case study

1. A diversity hiring case study
James, a human resources recruiter, was working with a supervisor, Dave, to fill an assistant manager position. Maggie,
one of the applicants, called James with concerns about the hiring process. She had not heard anything for more than
three weeks and wondered whether she was still being considered for the job. James assured her that she was qualified
and offered to follow up with the hiring supervisor that day and get back with her. James was concerned that Maggie
would not be given full consideration because she is not originally from the United States and her English is not as strong
as that of other candidates.
James stopped by to discuss the vacancy with Dave. Dave said he was glad to see James because it would save him a phone call to
report the three candidates he planned to interview. James asked Dave who the final candidates were. Dave named Tom Smith,
Sally Jones, and Greg Thomas. James was shocked and asked Dave about Maggie. Dave found her resume and asked James how
to pronounce her last name. James was frustrated and told Dave it appeared to be a pattern that Dave only seemed interested in
people like him, rather than diverse candidates. Dave said he is not opposed to diversity, but he is in a time crunch and needs to
hire someone who can “hit the ground running.” James pointed out that Maggie had actually performed the job and would take
less time to get trained on the job than the other applicants. Dave responded that he has worked with each of the other three people
he named and has confidence in their abilities.
James asked Dave if he was aware of the University’s nondiscrimination policy. Dave said he had attended all the diversity
workshops and understood the importance of being a diverse employer, but he didn’t think it applied in his situation. James
persisted in asking Dave to reconsider his decision not to interview Maggie. Dave was getting angry and asked James to define his
responsibility in the hiring process. James was confused about the question. Dave spelled it out, asking if James’s responsibility
was to provide a list of qualified applicants and whether James had done that. James agreed that he had done so. Dave then
pointed out that he was the hiring supervisor, and it was his responsibility to make a hiring decision based on the candidates that
James referred. Dave suggested that if James didn’t want him to consider certain applicants, he shouldn’t have put them on the
list.
James continued to try to get Dave to consider giving Maggie an interview. He thought that after an interview, Dave would be
impressed with her qualifications. Dave insisted interviewing Maggie would be a waste of everyone’s time, especially his. He
was adamant about only interviewing the three candidates he had already contacted. Dave told James he was very busy and
needed to get back to work. James left and wondered what he would tell Maggie.
Discussion Questions:
1. What is the problem?
The problem with this scenario is that the supervisor is cutting corners in the hiring process. He is not giving serious consideration
to all the candidates. He is eliminating candidates based on ethnic heritage because one of them has a foreign-sounding name.
2. What did James, Maggie, and Dave each want?
James wants all candidates that meet qualifications to be given equal consideration. He also wants Dave to interview Maggie.
Maggie wants information about her status. Although she also wants a job, her immediate concern is the lack of communication.
Dave wants to hire someone without interference from anyone else. He wants to take the easy path and hire someone he knows
instead of spending time considering other well-qualified applicants.
3. Who was right? Why?
From a diversity standpoint, James is right in wanting all candidates to be given true consideration. Dave is right that he can hire
any qualified candidate, but he is wrong to disregard Maggie as a qualified candidate based on her last name. Maggie was right to
want timely feedback.
4. What could James have done differently?
For the future, James could try a variety of approaches to address Dave’s lack of concern for diversity. Ultimately, James needs to
point out the University’s policies and goals that apply to this situation. Further, James needs to tell Dave that if he continues to
discriminate unfairly, he will be obligated to contact Dave’s manager. Dave needs to understand the seriousness of his position
and how it affects not just his department, but the candidate and the reputation of the University, as well.

