Practical applications: From awareness to transformation

How can educators move beyond awareness and create meaningful change around bias and equity in health professions education? Here, you’ll find pragmatic, evidence-informed insights how meaningful change can happen through everyday practice, collective effort, and gradual redesign.

Expert Insight:
“Awareness is best understood as an entry point, not an endpoint of change. ”
– Javeed Sukhera

Intro - or invitation to use the cases somewhere on the page?

video and links to two cases

Video: Introduction to cases

Making change at individual level

Many educators care deeply about equity but do not have the mandate to redesign assessment systems or institutional policies. Change is still possible — just differently scaled.

Research and practice suggest several levers that individuals can use to address bias:

Making criteria explicit in teaching, supervision, and feedback;
Slowing down judgment in high-stakes moments (when possible);
Using shared language when describing performance;
Inviting multiple perspectives into decisions, even informally; and
Noticing patterns over time, rather than treating events as isolated.

These actions do not eliminate bias, but they reduce its impact locally and create conditions for broader change.

Expert Insight:
“Small, consistent shifts at the level of everyday practice often accumulate into momentum.”
– Nicole Perez

Making change sustainable

When institutions aim to move beyond individual effort, research points to approaches that align people, processes, and structures. Change is most durable when it does not rely on constant vigilance, but is supported by how everyday work is organized.

Across studies, several strategies recur are recurringly identified as helping to address plus mitigate bias:

Structured assessment and feedback tools that guide judgment and reduce reliance on informal impressions;
Longitudinal faculty development, allowing time to practice, reflect, and recalibrate rather than “get it right” in one session;
Regular review of outcomes, making patterns of inequity visible and discussable; and
Clear leadership signals that equity is part of educational quality, not an optional extra.

These approaches work because systems can make better decisions easier and more consistent.

Structural redesign: a direction, not a prerequisite

Structural change matters, but it is rarely immediate, complete, or fully within one person’s control.

Thinking of transformation as a direction of travel, rather than a single intervention, helps keep the work of addressing bias grounded and realistic. Progress often takes the form of:

piloting new approaches;
adjusting tools and criteria;
learning from unintended consequences; and
refining practices over time.

Even partial changes (e.g., clearer expectations, more transparent processes, better feedback structures) can meaningfully shift experiences for learners and educators. Structural redesign is not an all-or-nothing proposition; it often unfolds incrementally.

Shared responsibility, realistic accountability

Moving from awareness to transformation does not mean assigning blame. It means locating responsibility where it can be acted on.

In practice:

Individuals are responsible for reflection, skill-building, and everyday decisions
Teams are responsible for shared norms, language, and sense-making
Institutions are responsible for systems, incentives, and outcomes

When responsibility is distributed in this way—and expectations are realistic—equity work becomes sustainable rather than exhausting. People are supported to act differently, rather than asked to compensate for weak systems on their own.

Transformation does not require perfect conditions. It requires direction, consistency, and learning over time.