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Introduction Implicit biases of health professionals could cause biased judgements. Many anti‐bias interventions seem to be ineffective, and some even counterproductive. People tend to be compliant to standards describing what the majority of people finds or does, and this could cause people to think in a stereotype‐consistent manner. This study examines whether descriptive social norms such as 'the majority of people have stereotypes' (majority message), as often stated in interventions, actually increase people's stereotypes. To examine the effect of descriptive social norms (Hypothesis 1) and the effect of individual perceptions and preferences (Hypothesis 2a and 2b) on stereotypical expressions towards medical students. Methods: First, we determined which ethic stereotypes regarding medical students prevail in Dutch medical education (N = 52). Next, two similar randomised controlled trials, both with teachers and students, were carried out (N = 158 and N = 123, respectively), one with an East Asian student picture (ethnic minority) and one with a native Dutch student picture (ethnic majority). Participants were randomly assigned to either a majority‐message, minority‐message or no‐message condition, and rated the presented minority or majority picture on specific stereotypical features. Subsequently, participants described a typical day of that same student's life. These descriptions were rated for stereotypicality by two independent raters, who were blind for condition and stimulus. Inclusive work environment (IWC) and social dominance orientation (SDO) of participants were measured as indicators of individual perceptions and preferences. Results: Stereotypes were expressed towards both picture stimuli, yet message condition did not affect stereotypical expressions. SDO positively related to stereotypical expressions towards the East Asian student, whereas IWC positively related to stereotypical expressions towards the native Dutch student. Conclusion: Interventions do not unintentionally increase stereotypes by communicating what the majority of people thinks or does. Individual perceptions and preferences are predictive of stereotypes, whereas descriptive social norms are not. The authors empirically test concerns about anti‐bias interventions unintentionally increasing stereotyped expressions, additionally reporting individual beliefs to be more predictive of such expressions than context. [ABSTRACT FROM AUTHOR]

Context Ethnic minority students find that their ethnicity negatively affects the evaluation of their capacities and their feelings in medical school. This study tests whether ethnic minority and majority students differ in their 'self‐regulatory focus' in clinical training, that is, their ways to approach goals, due to differences in social learning experiences. Self‐regulatory focus consists of a promotion and prevention focus. People who are prone to stereotypes and unfair treatments are more likely to have a prevention focus and conceal certain identity aspects. The objectives of the study are to test whether ethnic minority students, as compared with ethnic majority students, are equally likely to have a promotion focus, but more likely to have a prevention focus in clinical training due to more negative social learning experiences (Hypothesis 1), and whether the relationship between student ethnicity and clinical evaluations can be explained by students' gender, social learning experiences, self‐regulatory focus and impression management (Hypothesis 2). Methods: Survey and clinical evaluation data of 312 (71.2% female) clerks were collected and grouped into 215 ethnic majority (69.4%) and 95 ethnic minority students (30.6%). Students' social learning experiences were measured as perceptions of unfair treatment, trust in supervisors and social academic fit. Self‐regulatory focus (general and work specific) and impression management were also measured. A parallel mediation model (Hypothesis 1) and hierarchical multiple regression analyses were used (Hypothesis 2). Results: Ethnic minority students had higher perceptions of unfair treatment and lower trust in their supervisors in clinical training. They were more prevention focused in clinical training, but this was not mediated by having more negative social learning experiences. Lower clinical evaluations for ethnic minority students were unexplained. Promotion focus in clinical training and trust in supervisors positively relate to clinical grades. Conclusion: Student ethnicity predicts social learning experiences, self‐regulatory focus and grades in clinical training. The hidden curriculum plausibly plays a role here. van Andel et al. demonstrate that systematic differences between ethnic minority and majority students can be predicted based on social learning experiences, self‐regulatory focus and clinical grades. [ABSTRACT FROM AUTHOR]

Context Medical students' clinical competencies are customarily assessed using convenience samples of performance from real practice. The question is how these convenience samples can be turned into purposeful samples to extrapolate students' overall competency profile at the end of medical school, particularly given the context specificity of clinical performance. In this paper, we will address this issue of inferring signs from samples using insights from the discipline of psychology. Theoretical perspective: We adapted Smith's theory of predictor validity of universals, occupationals and relationals to the context of clinical competency assessment. Universals are characteristics required by all working individuals and therefore not context dependent. Occupationals refer to characteristics required by certain jobs but not others and therefore are dependent on task‐related features of an occupation. Relationals are required in a specific organisational context with habitual ways of working together. Application: Through seven propositions, we assert that generalising from samples of assessed clinical competencies during clerkships to generic competencies (i.e., signs) is dependent on whether characteristics are universals, occupationals and relationals, with universals most and relationals least generalisable. Conclusion: When determining what types of ratings to use to evaluate medical student competence, medical education has shown too little nuance in considering the degree to which particular characteristics are likely to be generalisable, approaching the issue in an all‐or‐none manner. Smith's distinction between universals, occupationals and relationals offers a promising way forward that has implications for assessment, student selection and career choice. Unravelling the qualities we desire in clinicians into universals, occupationals and relationals will enable medical schools to move towards more purposeful sampling of student competencies during training. [ABSTRACT FROM AUTHOR]