Gender, Race, and Grant Reviews: Translating and Responding to Research Feedback.

Grant-writing and grant-getting are key to success in many academic disciplines, but research points to gender gaps in both, especially as careers progress. Using a sample of National Institutes of Health (NIH) K-Awardees-Principal Investigators of Mentored Career Development Awards-we examined gender and race effects in response to imagined negative grant reviews that emphasized either promise or inadequacy. Women translated both forms of feedback into worse NIH priority scores than did men and showed reduced motivation to reapply for funding following the review highlighting inadequacy. Translation of feedback mediated the effects of gender on motivation, changing one's research focus, and advice-seeking. Race effects were less consistent, and race did not moderate effects of gender. We suggest that gender bias in grant reviews (i.e., greater likelihood of highlighting inadequacy in reviews of women's grants), along with gender differences in responsiveness to feedback, may contribute to women's underrepresentation in academic medicine.

Write More Articles, Get More Grants: The Impact of Department Climate on Faculty Research Productivity.

BACKGROUND: Many studies find that female faculty in academic medicine, science, and engineering experience adverse workplace climates. This study longitudinally investigates whether department climate is associated with future research productivity and whether the associations are stronger for female than male faculty. METHOD: Two waves of a faculty climate survey, institutional grant records, and publication records were collected for 789 faculties in academic medicine, science, and engineering at the University of Wisconsin-Madison between 2000 and 2010. Research productivity was measured as Number of Publications and Number of Grants awarded, and department climate was measured with scales for professional interactions, department decision-making practices, climate for underrepresented groups, and work/life balance. Ordinary least squares and negative binomial regression methods were used to assess gender differences in productivity, influences of department climate on productivity, and gender differences in effects of climate on productivity. RESULTS: Female faculty published fewer articles and were awarded fewer grants in the baseline period, but their productivity did not differ from male faculty on these measures in subsequent years. Number of Publications was positively affected by professional interactions, but negatively affected by positive work/life balance. Number of Grants awarded was positively affected by climate for underrepresented groups. These main effects did not differ by gender; however, some three-way interactions illuminated how different aspects of department climate affected productivity differently for men and women in specific situations. CONCLUSIONS: In perhaps the first study to assess the longitudinal impact of department climate on faculty research productivity, positive department climate is associated with significantly greater productivity for all faculty-women and men. However, some positive aspects of climate (specifically, work/life balance) may be associated with lower productivity for some female faculty at specific career periods. These findings suggest that departments that wish to increase grants and publications would be wise to foster a positive workplace climate.

Are Female Applicants Disadvantaged in National Institutes of Health Peer Review? Combining Algorithmic Text Mining and Qualitative Methods to Detect Evaluative Differences in R01 Reviewers' Critiques.

BACKGROUND: Women are less successful than men in renewing R01 grants from the National Institutes of Health. Continuing to probe text mining as a tool to identify gender bias in peer review, we used algorithmic text mining and qualitative analysis to examine a sample of critiques from men's and women's R01 renewal applications previously analyzed by counting and comparing word categories. METHODS: We analyzed 241 critiques from 79 Summary Statements for 51 R01 renewals awarded to 45 investigators (64% male, 89% white, 80% PhD) at the University of Wisconsin-Madison between 2010 and 2014. We used latent Dirichlet allocation to discover evaluative "topics" (i.e., words that co-occur with high probability). We then qualitatively examined the context in which evaluative words occurred for male and female investigators. We also examined sex differences in assigned scores controlling for investigator productivity. RESULTS: Text analysis results showed that male investigators were described as "leaders" and "pioneers" in their "fields," with "highly innovative" and "highly significant research." By comparison, female investigators were characterized as having "expertise" and working in "excellent" environments. Applications from men received significantly better priority, approach, and significance scores, which could not be accounted for by differences in productivity. CONCLUSIONS: Results confirm our previous analyses suggesting that gender stereotypes operate in R01 grant peer review. Reviewers may more easily view male than female investigators as scientific leaders with significant and innovative research, and score their applications more competitively. Such implicit bias may contribute to sex differences in award rates for R01 renewals.

Patterns of Feedback on the Bridge to Independence: A Qualitative Thematic Analysis of NIH Mentored Career Development Award Application Critiques.

