Reducing Implicit Bias: Association of Women Surgeons #HeForShe Task Force Best Practice Recommendations

Abstract

It is imperative to identify and act on potential barriers to the equitable treatment of women, and racial, ethnic, and sexual minorities within our professional surgical community. This includes the identification and counteraction of implicit biases, which are unconscious beliefs and attitudes that often drive our behaviors and decision-making, and eventually determine the climate of relative opportunity and challenge for those who are underrepresented within our field. Increasing diversity in universities, medical schools, residencies, and surgical departments will ultimately heighten the quality of our care, deepen our connection with patients, and further our achievements as surgeons and leaders in medicine and society. A tradition of excellence in surgery includes a rigorous pursuit of intellectual development and the questioning of implicit dogma, and for this reason we must actively work to eradicate unconscious biases that compromise the integrity of this pursuit. We recommend the following steps with an aim towards this goal: 1.Commit to a Culture Shift 2.Introduce Bias Literacy 3.Provide Counter-Stereotypic Exposure 4.Conduct an Introspective Departmental Assessment 5.Implement Deliberative Processing Strategies for Hiring and Promotion 6.Encourage Mentoring and Sponsorship 7.

Gender imbalance in executive management positions at the Mexican National Institutes of Health

“…These stereotypes center on perceived characteristics, skills, and aspirations of women and how they have been perceived to not coincide with what it has been declared valuable for effective leadership, e.g., "how can a woman be the leader of a large hospital?" the challenges can be "too much" for her [39,57,58].…”

“…Gender imbalance is pervasive in many contexts within medical leadership, but some authors have stated that once uncovered, such imbalance may become malleable. They sustain that possible strategies include a longitudinal approach combined with progressive small-scale training that will be more effective to empower women and may result in durable change towards an increasingly modern and developed society, one with a narrower gender gap [55,58].…”

Gender differences among surgical fellowship program directors

“…2 Other strategies to mitigate implicit bias include exposure to counter-stereotypes, building strong mentorementee relationships centered on common interests and career trajectories rather than demographics, and focusing on merit for promotion and tenure. 12 The following 3 major factors may contribute to the gender gap in the leadership of academic medicine: traditional gender roles, manifestations of sexism in the medical environment, and lack of effective mentors. 11 Gender schema affect expectations of men and women, the evaluations of their work, and their performance as professionals.…”

Stop the bleeding: we must combat explicit as well as implicit biases affecting women surgeons

“…The Association of Women Surgeons recently published best practice recommendations for reducing implicit bias from their #HeForShe Task Force 8. Noting that ‘through the gradual, purposeful unlearning of biases, durable change can be achieved, and even the most pervasive patterns of discriminatory behaviour may be altered and eventually eliminated’, they propose that each institution undertake a seven-step process to reduce implicit bias 8. DiBrito et al argue that we may have a moral imperative to do so, as diversity in surgery allows for “more inclusive and better care of patients” 8.…”

“…Noting that ‘through the gradual, purposeful unlearning of biases, durable change can be achieved, and even the most pervasive patterns of discriminatory behaviour may be altered and eventually eliminated’, they propose that each institution undertake a seven-step process to reduce implicit bias 8. DiBrito et al argue that we may have a moral imperative to do so, as diversity in surgery allows for “more inclusive and better care of patients” 8. For the field of surgery to uphold its commitment to the patients it serves, combating implicit bias is both necessary and urgent.…”