Overcoming Implicit Bias: Health Equity Evaluation and Reporting Tool

Thank you for using the IAFP's Implicit Bias toolkit

Your feedback is essential in helping to improve the toolkit and also document the reach of this tool in assisting residency programs and their residents and faculty members in recognizing and addressing biases among interactions with colleagues, staff and patients. Thank you from the IAFP Health Equity Member Interest Group.

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1. Program Name

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2. Date part 1 of the program was presented (Required.)

Date / Time

Date

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3. Date part 2 was presented (Required.)

Date / Time

Date

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4. How many of the following attended the presentation? (Required.)

Residents

Faculty physicians

Other staff

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5. Which bias topics did your program address? (Required.)

Race

Sexual Orientation

Gender and Gender Identity

Disability

Weight bias

Socioeconomic Standing

Immigrant/Undocumented

Other (please specify)

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6. From the discussion, our residents can name one form of bias against each of the communities we covered in the presentations (Required.)

All of them

Some of them

None

Comments about any obstacles to saying Yes to all of them?

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7. How often do you think that healthcare disparities were occurring within your workplace? (Required.)

Very Frequently

Frequently

Occasionally

Rarely

Very Rarely

Never

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8. How frequently does your program discuss issues or occurrences of biases? (Required.)

Very Frequently

Frequently

Occasionally

Rarely

Very Rarely

Never

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9. Commitment to change: After attending this webinar, what, if any, changes will you be making in your practice? (Required.)

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10. Prior to this presentation: Please rate your knowledge or skill on this topic: (Required.)

Very High

High

Average

Low

Very Low

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11. AFTER this presentation: Please rate your knowledge or skill on this topic: (Required.)

Very High

High

Average

Low

Very Low

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12. This activity avoided commercial bias or influence: (Required.)

Yes

If no, please explain.

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13. Would you change anything about how you presented your topic? (Format, Visual Aids, Case Studies)

Yes

Comments

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14. Will you use this program again in future years?

Very likely

Likely

Neither likely nor unlikely

Unlikely

Very unlikely

Comments

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15. Would you recommend this training to other residency programs? (Required.)

Definitely

Very Probably

Probably

Possibly

Probably Not

Very Probably Not

Other (please specify)

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16. Please use the text box to provide any comments/feedback for toolkit authors

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17. Please use the text box to provide any overall feedback on this format (two-part series, topics offered)

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18. What other IAFP-led activities or discussions on health equity would you like to see in the future?

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19. Contact Information (Required.)

Name & credentials (e.g., Jane Doe, MD) *

Residency Program

Email Address *

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* 1. Program Name

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* 2. Date part 1 of the program was presented (Required.)

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* 3. Date part 2 was presented (Required.)

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* 4. How many of the following attended the presentation? (Required.)

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* 5. Which bias topics did your program address? (Required.)

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* 6. From the discussion, our residents can name one form of bias against each of the communities we covered in the presentations (Required.)

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* 7. How often do you think that healthcare disparities were occurring within your workplace? (Required.)

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* 8. How frequently does your program discuss issues or occurrences of biases? (Required.)

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* 9. Commitment to change: After attending this webinar, what, if any, changes will you be making in your practice? (Required.)

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* 10. Prior to this presentation: Please rate your knowledge or skill on this topic: (Required.)

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* 11. AFTER this presentation: Please rate your knowledge or skill on this topic: (Required.)

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* 12. This activity avoided commercial bias or influence: (Required.)

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* 13. Would you change anything about how you presented your topic? (Format, Visual Aids, Case Studies)

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* 14. Will you use this program again in future years?

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* 15. Would you recommend this training to other residency programs? (Required.)

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* 16. Please use the text box to provide any comments/feedback for toolkit authors

Question Title

* 17. Please use the text box to provide any overall feedback on this format (two-part series, topics offered)

Question Title

* 18. What other IAFP-led activities or discussions on health equity would you like to see in the future?

Question Title

* 19. Contact Information (Required.)

1. Program Name

2. Date part 1 of the program was presented (Required.)

3. Date part 2 was presented (Required.)

4. How many of the following attended the presentation? (Required.)

5. Which bias topics did your program address? (Required.)

6. From the discussion, our residents can name one form of bias against each of the communities we covered in the presentations (Required.)

7. How often do you think that healthcare disparities were occurring within your workplace? (Required.)

8. How frequently does your program discuss issues or occurrences of biases? (Required.)

9. Commitment to change: After attending this webinar, what, if any, changes will you be making in your practice? (Required.)

10. Prior to this presentation: Please rate your knowledge or skill on this topic: (Required.)

11. AFTER this presentation: Please rate your knowledge or skill on this topic: (Required.)

12. This activity avoided commercial bias or influence: (Required.)

13. Would you change anything about how you presented your topic? (Format, Visual Aids, Case Studies)

14. Will you use this program again in future years?

15. Would you recommend this training to other residency programs? (Required.)

16. Please use the text box to provide any comments/feedback for toolkit authors

17. Please use the text box to provide any overall feedback on this format (two-part series, topics offered)

18. What other IAFP-led activities or discussions on health equity would you like to see in the future?

19. Contact Information (Required.)