Examining interviewer bias in medical school admissions: The interplay between applicant and interviewer gender and its effects on interview outcomes
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ABSTRACT:
SUBMITTER: Tsikas S
PROVIDER: S-EPMC11346660 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundGender inequity is widespread in academic medicine, including in the promotion, academic recognition, and compensation of female faculty.ObjectiveTo assess whether these inequities extend to the GME intern selection process, this study examines differences in the interview scores assigned to male and female applicants at one large internal medicine residency program.MethodsSubjects include 1399 applicants who completed 3099 interviews for internship positions for the Brigham and Women's Hospital internal medicine residency in Electronic Residency Application Service (ERAS) cycles 2015-2016, 2017-2018, 2018-2019, and 2019-2020. Unadjusted and multivariable linear regressions were used to assess the simultaneous effect of applicant gender, interviewer gender, and applicant academic characteristics on pre-interview, post-interview, and change in interview scores.ResultsOur analysis included 3027 interviews (97.7%) of 1359 applicants (97.1%). There were no statistically significant differences in the interview scores assigned to female versus male applicants. This was true across pre-interview scores (difference = 0.03, P = .61), post-interview scores (difference = 0.00, P = .98), and change in interview scores (difference = 0.01, P = .24) as well as when adjusting for the baseline academic characteristics of both male and female applicants. This was also true when analyzing individual application years, individual residency tracks, and accounting for the gender of the faculty interviewers.ConclusionsThe findings do not support the presence of gender inequity in the interview scores assigned to male and female applicants included in this study.
| S-EPMC8672829 | biostudies-literature
Project description:BackgroundMedical school acceptance rates in the United States (US) have been lower for applicants who identify as Underrepresented-in-Medicine (UiM) compared to non-UiM applicants. The gap between UiM and no-UiM groups is narrowing in recent years. Less well-studied are associations of acceptance decisions with family income and parental education. This study's purpose is to evaluate the relationships between medical school acceptance and family income, parental education status, racial/ethnic background, Grade Point Average (GPA), Medical College Admission Test (MCAT) score, and participation in extracurricular activities.MethodsThis is a cross-sectional study of first-time US medical school applicants between 2017 and 2020. Acceptance rates for first-time applicants were calculated for first-generation (FG), low-income (LI), and UiM applicants. Associations of these attributes with MCAT scores, science GPAs, and seven categories of extracurricular activities were evaluated. Regression analyses estimated associations between acceptance to medical school with all variables with and without interaction terms (FG*URM, LI*URM, FG*LI).ResultsThe overall acceptance rate for first-time applicants from 2017-2020 was 45.3%. The acceptance rates among FG, LI and UiM applicants were 37.9%, 39.6% and 44.2%, respectively. In univariable logistic regression analyses, acceptance was negatively associated with being FG (OR: 0.68, CI: 0.67-0.70), LI (OR: 0.70, CI: 0.69-0.72), and UiM (OR: 0.95, CI: 0.93-0.97). In multivariable regression, acceptance was most strongly associated with science GPA (OR: 7.15, CI: 6.78-7.54 for the highest quintile) and UiM (OR: 5.56, CI: 5.48-5.93) status and MCAT score (OR: 1.19, CI: 1.18-1.19), FG (OR: 1.14, CI: 1.10-1.18), and most extracurricular activities. Including interaction terms revealed a negative association between acceptance and LI (OR:0.90, CI: 0.87-0.94) and FG was no longer significant (OR:1.10, CI:0.96-1.08).ConclusionsCollectively these results suggest medical school admissions committees may be relying on holistic admission practices. While MCAT and GPA scores continue to predict acceptance, individuals from racially and ethnically UiM backgrounds have favorable odds of acceptance when controlling for MCAT and GPA. However, these positive associations were not seen for low-income and first-generation applicants. Additional preparation for college and the MCAT for these latter groups may help further diversify the medical profession.
