Awareness of implicit bias mitigates discrimination in radiology resident selection

PURPOSE: Implicit bias is common and is thought to drive discriminatory behavior. Having previously demonstrated discrimination against specific applicant demographics by academic radiology faculty in a simulated resident selection process, the authors sought to better understand the relationship between implicit bias and discrimination, as well as the potential and mechanisms for their mitigation. METHOD: Fifty-one faculty at three academic radiology departments, who had participated in a 2017 audit study in which they were shown to treat applicants differently based on race/ethnicity and physical appearance, were invited to complete testing for implicit racial and weight bias using the Implicit Association Test in 2019. Respondents were also surveyed regarding awareness of their own personal racial and weight biases, as well as any prior participation in formal diversity training. Comparisons were made between implicit bias scores and applicant ratings, as well as between diversity training and self-awareness of bias. RESULTS: Thirty-one of 51 faculty (61%) completed and submitted results of race and weight Implicit Association Tests. Seventy-four percent (23/31) reported implicit anti-obese bias, concordant with discrimination demonstrated in the resident selection simulation, in which obese applicants were rated 0.40 standard deviations lower than non-obese applicants (p 0.2). CONCLUSIONS: These findings suggest that implicit bias, as measured by the Implicit Association Test, does not inevitably lead to discrimination, and that personal awareness of implicit biases may allow their mitigation.