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Academic translational research is growing at a great pace at a time in which questions have been raised about the reproducibility of preclinical findings. The development of Hedgehog (HH) pathway inhibitors for the treatment of cancer over the past two decades offers a case study for understanding the root causes of failure to predict clinical outcomes arising from academic preclinical translational research. Although such inhibitors were once hoped to be efficacious in up to 25% of human cancer, clinical studies showed responses only in basal cell carcinoma and the HH subtype of medulloblastoma. Close examination of the published studies reveals limitations in the models used, lack of quantitative standards, utilization of high drug concentrations associated with non-specific toxicities and improper use of cell line and mouse models. In part, these issues arise from scientific complexity, for example, the failure of tumour cell lines to maintain HH pathway activity in vitro, but a greater contributing factor appears to be the influence of unconscious bias. There was a strong expectation that HH pathway inhibitors would make a profound impact on human cancer and experiments were designed with this assumption in mind.

Background: While SAGES prides itself on diversity and inclusivity, we also recognize that as an organization we are not impervious to blind spots impacting equity within the membership. To address this, the We R Sages task force was formed to identify the barriers and facilitators to creating a diverse organization and develop a strategic plan for the implementation of programing and opportunities that promote diversity and inclusivity within our membership. As the first step in the process, a survey was administered to gauge the current organizational climate.Methods: In September of 2017, a validated climate survey was administered to 704 SAGES committee members via SurveyMonkey®. Climate was assessed on: overall SAGES experience, consideration of leaving the organization, mentorship within the organization, resources and opportunities within the organization, and attitudes and experiences within the organization. Additional free text responses were encouraged to generate qualitative themes.Results: The survey response rate was 52.1% (n = 367). Respondent self-identified demographics were: male (73%), white (63%), heterosexual (95.5%), and non-disabled (98%). Average overall satisfaction was 8.1/10. 12.5% of respondents had considered leaving the organization and 74.4% had not identified a formal mentor within the organization. Average agreement with equitable distribution of resources and opportunities was 5.8/10. 93.6% of respondents had not experienced bias within the organization.Conclusion: Overall SAGES has a very positive climate; however, several key issues were identified from the quantitative survey as well as the free text responses. Strategic planning to address issues of membership recruitment, committee engagement, advancement transparency, diversity awareness, leadership development, and formal mentorship are being implemented. [ABSTRACT FROM AUTHOR]

Objective: Patients describe feelings of bias and prejudice in clinical encounters; however, their perspectives on restoring the encounter once bias is perceived are not known. Implicit bias has emerged as a target for curricular interventions. In order to inform the design of novel patient-centered curricular interventions, this study explores patients' perceptions of bias, and suggestions for restoring relationships if bias is perceived.Methods: The authors conducted bilingual focus groups with purposive sampling of self-identified Black and Latino community members in the US. Data were analyzed using grounded theory.Results: Ten focus groups (in English (6) and Spanish (4)) with N = 74 participants occurred. Data analysis revealed multiple influences patients' perception of bias in their physician encounters. The theory emerging from the analysis suggests if bias is perceived, the outcome of the encounter can still be positive. A positive or negative outcome depends on whether the physician acknowledges this perceived bias or not, and his or her subsequent actions.Conclusions: Participant lived experience and physician behaviors influence perceptions of bias, however clinical relationships can be restored following perceived bias.Practice Implications: Providers might benefit from skill development in the recognition and acknowledgement of perceived bias in order to restore patient-provider relationships. [ABSTRACT FROM AUTHOR]

Abstract: Western Governments concerned about the lack of gender equity in their workforces are increasingly seeking to address the negative effects of unconscious biases on employment decisions to counter the effects of hidden prejudices. Although unconscious bias has received limited attention in the human resource literature, social psychology literature has identified inadequacies with this practice, including that such training may entrench and normalise unconscious biases. We argue that the popularity of unconscious bias training invites agencies to view this practice as a ‘silver bullet’ to achieve gender equity, but that its effectiveness is likely to be limited unless accompanied by sustained interventions to address discrimination. Further, the impacts of unconscious bias training need to be rigorously evaluated to assess whether government resources are being effectively utilised. Consistent with international research, such an evaluation may reveal that unconscious bias training has unintended negative consequences, but that the training can be improved to reduce these consequences. [ABSTRACT FROM AUTHOR]