| S-EPMC10720109 | biostudies-literature
Project description:BackgroundThe Standardized Video Interview (SVI) was developed by the American Association of Medical Colleges to allow applicants to include objective data about professional behaviors and interpersonal and communication skills. Although the SVI pilot was administered to individuals applying to emergency medicine (EM) residency programs during the 2018 Electronic Residency Application Service (ERAS) cycle, little data have been published evaluating the applicant's perceptions. This survey aims to assess EM residency applicant attitudes toward the SVI.MethodsDuring the 2018 ERAS application season an anonymous survey was administered to interviewees at one urban Accreditation Council for Graduate Medical Education-approved EM residency. Respondents were asked questions regarding the production of their video interviews, thoughts regarding the additive value of the SVI, and individual demographic data such as ethnicity and sex. Participation was optional.ResultsA total of 219 of 238 candidates completed the survey representing a 92% response rate. While the majority of applicants did not feel that their ethnicity impacted their application, 58.1% of those who did self-identified as African American or Asian. A total of 8.7% of respondents felt the SVI added information about their professional behaviors and 11% felt that it added information about interpersonal and communication skills. Only 2.8% of survey respondents felt the SVI should remain a portion of the ERAS application.ConclusionsMost respondents felt that the SVI was not an accurate representation of their interpersonal and communication skills or their professionalism and that it did not add value to their applications. While most cohorts were not concerned about bias regarding sex, ethnicity, sex, or age, a small subset felt that there was a potential for the SVI to bias the party reviewing their applications. Very few applicants felt the SVI should remain a part of the ERAS application. Applicant attitudes toward the SVI are largely negative and require further investigation prior to becoming a standard part of applicants' ERAS files.
| S-EPMC6965673 | biostudies-literature
Project description:The COVID-19 pandemic has mandated the use of virtual interactions in medical school. Although this falls mainly in the area of didactic instruction, of necessity, it has extended to the critical Admissions Process and the Medical School Interview itself. The California University of Science and Medicine (CUSM) with their flipped classroom approach had previously entered a virtual space of instruction even before COVID-19. Because CUSM was, in a sense, already committed to 'virtual' education, in the face of the COVID-19 pandemic, CUSM focused not on what it might lose but what it might gain and what their applicants to medical school might gain with the virtual format. The COVID-19 pandemic provided a unique opportunity to initially compare the Virtual Interview with the traditional On-Campus (In-Person) Interview during the hybrid 2020 year when the COVID-19 pandemic began. The Virtual Interview was patterned after the On-Campus Interview with some modifications. The same faculty conducted both interviews. A number of inherent advantages of the Virtual Interview surfaced to these faculty interviewers based on their subjective observations and conclusions. The overall interviewee satisfaction with the Virtual Interview was very positive based on their subjective observations and conclusions. The objective data from the Virtual Interviews compared to the On-Campus Interviews in the hybrid year resulted in a greater percentage of both offers of acceptance (p = .001) and matriculations (p = .001). In order to strengthen our initial observations, we expanded our study to include 2 pre-COVID-19 years (2018, 2019) of exclusively On-Campus interviews (n = 743) and 1 additional COVID-19 year (2021) of exclusively Virtual Interviews (n = 529). In this expanded study, interviewee demographics were not confounding and the Virtual Interview gave rise to overall greater interviewee satisfaction (p = .001), a trend to greater interviewer satisfaction and a greater percentage of both offers of acceptance (p = .047) and matriculations (p = .036).
