OUR VISION
Achieving optimal health outcomes for all patients, families and communities by increasing the number of health professional program graduates who have the knowledge, skills and attitudes to provide equitable, inclusive care to all patients, regardless of their background and position in society.
(artwork by Nathan Ihemeremadu, 2023)
THE HISTORY OF The Bias Checklist
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about our team
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collaborating organizations
THE HISTORY OF The Bias Checklist
The Bias Checklist has an interesting provenance: in the fall of 2017, a lecturer made a remark intended to be humorous, and even positive, regarding weight gain. It was decidedly not received as such by the medical students in the audience. A few weeks later, Dr. Caruso Brown, who had given a few brief talks on unconscious bias for faculty, received an email from a senior administrator, who asked if she could draft a one-page handout on the topic to distribute. Her first instinct was to roll her eyes; her second to bury her face in her hands. But because she was seeing patients in the pediatric oncology clinic all day, she didn’t immediately respond. Instead, between appointments, she returned again and again to the intent of the request—and the cry for help underpinning it. The administrator didn’t ask for a “one-page handout” because he had no appreciation for the complexity of racism and other forms of structural oppression in healthcare; he asked for a one-page handout because faculty were already feeling strapped for time and he hoped that a brief intervention might reach people who would never choose to invest in more intensive training. And because she was in a clinical space, she turned to an idea that had taken off in clinical practice: checklists. Checklists are intended to mitigate harm to patients by making sure expert clinicians and healthcare professionals don’t miss key steps in complex procedures. Teaching, especially teaching in the health professions, which bring together science, technology, art, and society, is incredibly complex. Could a checklist help teachers identify where biased information had crept into their content?
Between patients, Dr. Caruso Brown sketched out the first Bias Checklist—a one-page Word document, with a table on the front containing rough questions like “Does this content describe explicit biological differences between races?” and another table on the back with examples of bias in medical education (“Describing racial differences in the epidemiology of disease without discussing the causes of these differences or that race is a social construct”). She pulled the questions and examples from her own expertise and from conversations with medical students and student feedback data from the previous three years. Travis Hobart, MD, MPH, a general pediatrician and co-director of Upstate’s health systems science curriculum, gave feedback on the first draft. Over the next few weeks, Dr. Caruso Brown conducted a review of literature to further revise the Checklist. Then it went live, circulated to faculty and presented in curriculum meetings.
Lauren Germain, PhD, Upstate’s Director of Evaluation, Assessment and Research joined the team soon after to support the design and conduct of validation studies. In spring of 2018, directors of organ-based units were recruited to use the Checklist on content in their units, along with the lecturers and a group of student volunteers. Prior to the study, the Checklist was built in REDCap, a secure electronic data-entry system, to make it more accessible. The data from this project were published in the journal Medical Education in 2019. The National Collaborative for Social Determinants of Health share the PDF version of Checklist on their website, and Dr. Caruso Brown gave a webinar on it in November 2019.
After that, very little happened. The Checklist existed, we encouraged our colleagues to use it, and they mostly did not. Our team focused on the publication of a case-based health equity book, and the evaluation of a course for medical students based on the book, and many of us regarded the Checklist as another good idea that didn’t lead to the change we’d envisioned. Then, on May 25, 2020, George Floyd was murdered by police officers in Minnesota and, suddenly it seemed, healthcare institutions were paying attention to racism in medicine—really paying attention. Over the summer, interest in the Checklist exploded, both locally and nationally. Upstate’s Dean required its use for all content taught in the MD program, which led Dr. Germain to develop the first plan for monitoring adherence. Colleagues from Upstate’s College of Nursing joined our team. Premal Patel, MD invited Dr. Caruso Brown to lead a seminar at the University of Texas Medical Branch, which became the first of almost two dozen invitations to speak about the Checklist.
In October 2020, Dr. Caruso Brown and Dr. Germain met with Maria Alonso Luaces, PhD and Natabhona Mabachi, PhD, MPH from the University of Kansas’ Office of Diversity and Inclusion. Their interest in adapting the Checklist, and their creative approaches to some of the challenges the Upstate team had encountered, inspired us to start the Bias Checklist Collaborative, along with educators and leaders from Ohio State University, Cleveland Clinic, and the University of Texas Medical Branch. Over the next two years, educators from fifteen other schools joined in on monthly meetings to share experiences with curricular bias mitigation.
In the spring of 2022, Dr. Caruso Brown and Dr. Germain were awarded a President’s Grant from the Josiah H. Macy, Jr. Foundation to support the construction of the website and a new Community of Practice centered on the Bias Checklist. Their grant application was inspired and supported by colleagues at Oregon Health and Sciences University, Reem Hasan, MD, PhD, Brian Park, MD, MPH, and Estela Vasquez Guzman, PhD.