In a rapidly globalizing world, high growth sectors like information technology (IT) hold the key to narrow or broaden the gulf between men and women at work. However, there is a serious underrepresentation of women in the technology sector, particularly in leadership roles. This gulf between men and women at work is likely to widen unless immediate action is taken. ICT jobs can provide women with greater opportunities and higher wages, compared to the low-skill jobs that women are often crowded into. Yet, achieving gender neutrality and inclusivity in the IT sector is an uphill task. This paper focuses on the challenges, opportunities and conditions that can be created to facilitate the participation of urban, educated women of Pakistan in the IT sector. Although the empowerment aspects of individualization in the workplace for women are tangible, in Pakistan, there are a number of socio-cultural barriers and an implicit gender bias in education and employment which prevents greater participation of women in the IT sector. The paper also sets out specific recommendations for the government and private sectors to further increase gender inclusivity in employment. In doing so, it draws upon primary research and current behavioral economic insights and makes the case that a multi-sectoral effort involving the private sector, government, and macro-social environment is critical to radically disrupting bias, providing norm-changing solutions, and ensuring rapid gains to the economy from the inclusion of women in the sector. [ABSTRACT FROM AUTHOR]

Background and purpose Identify and analyze pharmacy students’ perceptions about their own implicit racial biases. Educational activity and setting First year pharmacy students (n = 97) enrolled in a Pharmacy Practice course completed a test, Harvard Race Implicit Association Test (IAT), for homework to uncover their unconscious black-white racial bias. All students then wrote at least one paragraph reflecting on if they agreed or disagreed with their results and why. At the beginning of class, students were given a brief survey to capture their IAT results and demographic information. Retrospectively and following Institutional Review Board approval, pharmacy students’ reflections were subjected to thematic analysis with the assistance of NVivo 10 and descriptive analyses were completed of their demographic info. Findings Out of the 97 students enrolled in this course, all completed the self-reflection. But only 90 completed the survey. From those that completed the survey, 54% (N = 49) self-identified as women. The average age was 22.6 years old. Most of the students (77%) identified themselves as White Non-Hispanic. Six percent (N = 5) identified as Black. Most students (66%) reported that their results from the Race IAT indicated some level of preference for European Americans; 13% of the students reported some level of preference for African-Americans. All students’ reflections were categorized by their agreement or lack of agreement with their implicit association test results. Those that agreed with their results cited family, friends, and community contributing to their implicit biases. Students who did not agree with their results were subcategorized as denying their results, believing that their implicit association did not affect their behavior, or believing that the Race IAT was invalid. Discussion/summary Many pharmacy students were found to be unaware of their implicit biases and some do not believe that these biases will negatively affect the treatment of others. Pharmacy curricula should be developed to provide adequate self-awareness training and space in the curriculum so students can challenge these unconscious beliefs. [ABSTRACT FROM AUTHOR]

‘Unconscious bias happens by our brains making incredibly quick judgements and assessments without us realising.   Biases are influenced by background, cultural environment and experiences and we may not be aware of these views and opinions, or of their full impact and implications. This article opposes this point of view by arguing that bias is not unconscious but is (un)conscious and linked to Charles Mills’ ‘Racial Contract’ and its ‘epistemologies of ignorance’. These epistemologies emerge from what the Equality Challenge Unit (ECU) calls ‘our background, cultural environment and personal experience’. Asserting that racism stems from ‘unconscious bias’ diminishes white supremacy and maintains white innocence as a ‘will to forget’ institutional racism. In equality and diversity training ‘unconscious bias’ has become a performative act to move beyond racism through  training to participate in a constructed ‘post-racial’ reality. The article argues that through decolonizing ‘unconscious bias’, ‘white fragility’ and ‘self-forgiveness’ we can begin to see hidden institutional whiteliness at the base of (un)conscious bias. [ABSTRACT FROM AUTHOR]

