Assignment/exercise
Be AWARE: An Anti-bias Toolkit to Limit Bias in Narrative Evaluation of Medical Trainees
MedEdPORTAL, Vol.22, 11594
Association of American Medical Colleges
04/17/2026
DOI: 10.15766/mep_2374-8265.11594
PMCID: PMC13086828
PMID: 42004218
Abstract
Introduction: Gender and racial biases continue to be pervasive within the field of medicine. These biases can have significant, lifelong impacts on career trajectory and continue to promote inequities for women and groups that are underrepresented in medicine. There is ample literature demonstrating that a prudent approach to combat these biases is through narrative evaluation of medical trainees. Methods: An interactive workshop was developed for all health care providers, including trainees, who currently have, or will have, responsibility for evaluating medical trainees. Its aim was to provide an evidence-based framework for recognizing implicit biases in narrative evaluations and for adapting language to limit them. A toolkit (Be AWARE Anti-bias Toolkit) was developed from existing literature, highlighting 5 key elements of linguistic bias in narrative evaluations: (1) acknowledge that bias exists; (2) word choice matters; (3) active verbs get the job done; (4) resist raising doubt; and (5) emphasize accomplishments over effort. The workshop included interactive small-group activities, with practice in reading and writing narrative evaluations. A postworkshop evaluation survey was distributed after the session to assess relevance and effectiveness. Results: This workshop was presented 5 times (2 local and 3 national conferences) and was attended by 80 participants, 25 of whom completed the postworkshop survey. The responses were overwhelmingly favorable; all respondents agreed or strongly agreed with the survey questions, indicating they found the session useful, relevant, effective, and worthwhile. Discussion: This workshop provided an effective toolkit to help participants recognize and limit biased language in narrative evaluations of trainees.
Educational Objectives
By the end of this activity, learners will be able to:
1. Identify 5 core principles in preventing racial and gender bias in evaluation of trainees.
2. Explain how biases in evaluation can affect the training, education, and career opportunities of underrepresented populations in medicine.
3. Summarize communal/agentic adjectives and passive/active verbs, as well as identify why these different terms can reinforce bias.
4. Outline and compare evaluations that use the AWARE principles versus those that do not and demonstrate how these principles create a stronger assessment of underrepresented trainees.
5. Implement the Be AWARE Toolkit to mitigate future bias in narrative evaluations.
Details
- Title: Subtitle
- Be AWARE: An Anti-bias Toolkit to Limit Bias in Narrative Evaluation of Medical Trainees
- Creators
- Kristen Sandgren - University of Iowa Stead Family Children’s HospitalMelissa Baranay - Wake Forest UniversityBryan Koestner - University of Iowa Stead Family Children’s HospitalAnna Schmitz - University of Iowa Stead Family Children’s Hospital
- Resource Type
- Assignment/exercise
- Publication Details
- MedEdPORTAL, Vol.22, 11594
- DOI
- 10.15766/mep_2374-8265.11594
- PMID
- 42004218
- PMCID
- PMC13086828
- ISSN
- 2374-8265
- eISSN
- 2374-8265
- Publisher
- Association of American Medical Colleges
- Language
- English
- Date published
- 04/17/2026
- Academic Unit
- Stead Family Department of Pediatrics; Hospital Medicine
- Record Identifier
- 9985153529802771
Metrics
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