Our Team
Amy Caruso Brown she/her | CREATOR + FOUNDER
Amy E. Caruso Brown, MD, MSc, MSCS, HEC-C is the creator of the Upstate Bias Checklist and the founder of the Bias Checklist Collaborative. She is currently the Interim Chair of Bioethics and Humanities and an Associate Professor of Bioethics and Humanities and of Pediatrics at SUNY Upstate Medical University in Syracuse, New York, where she also co-directs the equity-centric health systems science curriculum for medical students. She is the lead editor of Bioethics, Public Health and the Social Sciences for the Medical Professions: An Integrated, Case-Based Approach (Springer, 2019). Dr. Caruso Brown earned a bachelor’s degree from the University of Virginia in 2002, a medical degree from Emory University in 2008, a master’s degree in medical anthropology from the University of Oxford, also in 2008, and a master’s degree in clinical science from the University of Colorado in 2014. She completed residency training in general pediatrics at the Children's Hospital of Philadelphia from 2008-2009 and the University of Colorado from 2009-2011, and fellowship training in pediatric hematology/oncology at the University of Colorado from 2011-2014. She is board-certified in general pediatrics, pediatric hematology/oncology, and healthcare ethics consultation.
LAUREN Germain she/her | RESEARCH + EVALUATION
Lauren J. Germain, PhD, MEd leads research and evaluation for the Bias Checklist Collaborative. She is currently the Director of Evaluation, Assessment and Research and an Assistant Professor of Public Health and Preventive Medicine and of Medicine at SUNY Upstate. She also co-directs the “Systems Approach to Assessment in Health Professions Education” course at the Harvard Macy Institute. She is the author of Campus Sexual Assault: College Women Respond (Johns Hopkins University Press, 2016) and the co-editor of Leadership at the Intersection of Race and Gender in Healthcare and Science (Routledge, 2022). Dr. Germain earned a bachelor’s degree from Providence College in 2005, a master’s degree in education from the University of Virginia in 2006, and a doctoral degree in higher education, also from the University of Virginia, in 2012.
sophie pollack-milgate she/her | WEBMASTER
Sophie Pollack-Milgate, BA is the webmaster for the Bias Checklist Collaborative. She is currently the Research Associate for the Center for Bioethics and Humanities at SUNY Upstate. Sophie earned a bachelor’s degree in Contemplative Studies from Brown University in 2023.
Our partners
Tracey L. Henry, MD, MPH, MS, Associate Professor of Medicine, Emory University School of Medicine, Diversity, Equity, Inclusion and Racial Advocacy Curriculum Thread Director
Travis Hobart, MD, MPH, Assistant Professor of Public Health and Preventive Medicine and of Pediatrics, SUNY Upstate Medical University, Co-Director of Health Systems Science, Director of the Population Health Clerkship, and Thread Leader for Population Health and Preventive Medicine (email: hobartt@upstate.edu)
Sarah J. Jennings, DNP, MPA, RN, Assistant Professor, School of Nursing, Northern Michigan University, Co-Chair Interim Strategic Planning Committee for Diversity, Equity, and Inclusion at NMU, Faculty Representative for Multicultural Student Nurses Association at NMU, Chair of the Student Affairs Committee in the School of Nursing (email: sajennin@nmu.edu)
Sarah Kureshi, MD, MPH, Associate Professor of Family Medicine, Georgetown University School of Medicine, Health Equity and Advocacy: Anti-Racism Longitudinal Thread Director, Racial Justice Curricular Reform Subcommittee Co-Chair, Center for Health Equity Advisory Committee Co-Chair (email: sk795@georgetown.edu)
Maria Alonso Luaces, PhD, Education Assistant Professor, Department of Family Medicine, Director Diversity and Inclusion, Kansas University Medical Center
Natabhona Mabachi, PhD, MPH (she/her), Director of Evaluation at the American Academy of Family Physicians (AAFP) National Research Network (NRN)
Funding Acknowledgment
Funding for development of the Bias Checklist Collaborative website and Community of Practice was provided by the Josiah Macy, Jr. Foundation, through a President’s Grant (2022-2023).
Design Team
Day corso they/them | lead brand design + strategist consultant
email: daisyjesaria@gmail.com | IG: @jesariaa | portfolio website here
Carolina cará she/her | accessibility engineer consultant
email: c.carabr@gmail.com
aaron hilst he/him | website design consultant
email: aaron@aaronhilst.com | portfolio website here
UPSTATE ART ALLIANCE
Nathan Ihemeremadu he/him | illustrator
IG: @art._.block | email: ni42@cornell.edu
AUDREY Li she/her | illustrator
email: liau@upstate.edu