The latest fashion of ‘unconscious bias training’ is a diversity intervention based on unproven suppositions and is unlikely to help eliminate racism in the workplace. Knowing about bias does not automatically result in changes in behaviour by managers and employees. Even if ‘unconscious bias training’ has the theoretical potential to change behaviour, it will depend on the type of racism: symbolic/modern/colour-blind, aversive or blatant. In addition, even if those deemed racist are motivated to change behaviour, structural constraints can militate against pro-diversity actions. Agency is overstated by psychology-inspired ‘unconscious bias training’ proponents, leading them to assume the desirability and effectiveness of this type of diversity training intervention, but from a critical diversity perspective (sociologically influenced) the training looks pointless. [ABSTRACT FROM AUTHOR]

Introduction As part of national efforts to reduce disparities in access to care, health professions schools have committed to increasing the proportion of faculty members from underrepresented minority groups. Responsibility for recruiting and vetting candidates for faculty positions, however, tends to rest in decentralized search committees that may receive no training in the science of human judgment. Simply as a product of living in a stratified culture, we form unthinking stereotypes about certain groups of people. Fortunately, when people become sensitized to their unconscious biases, they can minimize cognitive errors. Methods This 2-hour workshop is designed to introduce health professions faculty search committee members to the concept of unconscious bias and to spur reflection on how it can influence the decisions they make. In small-group activities, participants create and test materials that can facilitate their efforts to hire qualified candidates. Results Search committee members who attended the workshop consistently rated it somewhat or very helpful in carrying out their roles. At one institution, the proportion of faculty members from underrepresented minority groups has increased each year that the workshop has been implemented. Discussion The modules follow the work flow of a typical search process and are generalizable to any health professions department. While the challenge of diversifying the faculty involves many factors external to a university, calling search committee members' attention to unconscious bias is a strategy that faculty affairs officers can control.

Despite the high prevalence of women in graduate degree programs and equal or more women earning PhDs, MDs, and MD/PhDs, and despite efforts at individual and institutional levels to promote women in STEM fields, there remains a disparity in pay and academic advancement of women. Likewise, there is a paucity of women in top scientific and academic leadership positions. The causes of this gender disparity are complex and multi-factorial and to date no “magic bullet” approach has been successful in changing the landscape for women in academic and scientific fields. In this report we detail our experiences with a novel mechanism for promoting discussion and raising awareness of the challenges of gender disparity in the sciences. The Gordon Research Conferences (GRC) launched the Power Hour at its meetings in 2016: a dedicated, scheduled session held during the scientific meeting to facilitate discussion of challenges specific to women in science. Here we share our experience with hosting the second Power Hour at the 2019 GRC Immunology of Fungal Infections (IFI) meeting held in Galveston, TX. We will discuss the overall structure, key discussion points, and feedback from participants with the aim of supporting future efforts to empower women and underrepresented minority groups in science.

Recent events around the world point to the dire need to counter harmful unconscious bias. Reams of evidence now exists that literal pre-judgement in regards to race, sex, ethnicity, age and religion among other categories strongly affects our behaviour in ways that when we consciously contemplate it, we would condemn. Using Community of Inquiry methods in developing critical reasoning and empathy offer some possible remedies but also hold pitfalls. The dilemma concerns the fact that if harmful unconscious connotative representations are unconscious, then it's terribly hard to spot and correct them. We need a better way of exploring our own poorly-arrived at beliefs: we need other people. Mikhail Bakhtin's notion of dialogic understanding allows meaning to be created through the process of discussion. It gets particularly interesting when this idea combines with the notion of a "floating signifier." This suggests that a discussion could then also alter the connotative value of words, signs and concepts through making what had been hidden overt. This paper explores the ways that the dilemma of damaging discourse could be altered and strategies for interrupting this, including the format of a Community of Inquiry. The promise offered by a Community of Inquiry is that connotative meanings can be made explicit. It also points to the challenge: unveiling hidden bias only becomes possible in a setting of great diversity. In the end, while a Community of Inquiry may not be able to solve the problem of unconscious bias, it may help combat the consequences. [ABSTRACT FROM AUTHOR]