2. A diversity hiring case study
James, a human resources recruiter, was working with a supervisor, Dave, to fill an assistant manager position. Maggie,
one of the applicants, called James with concerns about the hiring process. She had not heard anything for more than
three weeks and wondered whether she was still being considered for the job. James assured her that she was qualified
and offered to follow up with the hiring supervisor that day and get back with her. James was concerned that Maggie
would not be given full consideration because she is not originally from the United States and her English is not as strong
as that of other candidates.
James stopped by to discuss the vacancy with Dave. Dave said he was glad to see James because it would save him a phone call to
report the three candidates he planned to interview. James asked Dave who the final candidates were. Dave named Tom Smith,
Sally Jones, and Greg Thomas. James was shocked and asked Dave about Maggie. Dave found her resume and asked James how
to pronounce her last name. James was frustrated and told Dave it appeared to be a pattern that Dave only seemed interested in
people like him, rather than diverse candidates. Dave said he is not opposed to diversity, but he is in a time crunch and needs to
hire someone who can “hit the ground running.” James pointed out that Maggie had actually performed the job and would take
less time to get trained on the job than the other applicants. Dave responded that he has worked with each of the other three people
he named and has confidence in their abilities.
James asked Dave if he was aware of the University’s nondiscrimination policy. Dave said he had attended all the diversity
workshops and understood the importance of being a diverse employer, but he didn’t think it applied in his situation. James
persisted in asking Dave to reconsider his decision not to interview Maggie. Dave was getting angry and asked James to define his
responsibility in the hiring process. James was confused about the question. Dave spelled it out, asking if James’s responsibility
was to provide a list of qualified applicants and whether James had done that. James agreed that he had done so. Dave then
pointed out that he was the hiring supervisor, and it was his responsibility to make a hiring decision based on the candidates that
James referred. Dave suggested that if James didn’t want him to consider certain applicants, he shouldn’t have put them on the
list.
James continued to try to get Dave to consider giving Maggie an interview. He thought that after an interview, Dave would be
impressed with her qualifications. Dave insisted interviewing Maggie would be a waste of everyone’s time, especially his. He
was adamant about only interviewing the three candidates he had already contacted. Dave told James he was very busy and
needed to get back to work. James left and wondered what he would tell Maggie.
Discussion Questions:
1. What is the problem?
2. What did James, Maggie, and Dave each want?
3. Who was right? Why?
4. What could James have done differently?

3. Preferential Treatment
An African-American female medical student walks into a study group of three Caucasian-American male medical
students. One of them is overtly hostile to her, saying that by her receiving a scholarship he was prevented from
getting one. He says that "It's unfair that you get treated better than everybody else, just because you're a
minority..." The female student protests that she just wants to be treated like any other person, but the male student
continues to harass her saying, "You're going to have to prove yourself to me."
Discussion Questions:
1. Why would the Caucasian student have the perception that the Black student is "treated better than
everybody else?"
2. What are reasons that no one spoke up during the discussion?
3. If you were an observer to this scene, would you intervene? If so, how?
4. What kinds of psychological preparation and counseling should a person of color have prior to becoming a
student at a predominately Caucasian medical school? What kind of support system might this person need?
5. How should a class of medical students become sensitized to issues of racial and cultural bias in medicine?
6. What is the Black student feeling? The white student?
7. Are non-minority students at your institution resentful of minority students regarding special programs
specifically designed for minorities?
8. If you are a student, do you feel welcome at your school?

4. Cultural Beliefs in a Scientific Presentation
A Hispanic female medical student is doing a case representation of a Hispanic female patient to a white male
attending physician. The presentation includes a sympathetic recounting of the patient's beliefs, including naive ideas
about illness, ideas of spirit possession and exorcism, and comfort from religious faith. The attending finds the
presentation "excessively informal and unscientific," and suggests that the student includes this material because,
"You're from her race, and are sympathetic to her." He scolds her that they are working at a prestigious medical
center and suggests she make more conventional presentations.
Discussion Questions:
1. Why would the attending physician be so unsympathetic to this style of presentation and these aspects of a
patient's life? Is his behavior appropriate?
2. If you were the student how would you feel? How would you react?
3. How can medical school faculty become better informed about the relevance of racial and cultural issues in
patient care?
4. How can a resident or medical student best learn to incorporate both scientifically and culturally relevant
issues within a brief presentation?
5. Since understanding cultural factors appears crucial for patient compliance, how should a resident or medical
student become knowledgeable about these cultural factors considering the vast diversity of cultures currently
within the United States?
6. What is the attending physician accomplishing with his attitude? What value is given to the knowledge
possessed by the Hispanic physician regarding Hispanic culture? What other responses are possible?
7. Does your school have an established protocol for minority students to report racially-related incidents?

