Bias Reduction in Academic Recruitment (BRIAR)

April 18, 2023 updated by: Community Medical Center, Toms River, NJ

The aim of this study is to determine if, with respect to medical students applying for residency in emergency medicine, prior knowledge of an applicant's academic record affects their ranking during their interviews.

Attendings interviewing candidates will either be blinded to their prior academic records or be allowed to review them prior to the interview. The interviewer's final score of the applicant will be measured, comparing blinded versus unblinded assessors.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

In residency recruitment and ranking, the most honest admission educators can offer is that there truly is no exact way to identify candidates who will thrive in a given discipline or residency program. Along with applications and letters of reference, the traditional residency interview process has long been thought to be one of the best available tools to evaluate a given candidate as well as assess their 'fit' for the culture of the program they wish to enter. Despite this decades-used tool, little uniformity exists in practice, with various disciplines and programs using various techniques to evaluate potential residents. To wit, prospective resident themselves, in one study, have listed their top three consideration when selecting a residency to be the friendliness of the program and faculty, the overall environment, and the interview day itself. Spending time in the department and hospital and having contact with the faculty and staff has long been seen as the best way to 'get to know' the program. This is among the main reasons why medical students will often schedule 'audition rotations' at hospitals and programs that draw their interest.

With respect to the interviews themselves, there has been some evolution of thought, despite the variability. Recently, structured interviews and other techniques have been discussed to reduce bias and increase efficiency in residency recruitment.

While this has been discussed in academic circles for some time, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has brought these issues to the fore. Forcing interviews to be done remotely has effectively removed the intimacy of an in-person visit or interview, making an assessment of 'fit' for both the applicant and the program more challenging. Many program leaders and resident educators have described 'fit' as among the most important predictors of residency success, sometimes more so than pure academic prowess.

Of the many biases in residency interviewing, among the easiest and most seductive is hinging a decision on academic achievement alone. It is well understood by many residency educators that academic success in medical school does not always translate to the same level of performance in residency. With the virtual method of interviews continuing for at least this year (and likely going forward), our study ponders the question if the removal of knowledge of an applicant's academic record changes their interviewer's perception of their potential as a resident in an emergency medicine.

This study will examine if blinding interviewers to the academic performance of residency applicants impact the assessor's recommendation for the candidate's match day rank list placement. Candidates will be assigned to have one of three of their interviews performed during the standard interview process, to have a single assessor who is instructed not to look at either medical school transcripts or standardized test scores. Assessors will be permitted to look at letters of recommendation, personal statements, research and work experience, and hobbies.

The absolute value of the difference of between blinded and unblinded assessors will be compared and tested for statistical significance by matched student T testing. The study is powered for an absolute difference of 1 point on a ten-point scale, which translates linearly to rank list placement. Additionally, this 1-point difference is considered significant from a standpoint of residency operations. Also, blinded versus unblinded assessors will be compared to the placement by the residency program director, who will remain unblinded and also makes independent recommendations for every candidate. As a subanalysis, a qualitative assessment of candidates who get ranked either substantially higher or lower when blinded compared to unblinded will also be conducted.

Study Type

Interventional

Enrollment (Actual)

212

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • New Jersey
      • Toms River, New Jersey, United States, 08755
        • Community Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • All candidates who have or are anticipating completing their medical school education, and have applied for a position in our residency during the 2022-2023 match cycle.

Exclusion Criteria:

  • Candidates our program declined to grant an interview spot or have canceled their interview prior to completing it.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Blinded
Interviewers will be assigned a candidate to interview. They will be asked not to review the medical school transcripts or standardized test scores (USMLE, COMLEX). They will be permitted to review personal statements, letters or recommendation, and other personal information in the application.
Other: Blinding to academic performance of candidate
Each candidate applying to our program will be interviewed by three core faculty. One of them will be selected, a priori, to be asked not to view a candidate's academic performance (medical school transcripts, standardized test scores). This will not be randomized. Instead, it shall be set up so that each assessor has two blinded candidates to interview each day scheduled. Given that different faculty will be scheduled each day, it may end up that certain faculty will be blinded more than others.
Active Comparator: Unblinded
Interviewers will be assigned a candidate to interview. They will be given full permission to review the full application of their candidate as per their normal interview protocol.
Other: Usual Interview methodology
Each candidate applying to our program will be interviewed by three core faculty. Two of them will be selected, a priori, to be asked to interview their candidates as they see fit.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Assessor recommendation for match list position
Time Frame: Immediately after interview
Assessors will be asked to score their applicant, 1-10, with 1 corresponding to a Do Not Rank recommendation, 2-4 with lower third of list, 5-7 middle third of list, and 8-10 upper third of list.
Immediately after interview

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Community Medical Center, Toms River, NJ

Investigators

  • Principal Investigator: Joel Kravitz, MD, Associate Program Director, Emergency Medicine Residency

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 12, 2022

Primary Completion (Actual)

February 8, 2023

Study Completion (Actual)

February 8, 2023

Study Registration Dates

First Submitted

November 7, 2022

First Submitted That Met QC Criteria

November 7, 2022

First Posted (Actual)

November 15, 2022

Study Record Updates

Last Update Posted (Actual)

April 19, 2023

Last Update Submitted That Met QC Criteria

April 18, 2023

Last Verified

April 1, 2023

More Information

Terms related to this study

Other Study ID Numbers

  • 22-029

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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