BACKGROUND: NIH Mentored Career Development (K) Awards bridge investigators from mentored to independent research. A smaller proportion of women than men succeed in this transition. The aim of this qualitative study was to analyze reviewers' narrative critiques of K award applications and explore thematic content of feedback provided to male and female applicants. METHOD: We collected 88 critiques, 34 from 9 unfunded and 54 from 18 funded applications, from 70% (n = 26) of investigators at the University of Wisconsin-Madison with K awards funded between 2005 and 2009 on the first submission or after revision. We qualitatively analyzed text in the 5 critique sections: candidate, career development plan, research plan, mentors, and environment and institutional commitment. We explored thematic content within these sections for male and female applicants and for applicants who had received a subsequent independent research award by 2014. RESULTS: Themes revealed consistent areas of criticism for unfunded applications and praise for funded applications. Subtle variations in thematic content appeared for male and female applicants: For male applicants criticism was often followed by advice but for female applicants it was followed by questions about ability; praise recurrently characterized male but not female applicants' research as highly significant with optimism for future independence. Female K awardees that obtained subsequent independent awards stood out as having track records described as "outstanding." CONCLUSION: This exploratory study suggests that K award reviewer feedback, particularly for female applicants, should be investigated as a potential contributor to research persistence and success in crossing the bridge to independence.

A quantitative linguistic analysis of National Institutes of Health R01 application critiques from investigators at one institution.

PURPOSE: Career advancement in academic medicine often hinges on the ability to garner research funds. The National Institutes of Health's (NIH's) R01 award is the "gold standard" of an independent research program. Studies show inconsistencies in R01 reviewers' scoring and in award outcomes for certain applicant groups. Consistent with the NIH recommendation to examine potential bias in R01 peer review, the authors performed a text analysis of R01 reviewers' critiques. METHOD: The authors collected 454 critiques (262 from 91 unfunded and 192 from 67 funded applications) from 67 of 76 (88%) R01 investigators at the University of Wisconsin-Madison with initially unfunded applications subsequently funded between December 2007 and May 2009. To analyze critiques, the authors developed positive and negative grant application evaluation word categories and selected five existing categories relevant to grant review. They analyzed results with linear mixed-effects models for differences due to applicant and application characteristics. RESULTS: Critiques of funded applications contained more positive descriptors and superlatives and fewer negative evaluation words than critiques of unfunded applications. Experienced investigators' critiques contained more references to competence. Critiques showed differences due to applicant sex despite similar application scores or funding outcomes: more praise for applications from female investigators, greater reference to competence/ability for funded applications from female experienced investigators, and more negative evaluation words for applications from male investigators (all P<.05). CONCLUSIONS: Results suggest that text analysis is a promising tool for assessing consistency in R01 reviewers' judgments, and gender stereotypes may operate in R01 review.

"Fair Play": A Videogame Designed to Address Implicit Race Bias Through Active Perspective Taking.

OBJECTIVE: Having diverse faculty in academic health centers will help diversify the healthcare workforce and reduce health disparities. Implicit race bias is one factor that contributes to the underrepresentation of Black faculty. We designed the videogame "Fair Play" in which players assume the role of a Black graduate student named Jamal Davis. As Jamal, players experience subtle race bias while completing "quests" to obtain a science degree. We hypothesized that participants randomly assigned to play the game would have greater empathy for Jamal and lower implicit race bias than participants randomized to read narrative text describing Jamal's experience. MATERIALS AND METHODS: University of Wisconsin-Madison graduate students were recruited via e-mail and randomly assigned to play "Fair Play" or read narrative text through an online link. Upon completion, participants took an Implicit Association Test to measure implicit bias and answered survey questions assessing empathy toward Jamal and awareness of bias. RESULTS: As hypothesized, gameplayers showed the least implicit bias but only when they also showed high empathy for Jamal (P=0.013). Gameplayers did not show greater empathy than text readers, and women in the text condition reported the greatest empathy for Jamal (P=0.008). However, high empathy only predicted lower levels of implicit bias among those who actively took Jamal's perspective through gameplay (P=0.014). CONCLUSIONS: A videogame in which players experience subtle race bias as a Black graduate student has the potential to reduce implicit bias, possibly because of a game's ability to foster empathy through active perspective taking.

Physicians and implicit bias: how doctors may unwittingly perpetuate health care disparities.

Although the medical profession strives for equal treatment of all patients, disparities in health care are prevalent. Cultural stereotypes may not be consciously endorsed, but their mere existence influences how information about an individual is processed and leads to unintended biases in decision-making, so called "implicit bias". All of society is susceptible to these biases, including physicians. Research suggests that implicit bias may contribute to health care disparities by shaping physician behavior and producing differences in medical treatment along the lines of race, ethnicity, gender or other characteristics. We review the origins of implicit bias, cite research documenting the existence of implicit bias among physicians, and describe studies that demonstrate implicit bias in clinical decision-making. We then present the bias-reducing strategies of consciously taking patients' perspectives and intentionally focusing on individual patients' information apart from their social group. We conclude that the contribution of implicit bias to health care disparities could decrease if all physicians acknowledged their susceptibility to it, and deliberately practiced perspective-taking and individuation when providing patient care. We further conclude that increasing the number of African American/Black physicians could reduce the impact of implicit bias on health care disparities because they exhibit significantly less implicit race bias.