#KEYLIMEPODCAST 283: The Weight of the Burden They Bear

In this week’s episode…The co -hosts discuss a study where the team set out to determine the prevalence of racial stereotype threat in medical students and to explore students’ experiences of stereotype threat in clinical rotations.

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KeyLIME Session 283

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Bullock et. al., They Don’t See a Lot of People My Color: A Mixed Methods Study of Racial/Ethnic Stereotype Threat Among Medical Students on Core Clerkships. Acad Med. 2020 Aug 4. Online ahead of print.


Lara Varpio (@LaraVarpio)


  • This is a study about stereotype threat which the authors define as a psychological phenomenon in which members of a negatively stereotyped group worry that they will conform to those stereotypes—a fear that impairs their performance. This is the phenomenon wherein an individual’s awareness of the stereotypes that others hold about them is such a burden that it impairs that individual’s cognitive, emotional, and motivational states.


  • The research team set out to determine the prevalence of racial stereotype threat in medical students AND to explore students’ experiences of stereotype threat in clinical rotations.

Key Points on the Methods

  • The authors used an explanatory sequential design—a quantitative survey followed by qualitative interviews
  • Phase 1: They administered the Stereotype Vulnerability Scale survey to 4th year students. The survey assessed the prevalence of racial or ethnic stereotype threat experienced by individual medical students. They had a 52% response rate
  • Phase 2: They interviewed those individuals whose survey scores showed they had high stereotype threat experiences. The interviews were constructed to enable the researchers to understand why these individuals had a high vulnerability to stereotype threat and to explore their experiences of stereotype threat in medical training
  • They used phenomenography to support the analysis of those interviews.

Key Outcomes

  • Of the 184 students who responded to the survey, 28% had high vulnerability to stereotype threat. To put that in a bit more context, over 80% of the black respondents and almost half of the Latinex and Asian respondents were highly vulnerable to stereotype threats.
  • Through this work they created a model that describe the three stages of stereotype threat that the participants expressed.
    • TRIGGERING. The participants described how their race or ethnicity meant that they stood out in the clinical context.
    • INTERNAL DIALOGUE. The participants engaged in internal dialogue to make sense of these offensive interactions. They spent substantial time and energy processing triggering events, figuring out how to navigate the racial and ethnic hostility surrounding them, and the power dynamics that were interfering with their clinical learning
    • RESPOND AND COPE: Participants described needing to withstand stereotype threats during clerkship. They rarely confronted triggers directly.

Key Conclusions

  • The researchers did add the notion of allies because participants described that there were individuals – like supervisors – who could serve as allies who created safe environments that reduced stereotype threats. Allies could also be patients or minority care providers who provided strength and positivity. Allies buoyed the ability for individuals to withstand stereotype threat. 
  • We have to do something about stereotype threat, because those invisible vests are heavy and they impede the ability of our learners to achieve the excellence that they can achieve.

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