ImportanceBest recruitment practices for increasing diversity are well established, but the adoption and impact of these practices in ophthalmology residency recruitment are unknown.ObjectiveTo describe the adoption of bias reduction practices in groups underrepresented in ophthalmology (URiO) residency recruitment and determine which practices are effective for increasing URiO residents.Design, Setting, and ParticipantsThis cross-sectional survey study used an 18-item questionnaire included in the online survey of the Association of University Professors in Ophthalmology (AUPO) Residency Program Directors. Data collection occurred from July 2022 to December 2022. The data were initially analyzed on January 16, 2023. Participants included residency program directors (PDs) in the AUPO PD listserv database.Main Outcomes and MeasuresDescriptive analysis of resident selection committee approaches, evaluation of applicant traits, and use of bias reduction tools. Primary outcome was diversity assessed by presence of at least 1 resident in the last 5 classes who identified as URiO, including those underrepresented in medicine (URiM), lesbian, gay, bisexual, transgender, queer, intersex, and asexual plus, or another disadvantaged background (eg, low socioeconomic status). Multivariate analyses of recruitment practices were conducted to determine which practices were associated with increased URiO and URiM.ResultsAmong 106 PDs, 65 completed the survey (61.3%). Thirty-nine PDs used an interview rubric (60.0%), 28 used interview standardization (43.0%), 56 provided at least 1 bias reduction tool to their selection committee (86.2%), and 44 used postinterview metrics to assess diversity, equity, and inclusion efforts (67.7%). Application filters, interview standardization, and postinterview metrics were not associated with increased URiO. Multivariate logistic regression analysis showed larger residency class (odds ratio [OR], 1.34; 95% CI, 1.09-1.65; P = .01) and use of multiple selection committee bias reduction tools (OR, 1.47; 95% CI, 1.13-1.92; P = .01) were positively associated with increased URiO, whereas use of interview rubrics (OR, 0.72; 95% CI, 0.59-0.87; P = .001) and placing higher importance of applicant interest in a program (OR, 0.83; 95% CI, 0.75-0.92; P = .02) were negatively associated. URiM analyses showed similar associations.Conclusions and RelevanceOphthalmology residency interviews are variably standardized. In this study, providing multiple bias reduction tools to selection committees was associated with increased URiO and URiM residents. Prioritizing applicant interest in a program may reduce resident diversity. Interview rubrics, while intended to reduce bias, may inadvertently increase inequity.

中文翻译：

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眼科住院医师招聘中代表性不足群体的减少偏见做法

重要性增加多样性的最佳招聘实践已经确立，但这些实践在眼科住院医师招聘中的采用和影响尚不清楚。目的描述在眼科住院医师招聘中代表性不足的群体中采用减少偏见的做法，并确定哪些做法对眼科住院医师招聘有效。设计、设置和参与者这项横断面调查研究使用了大学眼科教授协会 (AUPO) 住院医师项目主任在线调查中包含的 18 项调查问卷。数据收集发生于2022年7月至2022年12月。数据于2023年1月16日进行初步分析。参与者包括AUPO PD listserv数据库中的住院医师项目主管(PD)。主要成果和措施对住院医师选择委员会方法的描述性分析、对申请人的评估特征以及减少偏见工具的使用。主要结果是通过最后 5 个班级中至少有 1 名被认定为 URiO 的居民来评估多样性，包括医学界代表性不足的人 (URiM)、女同性恋、男同性恋、双性恋、跨性别者、酷儿、双性人和无性恋者，或其他弱势群体背景（例如，社会经济地位低）。对招聘实践进行了多变量分析，以确定哪些实践与 URiO 和 URiM 增加相关。结果 在 106 名 PD 中，65 名完成了调查（61.3%）。 39 名 PD 使用面试准则 (60.0%)，28 名使用面试标准化 (43.0%)，56 名向其选拔委员会提供至少 1 种减少偏见的工具 (86.2%)，44 名使用面试后指标来评估多样性、公平性、和包容性努力（67.7%）。应用筛选、面试标准化和面试后指标与 URiO 增加无关。多变量逻辑回归分析显示住院医师类别较大（比值比 [OR]，1.34；95% CI，1.09-1.65；磷= .01）并使用多重选择委员会偏差减少工具（OR，1.47；95% CI，1.13-1.92；磷= .01）与 URiO 增加呈正相关，而使用访谈量规（OR，0.72；95% CI，0.59-0.87；磷= .001）并高度重视申请人对项目的兴趣（OR，0.83；95% CI，0.75-0.92；磷= .02) 呈负相关。 URiM 分析显示出类似的关联。结论和相关性眼科住院医师访谈的标准化程度各不相同。在这项研究中，向选拔委员会提供多种减少偏见的工具与 URiO 和 URiM 居民的增加有关。优先考虑申请人对项目的兴趣可能会减少居民的多样性。面试规则虽然旨在减少偏见，但可能会无意中增加不平等。