Association for Behavior Analysis International

Change in large organizations is a complex and lengthy process. Many people with different interests are involved and the multiple decisions that must be made can substantially influence intended outcomes. These decisions are made by leaders, either established or emerging, who rely on a variety of techniques to determine the best course of action. Decision making at the leadership level requires information that may not be readily accessible. This symposium will outline the creation, adaptation and adoption of three tools used at the University of Nevada School of Medicine (UNSOM) during an organization-wide curricular restructuring. Leadership from UNSOM and the Behavior Analysis Program at the University of Nevada, Reno collaborated to create an emerging leader interview project to address faculty concerns regarding the curricular change and to adapt the Implicit Relational Assessment Procedure (IRAP) to guide aspects of curricular development regarding implicit biases in students. Leadership adopted the Association of American Medical Colleges (AAMC) Faculty Forward Engagement Survey to evaluate faculty engagement and development.

The impact of medical practitioners implicit biases on the quality of care provided to patients perceived as different from themselves has been well documented. Medical education has frequently addressed these biases in classroom settings, but there is evidence that in some cases, simply teaching about cultural differences may only reinforce some negative stereotypes. Therefore, understanding the nature of implicit biases and acknowledging the potential negative effect on doctor-patient relationships may offer a more effective approach to enhancing the cultural competence curriculum in medical education. At UNSOM, the IRAP has been adapted to measure implicit bias in this medical student population, with the intent of shaping the curriculum to address these biases. This presentation will discuss the process of developing the IRAP for this specific population, the current work being done and the intended outcome of integrating the IRAP into future curriculum development.

Medical schools employ large numbers of faculty in both the clinical and basic sciences, averaging about 500 faculty members per medical school. The assessment and evaluation of large numbers of faculty makes it difficult to pinpoint areas for development and opportunities to increase faculty engagement. The AAMC recognized this issue and created the Faculty Forward Engagement Survey which measures faculty satisfaction with numerous aspects of their work environment. Faculty members survey responses are aggregated and benchmarked against responses at cohort schools to create an institutional report detailing actionable areas for improvement. Identified areas can then be targeted by leaders to improve faculty development activities and engage faculty in problem solving. This presentation will detail the events at UNSOM leading up to the implementation of Faculty Forward, the reasons this survey instrument was chosen, how it was customized to this institution and how the results are being used to guide organizational change.