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Eating effects in lean meats mitochondrial bioenergetics associated with Boa constrictor (Serpentes: Boidae).
Despite a lack of intent to discriminate, physicians educated in U.S. medical schools and residency programs often take actions that systematically disadvantage minority patients. The approach to assessment of learner performance in medical education can similarly disadvantage minority learners. The adoption of holistic admissions strategies to increase the diversity of medical training programs has not been accompanied by increases in diversity in honor societies, selective residency programs, medical specialties, and medical school faculty. These observations prompt justified concerns about structural and interpersonal bias in assessment. This manuscript characterizes equity in assessment as a "wicked problem" with inherent conflicts, uncertainty, dynamic tensions, and susceptibility to contextual influences. The authors review the underlying individual and structural causes of inequity in assessment. Using an organizational model, they propose strategies to achieve equity in assessment and drive institutional and systemic improvement based on clearly articulated principles. This model addresses the culture, systems, and assessment tools necessary to achieve equitable results that reflect stated principles. CGS 21680 cost Three components of equity in assessment that can be measured and evaluated to confirm success include intrinsic equity (selection and design of assessment tools), contextual equity (the learning environment in which assessment occurs), and instrumental equity (uses of assessment data for learner advancement and selection and program evaluation). A research agenda to address these challenges and controversies and demonstrate reduction in bias and discrimination in medical education is presented.
Gender equity in leadership across academic medicine remains a concern. The case of chief resident (CR) offers an opportunity to explore novel strategies in leadership selection in graduate medical education (GME). Means of identifying potential candidates for CR often rely on faculty assessment of resident performance, yet implicit gender bias has the potential to influence this assessment.

To diversify the metrics used in CR selection, an intervention was implemented to solicit resident input to identify candidates for CR at 2 U.S. internal medicine residency programs in 2018 and 2019. This involved a simple, cross-sectional survey of residents in which they were asked to identify individual residents as good candidates for consideration for CR.

There were 298 of 518 internal medicine resident responses to this intervention across sites and years (mean 58.2% response rate). Nomination patterns of residents and program leaders correlated significantly (correlation coefficient 0.62, P < .001). Controlling for site and year, gender was a significant factor associated with who residents nominated for CR (β-coefficient 0.325, P = .004) with women residents more likely to identify women for CR (odds ratio 1.38, 95% confidence interval 1.11-1.73). Fifty residents nominated themselves for CR, and there was no significant difference by gender (β-coefficient 0.038, P = .91).

Soliciting resident input to identify candidates for CR may enable gender representation of candidates for this position. Influencing candidate choices may be a promising way to impact leadership selection in medicine.
Soliciting resident input to identify candidates for CR may enable gender representation of candidates for this position. Influencing candidate choices may be a promising way to impact leadership selection in medicine.
Faculty from different racial and ethnic backgrounds developed and piloted an anti-racism curriculum initially designed to help medical students work more effectively with patients of color. Learning objectives included developing stronger therapeutic relationships, addressing the effects of structural racism in the lives of patients, and mitigating racism in the medical encounter.

The anti-racism curriculum was delivered and evaluated in 2019 through focus groups and written input before and after each module. The process and outcome evaluation utilized a grounded theory approach.

Three emergent themes reflect how medical students experienced the anti-racism curriculum and inform recommendations for integrating an anti-racism curriculum into future medical education. The themes are 1) the differential needs and experiences of persons of color and Whites; 2) the need to address issues of racism within medical education as well as in medical care; 3) the need for structures of accountability in medical education.

Medical educators must address racism in medical education before seeking to direct students to address it in medical practice.
Medical educators must address racism in medical education before seeking to direct students to address it in medical practice.Bias can impact all aspects of human interactions and have major impacts on the education and evaluation of health care professionals. Health care and health professions education, being very dependent on interpersonal interactions and learning as well as on the assessment of interpersonal behaviors and skills, are particularly susceptible to the positive and negative effects of bias. Even trained and experienced evaluators can be affected by biases based on appearance, attractiveness, charm, accent, speech impediment, and other factors that should not play a role in the assessment of a skill. At the Morehouse School of Medicine, elements in the curriculum and the milieu help decrease the burden of bias experienced by learners. In addition, many of the learners develop knowledge, skills, and attitudes that appear to assist them with navigating bias in other learning or practice environments. In this case study, the authors reflect on these elements and how they can be replicated in other settings. According to the authors, modifying the learning environment to enhance and sustain relationships is key in addressing toxic bias.Successfully teaching about race and racism requires a careful balance of emotional safety and honest truth-telling. Creating such environments where all learners can thrive and grow together is a challenge, but a consistently doable one. This article describes 12 lessons learned within 4 main themes ground rules; language and communication; concepts of social constructs, intersectionality, and bidirectional biases; and structural racism, solutions, and advocacy. The authors' recommendations for how to successfully teach health professions students about race and racism come from their collective experience of over 60 years of instruction, research, and practice. Proficiency in discussing race and addressing racism will become increasingly relevant as health care institutions strive to address the social needs of patients (e.g., food insecurity, housing instability) that contribute to poor health and are largely driven by structural inequities. Having interprofessional team-based care, with teams better able to understand and counteract their own biases, will be critical to addressing the social and structural determinants of health for marginalized patients.
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