious bias (Appendix B)—all participants.•20 minutes: craft a position announcement using inclusive language (Appendix C)—each search committee works independently and then shares insights.•10 minutes: commit to a multipronged recruitment plan (Appendix D)—each search committee works independently and then shares insights.•20 minutes: develop criteria to screen applicants (Appendix E)—each search committee works independently and then shares insights.•20 minutes: test criteria with a sample applicant (Appendix F)—each search committee works independently and then shares insights.•10 minutes: correct for common cognitive errors (Appendix G)—each search committee works independently and then shares insights.•10 minutes: conclude and evaluate (Appendix H)—all participants. We found it important to have the lead facilitator come from a faculty affairs role to keep the focus on evaluating candidates for future academic performance. Because more technical questions about institutional processes also arise, having a representative from the Office of Human Resources present is helpful too. In using the workshop as a kickoff to the search cycle, we scheduled a 1-hour lunch following the training and invited the academic leaders of the schools involved in searches to join so that committee members could seek feedback on the materials they produced during the workshop. Allow 2 or 3 minutes for participants to complete the pretest (Appendix H). Note any questions that participants write. Then, the facilitators project the PowerPoint slides in Appendix A about the evidence for unconscious bias. If it is possible to obtain the names and contact information of the participants in advance, an optional preworkshop activity is for the search committee members to take an implicit association test (IAT). The Project Implicit website (https://implicit.harvard.edu/implicit/selectatest.html) offers free IATs to detect unconscious bias around several categories of people. The tests measure reaction time when certain images or descriptions of people are associated with positive words and then when they are associated with negative words. Slower reaction time indicates that we have to exert mental energy to overcome a deeply held belief we have about people from that category. The results provide empirical evidence that the test taker unconsciously associates certain people with certain attributes. If assigning prework is not possible, the facilitators may mention the resource in the overview of unconscious bias and encourage participants to visit the site after the workshop. The PowerPoint portion of the workshop (Appendix A) is confined to a brief introduction. After about 10 minutes, the participants should stand up to reinforce the idea that the success of the workshop depends on their active involvement. A gallery walk compels participants to engage with a range of perspectives by circulating and reading several artifacts. The materials for the gallery walk in Appendix B include seven quotations. Before the workshop begins, the facilitators should print the seven quotations, each on a separate sheet of paper, and affix them around the perimeter of the room. Allow enough space between each quotation for participants to spread out as they wander to read them. When everyone has read the sample of views, the facilitators lead a debrief in which participants reflect on how the quotations reinforce or differ from their own opinions about unconscious bias. Once the gallery walk and debrief are concluded, the participants should sit clustered in their departmental groups. If the position announcement has already been written, the facilitators should distribute copies of the existing job description. If not, the facilitators may use the sample position announcement in Appendix C. Although there is no single way to make the announcement more inclusive, the handout includes an annotated example of possible improvements in language. Every committee can use the matrix in Appendix D to develop a multipronged recruitment plan. Whether the committee members use an existing position announcement or have designed one of their own in the previous activity, they should have the text of the job description in front of them when reviewing the screening criteria (Appendix E). Distribute handouts of the screening criteria and ask the committee members to complete the tables based on the requirements and qualifications listed in the job description. They should come up with a single consensus document that they can use to assess candidate materials. Next, if the opening has already attracted applicants, use the cover letter and CV of one candidate as a test case for the screening criteria developed in the previous activity. If there are no actual applicants yet, use the sample cover letter and CV in Appendix F, which correspond to the sample position announcement in Appendix C. Ask the committee members to individually review the materials using the consensus screening document (created above). Once everyone has completed this assessment, have participants share their ratings and record them on a whiteboard or document projected on the screen. If the results cluster closely together, the screening criteria are probably useful and clear. If the ratings vary greatly, encourage the committee members to consider how to revise their screening criteria or agree on a common definition of certain categories. During the search process, after reviewing and rating all the application materials, the staff member supporting the committee should tally all the results and produce a ranked list of the candidates. Recognizing that committees will want to use the rankings as a springboard for deciding which candidates to pursue further, Appendix G reviews common cognitive errors that reviewers reveal in discussions of ranked applicants. Have the participants choose a few errors that resonate with them and generate possible responses to minimize bias. Again, there are no correct answers for each bias, but some possible responses are included in the instructor's version. Finally, distribute the evaluation (Appendix H). Review the questions participants wrote as part of the pretest to make sure they have all been answered. As a checkout, ask each participant what concrete steps he or she will take next to improve the faculty search process. Remind the committee members that the workshop activities address the early stages of recruitment and review of candidates and that the same inclusive approaches should apply to phone and in-person interviews. Results Across 2 years of offering the workshop, 22 participants have completed an evaluation. They included department chairs, search committee chairs, search committee members, and departmental administrators. I did not collect demographic information on the participants. To the question "How helpful did you find the training in preparing you for your role in faculty searches?" (see Figure 1), every respondent rated the workshop somewhat or very helpful. Suggestions for improvement included providing examples of recruitment plans from other academic institutions and offering ongoing support to ensure that the ideas generated during the workshop get implemented. Figure 1. Answers of participants (n = 22) in search committee training 2014–2015 to the question "How helpful did you find the training in preparing you for your role in faculty searches?" The open-text comments revealed appreciation for the practical advice and tools: •"I liked how this training had a specific focus and objectives so it did not feel repetitive of past trainings."