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Related Experiment Video

Updated: Dec 9, 2025

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Medical Education's Wicked Problem: Achieving Equity in Assessment for Medical Learners.

Catherine R Lucey1, Karen E Hauer2, Dowin Boatright3

  • 1C.R. Lucey is executive vice dean/vice dean for education and professor of medicine, University of California, San Francisco, School of Medicine, San Francisco, California.

Academic Medicine : Journal of the Association of American Medical Colleges
|September 5, 2020
PubMed
Summary

Medical education assessment often disadvantages minority learners and patients due to systemic bias. Addressing this "wicked problem" requires an organizational model focusing on culture, systems, and tools for equitable outcomes.

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Area of Science:

  • Medical Education
  • Health Equity
  • Bias in Assessment

Background:

  • Physicians trained in the U.S. may unintentionally disadvantage minority patients.
  • Learner assessment in medical education can perpetuate inequities for minority students.
  • Despite holistic admissions, diversity gains are not seen in advanced training or faculty positions.

Purpose of the Study:

  • To characterize equity in assessment as a complex challenge within medical education.
  • To review individual and structural causes of assessment inequity.
  • To propose an organizational model for achieving assessment equity.

Main Methods:

  • Conceptual analysis of assessment equity as a
  • wicked problem.
  • Review of individual and structural causes of inequity.
  • Development of an organizational model with principles for improvement.

Main Results:

  • Assessment inequity stems from individual and structural biases.
  • An organizational model is proposed, addressing culture, systems, and tools.
  • Three measurable components of equity: intrinsic, contextual, and instrumental.

Conclusions:

  • Achieving equity in medical education assessment is a complex, multifaceted issue.
  • The proposed model offers a framework for systemic improvement.
  • Further research is needed to demonstrate bias reduction in medical education.