"Time-In": A Tool for Interrupting Bias in Medical School Admissions Committee Meetings.

Abstract

During high-stakes committee meetings, bias is often expressed but goes uninterrupted because there is no formal structure to interrupt it. Bias impacts decision-making and can further disadvantage those from backgrounds that have been marginalized. The MD and MD-PhD admissions committees at the Icahn School of Medicine at Mount Sinai in NY in the 2020-2021 admissions season introduced a "Time-In" tool to interrupt bias during committee meetings. This study aimed to evaluate the impact of implementing the "Time-In" tool on committee members' perception of bias as a problem and the likelihood of committee members recognizing, reporting, discussing, and educating others about bias after implementation. There were 117 responses to the pre- and post-season surveys. In aggregate, respondents reported a statistically significant reduction in the perception of bias in the admissions process from pre-season to post-season. There was no change in the likelihood of committee members in aggregate endorsing comfort in recognizing, reporting, discussing, and educating about bias; however, notable gaps existed in the comfort of groups discussing bias publicly, i.e., respondents who are from backgrounds underrepresented in science and medicine, students, and new committee members were less comfortable than their comparators. By the post-season survey, these gaps were closed. Implementing a "time-in" allows for interruption of bias, with an impact of reducing the perception of bias, empowering individuals, and reducing gaps among groups to discuss bias publicly. A "time-in" can profoundly impact decision-making bodies that are critical gatekeepers to the composition of the physician workforce. Future directions will focus on enhancing committee members' skills in educating others about bias.