•"I thought this training was great—I feel very excited about implementing our plan of identifying future faculty at research meetings."•"Definitely useful to brainstorm in this manner. Feel this will result in a change of mindset in most who attended."•"Overall this session was well run and well organized and provided me with some helpful information." Other participants praised the hands-on activities as a welcome alternative to passive learning: •"Applied activities and discussions were very interesting and helpful."•"I did not think this was going to be a good use of my time and I found it quite useful. Thank you."•"Well organized; comprehensive; discussions/group work were engaging."•"Better than I expected a 3+ hour meeting to be. Thanks for making it active and interactive." Two comments gave weight to the idea of inviting multiple search committees to participate together: •"It was also useful to know that other departments are facing similar challenges."•"I wish more of the departments could have been there." Aside from the satisfaction of the participants, evidence for the effectiveness of the workshop comes from changes in the composition of the faculty. At the MGH Institute, with 114 full-time faculty members, the percentage of faculty from underrepresented minority groups has climbed each year since 2012 (see Figure 2). Admittedly, the proportion was already trending upward before the implementation of the unconscious bias workshops in 2014, but the institute has also added two new departments since 2012, so the increase reflects particular success in new faculty hires. Overall, the representation of members of underrepresented groups is still much lower than in the student population. Because only a small percentage of the faculty turns over each year, registering dramatic changes will take several years. Figure 2. The trainings accelerated the progress in recruiting a more diverse faculty as indicated by the rise in MGH Institute faculty who self-identify as members of underrepresented minority groups. Discussion Addressing the paucity of faculty members from underrepresented minority groups at the hiring stage ignores the deep-seated inequities that have already narrowed the pool of qualified candidates. Still, search committees are in the unique position to adopt relatively straightforward procedures that enhance the likelihood a minority candidate will apply and be offered a faculty position. As pernicious as implicit bias is, it is also easily neutralized. In a series of experiments, psychologists showed that priming subjects with counterstereotypic mental imagery was sufficient to weaken signs of bias.9 In presenting information about unconscious bias to seasoned faculty members, I worried that they might resent the implication they harbor bias or need training in reviewing their peers at all. However, I found that search committee members uniformly appreciated clarity on best practices for recruitment because they had been performing their roles for so long with minimal guidance. Occasionally, faculty members would question the science behind unconscious bias, but they did so out of intellectual curiosity, and I could refer them to a substantial body of evidence supporting the concept. One of the most persistent challenges with searches for faculty members in the health professions is not that committee members resist the idea of diversifying their ranks but that they believe candidates from underrepresented minority groups are vanishingly rare. While identifying candidates with both superb clinical and academic skills is daunting enough, finding applicants from disadvantaged backgrounds who meet that high bar seems improbable. Offering the example of searches for endowed chairs can provide a helpful perspective. To fill a prestigious position, search committees do not merely post an ad on a website and wait to see who replies. Rather, they target qualified candidates and encourage them to apply. The same approach is required for all open faculty positions. Faculty members tend to be comfortable with the committee part of their roles; to avoid reproducing the status quo, they need to recommit to the search function as well. Meeting with committee members at the beginning of a search helps prime their thinking to be mindful of ways that bias can seep into the hiring process. The lessons of a onetime workshop, however, tend to fade as the volume of work increases, and old practices reassert themselves. As a follow-up, I would like to design a refresher module for later in the search cycle and a more in-depth training for committee members who assume the role of equity officer during deliberations. Ultimately, recruitment is incomplete without retention. Once a candidate from an underrepresented group joins the faculty, he or she must be made to feel welcome and supported.10 An inhospitable work environment can undermine the labors of even the most diligent search committee. This workshop on unconscious bias must be paired with sincere efforts to help every faculty member thrive. References1. Nivet MA. Diversity 3.0: a necessary systems upgrade. 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Peek ME, Kim KE, Johnson JK, Vela MB. "URM candidates are encouraged to apply": a national study to identify effective strategies to enhance racial and ethnic faculty diversity in academic departments of medicine. Acad Med.2013;88(3):405–412. http://dx.doi.org/10.1097/ACM.0b013e318280d9f9Medline, Google Scholar Sign up for the latest publications from MedEdPORTAL Add your email below APPENDICESReferencesRelatedDetailsAppendices Unconscious Bias.pptx Gallery Walk.pptx Sample Position Announcement.docx Recruitment Plan.docx Screening Criteria.docx Sample Application.docx Common Cognitive Errors.docx Evaluation.docx All appendices are peer reviewed as integral parts of the Original Publication. Download CitationCahn PS. Recognizing and Reckoning With Unconscious Bias: A Workshop for Health Professions Faculty Search Committees. MedEdPORTAL. 2017;13:10544. https://doi.org/10.15766/mep_2374-8265.10544 Copyright & PermissionsCopyright © 2017 Cahn. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-No Derivatives license.KeywordsUnderrepresented MinoritiesCognitive ErrorGFAUnconscious BiasFaculty Search CommitteesGroup on Faculty AffairsFaculty AffairsFaculty RecruitmentDisclosures None to report. Funding/Support None to report. Ethical Approval Reported as not applicable. PDF downloadtabs.loading
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