Implicit versus explicit first impressions in performance-based assessment: will raters overcome their first...

Area of Science:

• Medical Education
• Psychology
• Performance Assessment

Background:

• First impressions can influence judgments, but their impact on rater bias in workplace performance evaluations remains unclear.
• Previous research on overcoming first impressions often involves experimental settings with explicit impressions, which may not reflect real-world implicit biases.

Purpose of the Study:

• To determine if initial impressions affect physician raters' judgments when a learner's workplace performance changes.
• To compare the effect of explicitly stated first impressions versus implicitly formed first impressions on subsequent ratings.

Main Methods:

• Physician raters viewed videos of learners with consistent or changing performance (Strong to Weak, Weak to Strong).
• One group (Explicit) made a first impression global rating (FIGR) before scoring with Mini-CEX; the other group (Implicit) only used Mini-CEX.
• Statistical analysis compared FIGR and Mini-CEX Global ratings (GR) within and between groups.

Main Results:

• In the Explicit group, FIGR significantly differed from Mini-CEX GR when performance changed (Strong to Weak: 5.94 vs. 3.02; Weak to Strong: 2.44 vs. 3.96).
• No significant difference was found between FIGR and Mini-CEX GR in the consistent performance condition (6.61 vs. 6.65).
• No significant differences in Mini-CEX GR were observed between the Explicit and Implicit groups across all conditions, indicating raters adjusted their judgments.

Conclusions:

• Physician raters successfully adjusted their judgments based on observed learner performance, mitigating the impact of initial impressions.
• Explicitly stating first impressions did not lead to greater rater bias compared to implicit impression formation in this workplace context.
• Findings suggest that raters can overcome initial biases when evaluating performance in a clinical setting.