Despite many initiatives to improve diversity, women working in science in the UK are still under-represented at senior levels. There are few studies drawing on the accounts of successful women scientists about gender discrimination and workplace stereotyping. We interviewed 39 women scientists working at an elite British university. A qualitative thematic analysis drew on three controversial 'explanations' for gender inequality in science, which are variously challenged by our data. The women we talked to were all ambitious and successful and (unsurprisingly, given this success) did not suggest that they have personally experienced serious discrimination in their careers. Some conceded that perhaps other women may not reach senior positions in science because of social expectations, low confidence or a lack of support. A few had experienced, or heard of, negative consequences of stereotyping, implicit bias or a 'boys' network', whereby men met outside work for activities such as pub visits or football, which were the main reasons given to explain why some women do not progress to senior positions. Encouragingly some described how gender stereotypes are being resisted; these women scientists are themselves role models for junior colleagues. [ABSTRACT FROM AUTHOR]

Background: Gender bias has been identified as one of the drivers of gender disparity in academic medicine. Bias may be reinforced by gender subordinating language or differential use of formality in forms of address. Professional titles may influence the perceived expertise and authority of the referenced individual. The objective of this study is to examine how professional titles were used in the same and mixed-gender speaker introductions at Internal Medicine Grand Rounds (IMGR). Methods: A retrospective observational study of video-archived speaker introductions at consecutive IMGR was conducted at two different locations (Arizona, Minnesota) of an academic medical center. Introducers and speakers at IMGR were physician and scientist peers holding MD, PhD, or MD/PhD degrees. The primary outcome was whether or not a speaker's professional title was used during the first form of address during speaker introductions at IMGR. As secondary outcomes, we evaluated whether or not the speakers professional title was used in any form of address during the introduction. Results: Three hundred twenty-one forms of address were analyzed. Female introducers were more likely to use professional titles when introducing any speaker during the first form of address compared with male introducers (96.2% [102/106] vs. 65.6% [141/215]; p < 0.001). Female dyads utilized formal titles during the first form of address 97.8% (45/46) compared with male dyads who utilized a formal title 72.4% (110/152) of the time ( p = 0.007). In mixed-gender dyads, where the introducer was female and speaker male, formal titles were used 95.0% (57/60) of the time. Male introducers of female speakers utilized professional titles 49.2% (31/63) of the time ( p < 0.001). Conclusion: In this study, women introduced by men at IMGR were less likely to be addressed by professional title than were men introduced by men. Differential formality in speaker introductions may amplify isolation, marginalization, and professional discomfiture expressed by women faculty in academic medicine. [ABSTRACT FROM AUTHOR]

The article presents an experimental study in determining implicit racial bias and its influences in pediatricians' recognition of child abuse. Data were collected anonymously by pediatricians using injury vignettes. Result showed no significant differences in suspicion for an abuse-related injury based on the race of the child.

To review aspects of the underlying methodological procedures in Atlas Methods of Dental Age Estimation (DAE) research publications. Attention is paid to issues of Reference Data supporting the Atlases, details of analytic procedures in the development of the Atlases, the statistical reporting of results of Age Estimation (AE), the problems of expressing uncertainty, and the viability of conclusions in the reporting of DAE studies. Research reports utilizing Dental Panoramic Tomographs for creating Reference Data Sets (RDS) were studied to unravel the processes of creating Atlases with a view to determining the appropriate procedures for developing numerical RDS and compiling them into an Atlas format to enable DAE of child subjects without birth records. The five different Atlases reviewed gave several different results in terms of AE. The possible causes of this were discussed – namely inadequate representation of Reference Data (RD) and lack of clarity in expressing uncertainty. It is suggested that the method of compiling Atlases needs to be more clearly defined. The yearly intervals described by some of the Atlases fails to take account of the Uncertainty of Estimates which is usually slightly greater than ±2½ years. The review of published Atlas design papers in the field of DAE shows a number of different study designs, statistical procedures, and presentational styles, particularly with regard to the statistical procedures and findings. These show that Atlas methods can only be accurate to what amounts to at best a year. Atlas methods lack the accuracy and precision of other methods of AE an example of which is the Simple Average Method (SAM).1 This inherent lack of accuracy must be taken into account when using Atlas methods for AE. • The 5 atlas methods described in the dental literature have been reviewed and compared. • The Dental Age determined using these Atlases (Chats) differ by up to one year. • The Turkish Atlas and the Australian Atlas are the only Charts that provide sex specific information. [ABSTRACT FROM AUTHOR]

