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Mitigating Bias in Medical Education at the Intersection of Standardized Patients and Medical Students

Purpose: The Standardized Patient [SP] Program is a potential avenue through which students from races and ethnicities underrepresented in medicine [URiM] experience bias, due in part to the inherent subjectivity of an SP’s evaluation of the doctor-patient interaction. In most training programs, medical students are assessed on their clinical and interpersonal skills via simulated encounters where students assume the doctor role and SPs act as patients. Researchers conducted this qualitative study to (1) understand the SPs’ perception of their role within the Objective Structured Clinical Exam and medical school education, (2) investigate biases that medical students may experience during SP evaluations of simulated clinical encounters.Methods: Participants were recruited from Lewis Katz School of Medicine at Temple University. Interviews and focus groups were conducted between August through October of 2022. A total of 14 medical students, 11 of which self-identified as URiM, were distributed into 6 focus groups. A total of 9 SPs were interviewed, 3 of which self-identified as non-white ethnic minorities. All interviews were then transcribed and analyzed using a combination of first-cycle coding methods. In the final stages of analysis, we examined the data to determine frequent themes across the study populations.
Results: The results demonstrated conflicting sentiments between SPs and students. Although SPs described an intensive training process that promoted standardization of DPI scoring across SPs, URiM students reported high interrater variability, referring to the variation in the interpretation of a student’s communication skills by SPs. The consensus amongst minority students was that SPs evaluate students more leniently in interactions where the SP and student share ethnic identities. The themes present in the resulting data aligned closely with a social determinants of health conceptual framework, illustrating how disregarding the topic of implicit bias in the SP Program leads to a downward trajectory of differential attainment.
Conclusion: Although medical education administrators have begun shifting their attention towards diversity, equity, and inclusion initiatives, there has been minimal focus on the key perspectives necessary to navigate this space. Our research analyzes those perspectives as an important first step towards acknowledging and effectively mitigating bias in medical education programs. / Urban Bioethics

Identiferoai:union.ndltd.org:TEMPLE/oai:scholarshare.temple.edu:20.500.12613/10335
Date05 1900
CreatorsDurojaye, Omodele, 0009-0003-8266-6067
ContributorsJones, Nora
PublisherTemple University. Libraries
Source SetsTemple University
LanguageEnglish
Detected LanguageEnglish
TypeThesis/Dissertation, Text
Format35 pages
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Relationhttp://dx.doi.org/10.34944/dspace/10297, Theses and Dissertations

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