5. Affirmative Action
A middle-aged, Caucasian faculty member reassures a Native American student that no matter what kind of
performance the student does, his work will be accepted, because "It's important that we have at least one Native
American student matriculate each year, and you're the only one this year."
Discussion Questions:
1. How do you imagine the student feels?
2. If you were the student, what would you say to the faculty member?
3. What is your opinion about whether disadvantaged students should be accepted and maintained preferentially
in training programs, even if their performance is poor?
4. Has a situation like this ever occurred in your experience?
5. Do faculty think that there are different admissions criteria for minority students? If so, in what ways?
6. If you are a student, how does this affect your interaction with faculty in the classroom, laboratories, and
clinical rotations?
7. How much should medical students be allowed to participate in the selection process of applicants including
ethnic minority students?

6. Racial Stereotyping
Two Caucasian-American third year medical students are talking in a casual conversation. Along comes a peer African-
American male who overhears their conversation. One of the white students says that she doesn't think that Black and
Hispanic students are very bright and "all of them are here only because there is a quota system."
Discussion Questions:
1. How prevalent is this student's attitude? Is it racist?
2. If you were the Black student, how would you have responded to overhearing this?
3. How could you help the white student develop a more balanced perspective about fellow students?
4. Do you think this student developed her stereotyped ideas from current classmates or had biases prior to
medical school experiences?
5. Would there be any way to anticipate and reduce this cultural and racial bias?
6. If you were the other white student, what would you say to her?
7. Do your classmates think that there are different admissions criteria for minority students? If so, in what
ways?
8. How does this affect your interactions with classmates in the classroom, laboratories, and clinical rotations?
9. How does the presence or absence of other minority students affect you?
10. Has your self esteem changed since entering medical school? How? Why?

7. Effect of Racial Bias
An African American student on the trauma surgery service is hurriedly sent to perform a discharge physical on a
patient the student about whom has been told nothing. The student enters the patient's room to start the physical
without first reading the patient's chart, and finds upon entering that the patient is an African American male whose
right arm and shoulder are bandaged. Giving the student his history, the man says that he was in a car accident. As
the student concludes his interview and begins to examine the patient, a team of Caucasian male orthopedic surgeons
enters the room. Without acknowledging either the student or the patient, they approach the patient and manipulate
his shoulder to determine its range of motion. Informing the patient that he should call to schedule an orthopedics
appointment next week, the chief surgeon assures the patient that, "These gunshot wounds always heal fast," and
then leaves. The student feels that he should be furious with the orthopedic surgeons, and almost corrects them, but
then wonders whether the man has lied to him. The student excuses himself to go read the patient's chart, which
documents the man's car accident.
Discussion Questions:
1. Why might the student have been furious with the surgeons initially? How might the student have felt towards
the surgeons after reading the chart?
2. Would the student's anger be less justified if the incident had occurred in a busy inner city hospital that admits
many minorities secondary to violent trauma? Would his anger be more justified if the incident had occurred in
a suburban community hospital that admits few minorities?
3. How might the student have felt towards himself after reading the chart? Why might he have doubted the
patient?
4. Is the student's failure to read the chart before seeing the patient evidence of poor clinical skills?
5. How should the student have dealt with the surgeons? Should he have spoken to them directly? Should he
speak to one of his attendings about their behavior?
6. How might the student's response to the surgeons have affected the patient?

