O3246: BRAVE: Bias Reporting and Verification Evaluation

Background: The University of Minnesota Pediatric Residency Program is committed to fostering a safe and inclusive learning environment. Our Graduate Medical Education office has an annual institutional survey which provided us with prevalence data about bias events but lacked actionable and specific examples. Our objective was to create a system that would allow us to measure and respond to bias events more effectively and ultimately use the data for ongoing improvement.

Methods: The Residency leadership team partnered with the resident-led Justice, Equity, Diversity, and Inclusion (JEDI) Council. The Council identified the previous mechanisms for bias reporting as having the following deficiencies: difficulty in locating the tool, the length of time to complete, and minimal follow-up to each report. The Council also identified providing support for residents who experience mistreatment or bias as a desired outcome. As a part of this initiative, we identified multiple faculty members to serve in an advocate role.

The Bias Reporting Form was designed to be anonymous, easy to use, and to collect key descriptors of bias events to help us better understand key areas for improvement. These were the type of bias, the source of bias, target of the bias, and the site of the bias. Reporters had an option to provide more details about the incident and to provide contact information if desired, with the program director and program coordinator receiving a notification to arrange appropriate follow-up and support.

Results: Since the rollout of this new reporting system (January 2023), and for the next 14 months, a total of 49 responses were collected. This represents an 11-fold increase from our previous annual average number of bias reports collected. The most common type of bias reported was racial in nature, with patients and their caregivers being the target of the bias most commonly. For the source of bias reported, faculty were the highest, followed by nursing staff. We have used the data from this tool to help motivate change and provide examples in a required faculty development workshop, “Mitigating Bias in the Learning Environment.” Our JEDI Council has also been actively involved in reviewing reports and providing guidance for next steps.

Conclusion: In this project we partnered with our resident JEDI Council to design and implement a bias reporting tool. The results informed explicit plans for supporting residents and transparent initiatives for faculty development. We found a significant increase in resident reporting, which provided valuable data leading to high levels of engagement from both learners and faculty. Future opportunities remain for growth of reporting and faculty engagement.