| S-EPMC8592618 | biostudies-literature
Project description:BackgroundStandardized patients (SPs) are essential stakeholders in the multiple mini interviews (MMIs) that are increasingly used to assess medical school applicants' interpersonal skills. However, there is little evidence for their inclusion in the development of instruments.ObjectiveThis study aimed to describe the process and evaluate the impact of having SPs co-design and cocreate a global measurement question that assesses medical school applicants' readiness for medical school and acceptance status.MethodsThis study used an exploratory, sequential, and mixed methods study design. First, we evaluated the initial MMI program and determined the next quality improvement steps. Second, we held a collaborative workshop with SPs to codevelop the assessment question and response options. Third, we evaluated the created question and the additional MMI rubric items through statistical tests based on 1084 applicants' data from 3 cohorts of applicants starting in the 2018-2019 academic year. The internal reliability of the MMI was measured using a Cronbach α test, and its prediction of admission status was tested using a forward stepwise binary logistic regression.ResultsProgram evaluation indicated the need for an additional quantitative question to assess applicant readiness for medical school. In total, 3 simulation specialists, 2 researchers, and 21 SPs participated in a workshop leading to a final global assessment question and responses. The Cronbach α's were >0.8 overall and in each cohort year. The final stepwise logistic model for all cohorts combined was statistically significant (P<.001), explained 9.2% (R2) of the variance in acceptance status, and correctly classified 65.5% (637/972) of cases. The final model consisted of 3 variables: empathy, rank of readiness, and opening the encounter.ConclusionsThe collaborative nature of this project between stakeholders, including nonacademics and researchers, was vital for the success of this project. The SP-created question had a significant impact on the final model predicting acceptance to medical school. This finding indicates that SPs bring a critical perspective that can improve the process of evaluating medical school applicants.
| S-EPMC9472042 | biostudies-literature
Project description:A single session of Emotional Awareness and Expression Therapy (EAET)-the EAET Interview-was previously shown to lead to clinical benefits for patients with centralized somatic conditions in primary care (Ziadni et al. in Health Psychol 37(3):282-290, 2018) and tertiary care (Carty et al. in Pain Med 20(7):1321-1329, 2019) settings. There has yet to be an examination of patients' experiences of and reactions to the EAET Interview, which is crucial in evaluating possible clinical implementation of the interview. We conducted secondary analyses on 88 patients (M age = 41.32, 90.9% women) from the two prior trials (primary care N = 51; tertiary care N = 37). Analyses examined interview processes (stress disclosure themes, working alliance, and emotional processing) and patients' reactions to the interview (interview credibility and perceived value of the interview), comparing the two samples and examining correlations among these variables. All patients disclosed at least one stressful life experience, commonly interpersonal problems (89.2%) and childhood adversity (51.5%). Patients had moderately high levels of working alliance and emotional processing during the interview and reported high interview credibility and perceived value of the interview. More extensive emotional processing of stressors was associated with more positive patient reactions to the interview, including higher interview credibility (r = .23) and perceived value (r = .32). We conclude that the single-session EAET Interview was valued by most patients, and patients' emotional processing is particularly beneficial. Addressing the trauma and emotional conflicts of patients with centralized somatic conditions is both feasible and valuable in front-line medical settings.
| S-EPMC10122833 | biostudies-literature
Project description:ImportanceMedical schools promote admission pathways as well as diversity and inclusivity to prospective students who are underrepresented in medicine (UIM) primarily via their websites. Research from organizational structures supports the use of instrumental values (which focus on behavior and core beliefs), rather than terminal values (which focus on the end goal), to promote diversity.ObjectiveTo characterize the use of instrumental and terminal values to promote institutional diversity and inclusivity on Canadian medical school websites.Design, setting, and participantsThis qualitative study analyzed the contents and themes of Canadian medical school websites based on a theoretical value framework and an organizational diversity management framework. A literature review was conducted to explore the use of instrumental and terminal values in promoting diversity and inclusivity, and a codebook was created that outlined the characteristics of these values. The content of all application pathway websites for UIM applicants to all Canadian medical schools was coded between July and August 2022.Main outcomes and measuresUse of terminal vs instrumental values across the UIM-targeted admission websites of medical schools.ResultsTwenty-two websites for 17 Canadian medical schools were included. Content on most of these websites promoted diversity in response to government policies or public accountability and often supported a dominant culture while treating diversity as an exception. The use of terminal rather than instrumental values was also more prominent on websites that targeted Indigenous prospective students compared with Black prospective students and applicants with lower socioeconomic status (11 [50%] websites vs 5 [23%] and 4 [18%] websites). Instrumental values, although seldom used, promoted diversity as a means to improve health care and training for all students in a program.Conclusions and relevanceResults of this qualitative study suggested that medical schools in Canada promoted diversity and inclusivity to prospective students primarily as an end goal rather than as a core value. Medical schools should highlight the benefits of diverse lived experiences and reinforce their commitment to diversity and inclusion by aligning their website content with their ongoing work in this area.