8. Misinformation
While preparing to get her microscope and slide set to study for a histopathology test, a Mexican American student
enters her assigned lab to find a small group of Asian American and Caucasian American students studying slides from
a projector. Inviting herself to join the group, she sits down while the group's apparent leader, a talkative and friendly
Caucasian American male, leads the discussion. Being a late arrival, the Mexican American student sits quietly and
watches the other students identify the slides. Although there is some debate, the other students seem to differ to
whomever speaks most authoritatively. As the other students get stumped by one of the slides, the Mexican American
student volunteers what she is certain is the right answer. To her surprise, the group leader says he's got to look it
up. Asking him why he feels the need to look up her answer but no one else's, he says, "We should know the answer.
We all went to top ten schools for undergrad." Packing up her microscope, she says, "Too bad you don't know how to
recognize the right answer."
Discussion Questions:
1. Does the Mexican American student seem excessively offended? Does she seem justifiably offended?
2. How do you think the Caucasian American student leading the discussion feels about this exchange?
3. How do you think the other students in the room feels about this exchange? How might they describe it to
their friends?
4. How do you feel about this exchange? Would it change your impression to know that the Mexican American
student rarely has her answers challenged? Would it change your impression to know that this student and
her friends feel that they're always having their answers challenged?
5. Did you make any assumptions about who her friends might be as you considered the preceding question? Is
there any relationship between your assumptions about who her friends might be and the group leader's
assumption that her answer was untrustworthy?

9. Preferential Treatment
A Native American M.D., Ph.D. student attending a conference on binary fission in bacteria unexpectedly bumps into
two of his classmates, an engaged Caucasian American couple whose parents are well-known faculty members at the
school the students attend. In response to the Native American student's surprise at their attendance, the female
member of the couple says that her father found grant money to pay for the couple's attendance, and that he's lined
the couple up with research positions for the next year. At this, the Native American expresses interest in bringing a
proposal to the woman's father, to which she says, "What are you worried about? Minorities get all the cushy research
positions, anyway."
Discussion Questions:
1. If you were the Caucasian American woman, would you take advantage of your familial connections in the
same way that she apparently does? Why or why not?
2. Were the Native American man to be in the position to grant opportunities like the ones described above, how
should he grant them? Should he give opportunities to his family members and acquaintances? Do you think
that medical professionals in general have a tendency to grant opportunities to those whom they know?
3. Are there any similarities between the opportunities the students like Native American man may receive
through affirmative action programs and the opportunities students like the Caucasian American woman
receive through personal contacts? Are there any differences between the opportunities the two
aforementioned group of students receive?
4. Are the qualifications of the medical students who are children of faculty members questioned to the same
degree that the qualifications of minority students sometimes are?
5. How should the Native American student react? What should he say to these two classmates?
6. Assuming that the woman's father is a famous researcher with whom the Native American student has been
eager to work, how might he react to the woman? Why?

10. Preferential Treatment
A Native American M.D., Ph.D. student attending a conference on binary fission in bacteria unexpectedly bumps into
two of his classmates, an engaged Caucasian American couple whose parents are well-known faculty members at the
school the students attend. In response to the Native American student's surprise at their attendance, the female
member of the couple says that her father found grant money to pay for the couple's attendance, and that he's lined
the couple up with research positions for the next year. At this, the Native American expresses interest in bringing a
proposal to the woman's father, to which she says, "What are you worried about? Minorities get all the cushy research
positions, anyway."
Discussion Questions:
1. If you were the Caucasian American woman, would you take advantage of your familial connections in the
same way that she apparently does? Why or why not?
2. Were the Native American man to be in the position to grant opportunities like the ones described above, how
should he grant them? Should he give opportunities to his family members and acquaintances? Do you think
that medical professionals in general have a tendency to grant opportunities to those whom they know?
3. Are there any similarities between the opportunities the students like Native American man may receive
through affirmative action programs and the opportunities students like the Caucasian American woman
receive through personal contacts? Are there any differences between the opportunities the two
aforementioned group of students receive?
4. Are the qualifications of the medical students who are children of faculty members questioned to the same
degree that the qualifications of minority students sometimes are?
5. How should the Native American student react? What should he say to these two classmates?
6. Assuming that the woman's father is a famous researcher with whom the Native American student has been
eager to work, how might he react to the woman? Why?