While the makeup of the Ohio State medical school’s student body was
already becoming increasingly more diverse at the time, committee
members wanted to go a step further.
“A fair, just and equitable admissions process is an important part of
increased diversity in medicine,” says Dr. Capers, who is also associate
professor of Internal Medicine (cardiology). And, he notes, diversity in
medicine can translate into reduced disparities in health care.
Dr. Capers’ interest led to the effort to measure implicit racial bias among
the admissions committee using the implicit association test (IAT), a web-based assessment tool widely used and recognized in clinical and social
science research. All 140 members of the OSUCOM committee took the
IAT before the 2012-2013 admissions cycle.
The IAT measures when and how quickly test takers assign positive and
negative words to black and white faces. The test advances to more
explicit measures by asking test takers to note what statements best
describe their own facial color preferences.
“If it is easy for your unconscious mind to associate a white face with
good things and a black face with bad things but difficult to associate
a black face with good things, that is defined as implicit white race
preference,” Dr. Capers says. In fact, he notes, “having unconscious
biases based on race, gender, looks, size, age, etc., is just being human.
In order to sort through millions of stimuli each day, the unconscious
mind often takes shortcuts by ‘coupling’ or associating items often seen
together. While outside of your conscious control, these automatic
associations, also called preferences or biases, may affect your behavior.”
The study found that all groups of admissions committee members—
men, women, students and faculty—showed significant levels of implicit
preference for white persons. Men and faculty had the highest bias
measures; students and women had the lowest levels. Meanwhile,
findings elsewhere indicate that African-American physicians and non-physicians tend to show no or minimal overall racial bias. Dr. Capers and
co-authors suggest that a strong representation of medical students,
women and African-Americans on admissions committees reduces
overall levels of implicit racial bias.
“The key word here is ‘unconscious’—not intentional—bias,” says Daniel
Clinchot, MD (Res), a study co-author and vice dean for education and
chair of the Department of Biomedical Education and Anatomy.
“While the study looked at admissions, it could be a patient encounter,”
he says. “It could be the way you talk with a family. It’s a matter of how
your understanding of those unconscious biases can change the way you
interact with individuals—hopefully for the better.”
The workshop suggests several strategies for
counteracting implicit bias:
n Find a common shared interest.
Our experiences influence our perceptions and
judgments about people who do not “fit” the
groups we might align with, says Dr. Capers.
“Probe until you find something you have in
common,” he says, whether that might be
being a Cleveland Cavaliers fan or enjoying a
n Take another person’s perspective.
“Doing so can help you understand that
individual’s experience and actions,” says
n Consider the opposite.
Look for possibilities that may not be obvious
about a person, rather than make assumptions.
For instance, a candidate for medical school
may not “look right” on paper as compared with
other applicants, says Dr. Capers, but that does
not mean the person does not have initiative or
passion for the field.
n Counter stereotypes.
“Spend time with people whom you admire
from groups you may have a bias against. This
effort helps connect you with ideas and greater
understanding about different communities,”
says Dr. Capers.