Objectives: Standardisation of medical examinations involves minimising assessor stereotyping and bias for a fair process. The objective of this study was to determine whether being a non-white candidate impacted scoring by simulated patients, when compared with a white candidate, at three different performance grades in the same history taking station.
Design: single-blinded, video-based, randomised study.
Participants: One hundred and sixty-three simulated patients watched a randomly allocated set of six videos. Each set consisted of three different white and three non-white (South Asian, black and Chinese) candidates performing at either fail, borderline or pass grades. Therefore, each simulated patient assessor observed one white and one non-white candidate at each grade and scored communication and professionalism domains.
Main outcome measure: The median and IQR of the difference between total scores for the white and non-white candidates were compared at all three performance grades.
Results: The black fail candidate scored statistically significantly lower than their white fail counterpart. The black borderline and Chinese borderline candidates scored significantly higher than their white counterparts. No other differences were statistically significant at p<0.0057.
Conclusions: Being black and failing was associated with a lower score compared to being white and failing thereby indicating negative stereotype against black students. However, being black or Chinese at a borderline grade was associated with higher scores than being white at the same grade potentially due to self-awareness of potential bias when there is uncertainty regarding the performance.
Objectives: Standardisation of medical examinations involves minimising assessor stereotyping and bias for a fair process. The objective of this study was to determine whether being a non-white candidate impacted scoring by simulated patients, when compared with a white candidate, at three different performance grades in the same history taking station.
Design: single-blinded, video-based, randomised study.
Participants: One hundred and sixty-three simulated patients watched a randomly allocated set of six videos. Each set consisted of three different white and three non-white (South Asian, black and Chinese) candidates performing at either fail, borderline or pass grades. Therefore, each simulated patient assessor observed one white and one non-white candidate at each grade and scored communication and professionalism domains.
Main outcome measure: The median and IQR of the difference between total scores for the white and non-white candidates were compared at all three performance grades.
Results: The black fail candidate scored statistically significantly lower than their white fail counterpart. The black borderline and Chinese borderline candidates scored significantly higher than their white counterparts. No other differences were statistically significant at p<0.0057.
Conclusions: Being black and failing was associated with a lower score compared to being white and failing thereby indicating negative stereotype against black students. However, being black or Chinese at a borderline grade was associated with higher scores than being white at the same grade potentially due to self-awareness of potential bias when there is uncertainty regarding the performance.