| S-EPMC10357339 | biostudies-literature
Project description: Not available
| S-EPMC8357063 | biostudies-literature
Project description:IntroductionInterviews are commonly used to select applicants for medical school, residency, and fellowship. However, interview techniques vary in acceptability, feasibility, reliability, and validity. This systematic review investigated the effectiveness of different interview methods in selecting the best qualified applicants for admission to medical school and developed a logic model to implement best practices for interviewing.MethodsFive electronic literature databases were searched for comparative studies related to interviewing in medical schools from inception through February 1, 2021. Inclusion criteria included publications in English that compared different methods of conducting a selection interview in medical schools with a controlled trial design. General study characteristics, measurement methodologies, and outcomes were reviewed. Quality appraisal was performed using the Medical Education Research Study Quality Instrument (MERSQI) and the Oxford Risk of Bias Scale. Based on these findings, a logic model was constructed using content analysis.ResultsThirteen studies were included. The multiple mini-interview (MMI) was reliable, unbiased, and predicted clinical and academic performance; the virtual MMI increased reliability and lowered costs. For unstructured interviews, blinding interviewers to academic scores reduced bias towards higher scorers; student and faculty interviewers rated applicants similarly. Applicants preferred structured over unstructured interviews. Study quality was above average per the MERSQI, risk of bias was high per the Oxford scale, and between-study heterogeneity was substantial.DiscussionThere were few high-quality studies on interviewing applicants for admission to medical school; the MMI appears to offer a reliable method of interviewing. A logic model can provide a conceptual framework for conducting evidence-based admissions interviews.
| S-EPMC9510545 | biostudies-literature
Project description:ImportanceWomen account for only 28% of current US medical school deans. Studying the differences between women and men in their preparation to becoming deans might help to explain this discrepancy.ObjectiveTo identify differences in the leadership development experiences between women and men in their ascent to the medical school deanship.Design, setting, and participantsIn this qualitative study, volunteers from the roster of the Association of American Medical Colleges Council of Deans were solicited and interviewed from June 15 to November 9, 2023. Women deans were recruited first, then men who had been appointed to their deanships at a similar time to their women counterparts were recruited. Deans were interviewed on topics related to number of applications for deanships, prior leadership roles, leadership development, personal factors, and career trajectories. Interviews were coded, and themes were extracted through conventional content analysis.Main outcome and measuresCareer and leadership development experiences were elicited using a semistructured interview guide.ResultsWe interviewed 17 women and 17 men deans, representing 25.8% (34 of 132) of the total population of US medical school deans. Most deans (23 [67.6%]) practiced a medicine-based specialty or subspecialty. No statistically significant differences were found between women and men with regard to years to attain deanship (mean [SD], 2.7 [3.4] vs 3.7 [3.7] years), years as a dean (mean [SD], 5.7 [5.2] vs 6.0 [5.0] years), highest salary during career (mean [SD], $525 769 [$199 936] vs $416 923 [$195 848]), or medical school rankings (mean [SD], 315.5 [394.5] vs 480.5 [448.9]). Their reports indicated substantive gender differences in their paths to becoming a dean. Compared with men, women deans reported having to work harder to advance, while receiving less support and opportunities for leadership positions by their own institutions. Subsequently, women sought leadership development from external programs. Women deans also experienced gender bias when working with search firms.Conclusions and relevanceThis qualitative study of US medical school deans found that compared with men, women needed to be more proactive, had to participate in external leadership development programs, and had to confront biases during the search process. For rising women leaders, this lack of support had consequences, such as burnout and attrition, potentially affecting the makeup of future generations of medical school deans. Institutional initiatives centering on leadership development of women is needed to mitigate the gender biases and barriers faced by aspiring women leaders.
| S-EPMC11227086 | biostudies-literature