Be AWARE: An Anti-bias Toolkit to Limit Bias in Narrative Evaluation of Medical Trainees

Gender and racial biases continue to be pervasive within the field of medicine. These biases can have significant, lifelong impacts on career trajectory and continue to promote inequities for women and groups that are underrepresented in medicine. There is ample literature demonstrating that a prudent approach to combat these biases is through narrative evaluation of medical trainees.

An interactive workshop was developed for all health care providers, including trainees, who currently have, or will have, responsibility for evaluating medical trainees. Its aim was to provide an evidence-based framework for recognizing implicit biases in narrative evaluations and for adapting language to limit them. A toolkit (Be AWARE Anti-bias Toolkit) was developed from existing literature, highlighting 5 key elements of linguistic bias in narrative evaluations: (1) acknowledge that bias exists; (2) word choice matters; (3) active verbs get the job done; (4) resist raising doubt; and (5) emphasize accomplishments over effort. The workshop included interactive small-group activities, with practice in reading and writing narrative evaluations. A postworkshop evaluation survey was distributed after the session to assess relevance and effectiveness.

This workshop was presented 5 times (2 local and 3 national conferences) and was attended by 80 participants, 25 of whom completed the postworkshop survey. The responses were overwhelmingly favorable; all respondents agreed or strongly agreed with the survey questions, indicating they found the session useful, relevant, effective, and worthwhile.

This workshop provided an effective toolkit to help participants recognize and limit biased language in narrative evaluations of trainees.