Background: Unconscious biases are one of the causes of health disparities. Health professionals have prejudices against patients due to their race, gender, or other factors without their conscious knowledge. This review aimed to provide an overview of research on unconscious bias among health professionals and to investigate the biases that exist in different regions of the world, the health professions that are considered, and the research gaps that still exist., Methods: We conducted a scoping review by systematically searching PubMed/MEDLINE, CINAHL, PsycINFO, PsycARTICLES, and AMED. All records were double-screened and included if they were published between 2011 and 2021., Results: A total of 5186 records were found. After removing duplicates ( n = 300), screening titles and abstracts ( n = 4210), and full-text screening ( n = 695), 87 articles from 81 studies remained. Studies originated from North America ( n = 60), Europe ( n = 13), and the rest of the world ( n = 6), and two studies were of global scope. Racial bias was investigated most frequently ( n = 46), followed by gender bias ( n = 11), weight bias ( n = 10), socio-economic status bias ( n = 9), and mental illness bias ( n = 7). Most of the studies were conducted by physicians ( n = 51) and nurses ( n = 20). Other health care professionals were rarely included in these studies., Conclusions: Most studies show that health professionals have an implicit bias. Racial biases among physicians and nurses in the USA are well confirmed. Research is missing on other biases from other regions and other health professions.

Objective: Falsehood and bias can have tangible effects, whether related to the "hoax" of Corona virus disease/COVID-19 or the impact of personal protective equipment in city-wide news. The spread of false information requires the diversion of time and resources into rebolstering the truth. Our objective is thus to elucidate types of bias that may influence our daily work, along with ways to mitigate them., Data Sources: Publications are included which delineate specific aspects of bias or address how to preempt, mitigate, or correct bias, whether conscious or unconscious., Review Methods: We discuss: (1) the background and rationale for proactively considering potential sources of bias, (2) relevant definitions and concepts, (3) potential means to limit effects of inaccurate data sources, and (4) evolving frontiers in the management of bias. In doing so, we review epidemiological concepts and susceptibility to bias within study designs, including database studies, observational studies, randomized controlled trials (RCTs), systematic reviews, and meta-analyses. We additionally discuss concepts such as the difference between disinformation and misinformation, differential or nondifferential misclassification, bias toward a null result, and unconscious bias, among others., Conclusion: We have the means to mitigate sources of potential bias in database studies, observational studies, RCTs, and systematic reviews, beginning with education and awareness., Implications for Practice: False information may spread faster than true information, so it is beneficial to understand potential sources of falsehood we face, in order to safeguard our daily impressions and decisions. Awareness of potential sources of falsehood and bias forms the foundation for accuracy in our everyday work., (© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation.)

To meet challenges related to changing demographics, and to optimize the promise of diversity, radiologists must bridge the gap between numbers of women and historically underrepresented minorities in radiology and radiation oncology as contrasted with other medical specialties. Research reveals multiple ways that women and underrepresented minorities can benefit radiology education, research, and practice. To achieve those benefits, promising practices promote developing and implementing strategies that support diversity as an institutional priority and cultivate shared responsibility among all members to create inclusive learning and workplace environments. Strategies also include providing professional development to empower and equip members to accomplish diversity-related goals. Among topics for professional development about diversity, unconscious bias has shown positive results. Unconscious bias refers to ways humans unknowingly draw upon assumptions about individuals and groups to make decisions about them. Researchers have documented unconscious bias in a variety of contexts and professions, including health care, in which they have studied differential treatment, diagnosis, prescribed care, patient well-being and compliance, physician-patient interactions, clinical decision making, and medical school education. These studies demonstrate unfavorable impacts on members of underrepresented groups and women. Learning about and striving to counteract unconscious bias points to promising practices for increasing the numbers of women and underrepresented minorities in the radiology and radiation oncology workforce. [ABSTRACT FROM AUTHOR]