Implementing Holistic Applicant Review and Addressing Biases in Anesthesiology Residency Committee Deliberations.

Area of Science:

• Medical Education
• Residency Recruitment
• Qualitative Research

Background:

• Holistic review may enhance resident recruitment by aligning applicant characteristics with program culture.
• This study aimed to develop a holistic scoring rubric, assess its correlation with final applicant rankings, and identify unconscious biases in recruitment discussions.

Purpose of the Study:

• To develop a stakeholder-driven holistic scoring rubric for residency applications.
• To measure the rubric's correlation with the final ranking for the National Resident Matching Program (NRMP) Match.
• To qualitatively analyze interview committee discussions for unconscious biases.

Main Methods:

• Forty stakeholders participated in a consensus process to define valued applicant attributes and create a scoring rubric.
• The rubric was applied to 203 interviewed applicants during virtual recruitment.
• Interview committee discussions were transcribed and analyzed using phenomenology to identify biases.

Main Results:

• A 10-dimension rubric was developed, with diversity receiving the lowest weight.
• The rubric score strongly correlated with the final global rating (r = 0.94, P < .001).
• Common biases identified included in-group bias, stereotyping, cohort bias, and anchoring bias.

Conclusions:

• Stakeholder-developed holistic review effectively evaluates residency applicants based on diverse attributes and experiences.
• Analysis of committee discussions revealed significant biases that necessitate targeted mitigation strategies.