An Institutional Approach to Fostering Inclusion and Addressing Racial Bias: Implications for Diversity in Academic Medicine.

Issue: While an increasingly diverse workforce of clinicians, researchers, and educators will be needed to address the nation's future healthcare challenges, underrepresented in medicine (UIM) perspectives remain relatively absent from academic medicine. Evidence: Prior studies have identified differential experiences within the learning environment, lack of social supports, and implicit bias in evaluations as barriers to the academic interests and successes of UIM learners. The UCSF Differences Matter initiative has shown that interventions focused on recruiting diverse academic faculty, building strong social communities, facilitating cross-cultural communication and understanding, and mitigating disparities in summative assessments can positively affect the educational experience for UIM learners and contribute to their academic success. Implications: Institution-level initiatives are needed to foster a culture of inclusion, teach cultural humility, and build a culture of trust within academic medicine. Such initiatives should aim to teach a common language to discuss diversity issues and place the responsibility of fostering inclusion on all members of the academic community. Our own institutional experience with systemic cultural reform challenges others to develop novel approaches toward fostering inclusion in academic medicine.

A Stochastic Model of Consensus Reaching in Committee Decisions for Faculty Advancement, Promotion and Tenure: Does Diversity Matter?

PURPOSE: There are considerable gender and racial disparities in academic promotions regardless of academic qualifications, suggesting bias. The investigators studied the academic promotions process by simulating the work of Advancement, Promotion and Tenure (APT) committees and applying a mathematical model to assess the impact of diversity on consensus reaching. METHOD: The study targeted academic faculty during an annual Association of American Medical Colleges (AAMC) meeting. Participants evaluated the academic dossier of a male Assistant Professor with a focus on community engagement during four simulations. All dossiers were identical, with the singular exception of the candidate's race (white vs. black). Committee composition varied with respect to racial diversity. Participants scored the candidate before and after the deliberations. The DeGroot Model was used to compare individual scoring to group convergence. RESULTS: While there was no statistically significant difference in the candidate's overall scores between the groups, the least diverse groups rated the candidate the lowest (p = 0.0595). Participants ranked activities related to diversity and equity as the least important. Moreover, criteria deliberated more heavily showed significant score changes after deliberation. Lastly, ambiguity about the review process at various institutions was reported by project participants, increasing the opportunity for bias in real world situations. CONCLUSIONS: While there was not enough statistical power to measure intragroup differences, the model shows promise in illuminating how individual perceptions, committee composition and group dynamics sway consensus reaching. The model also suggests that social research, community engagement and diversity work do not carry the same weight as traditional scholarship, impacting the career trajectory of minority scholars. The model can be used to evaluate bias not only in academic promotions but also in admissions, hiring and grant review. This will allow improved methods and processes for equitable academic performance reviews, enhancing the career trajectory and retention of minority scholars.