About the BRIM Initiative 

The BRIM Initiative was an NIH clinical study designed and conducted by Dr. Molly Carnes and colleagues at the University of Wisconsin-Madison (UW) and offered the opportunity to help our DOM faculty “break the bias habit” and align their judgments and behaviors with their explicit commitments to be fair and objective. The John T. Milliken Department of Medicine at the Washington University School of Medicine was one of several institutions nationwide that participated in the BRIM study.  

Over the course of 2 years, all divisions in the Department of Medicine completed a 3-hour interactive workshop with 3 modules: 

  1. Implicit bias as a habit
  2. Becoming bias literate: If you name it, you can tame it
  3. Evidence-based strategies to break the bias habit

What is the goal of the BRIM Initiative?

The overall goal was to study and facilitate the implementation of an effective pro-diversity intervention throughout academic medicine. To achieve this, a team from the University of Wisconsin-Madison (UW) presented the workshop to approximately half of your divisions and trained DOM implementers who presented the workshop to the remaining divisions. 


Professional interactions, performance evaluations, and hiring decisions can be inadvertently influenced by cultural stereotypes about race, gender, age, sexual preference, and weight. As a result, faculty from some groups experience a more positive and supportive work environment than faculty from other groups.1-7 These same stereotypes can unwittingly affect physicians’ perceptions and decisions about their patients. The Association of American Medical Colleges (AAMC), National Academies of Sciences (NAS), and National Institutes of Health (NIH) affirm that reducing stereotype-based bias will benefit medical education, patient care, population health, and scientific discovery. 

Unlike most diversity trainings that can be time consuming and ineffective, the BRIM Initiative drew on decades of research on behavioral change in approaching stereotype-based bias as a “habit of mind” that can be changed like any other unwanted habit by increasing awareness, motivation, and self-efficacy to practice evidence-based strategies.8,9  The BRIM Initiative also incorporated principles of implementation science to build capacity for continuing this approach at collaborating institutions and to help ensure sustainability. 

There are 3 phases of activities in the BRIM Initiative:

  1. Phase I – Site visit by the UW team members and launch of BRIM initiative in the Department of Medicine. 
  2. Phase II – Presentation of virtual workshops to group 1 by the UW team members followed by training of DOM BRIM Implementers. 
  3. Phase III – Presentation of virtual workshops to group 2 by DOM BRIM Implementers
  1. Chapman EN, Kaatz A, Carnes M. Physicians and implicit bias: how doctors may unwittingly perpetuate health care disparities. J Gen Intern Med. Nov 2013;28(11):1504-1510.
  2. Phelan SM, Burgess DJ, Yeazel MW, Hellerstedt WL, Griffin JM, van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obesity Review. Apr 2015;16(4):319-326.
  3. Sabin JA, Greenwald AG. The influence of implicit bias on treatment recommendations for 4 common pediatric conditions: pain, urinary tract infection, attention deficit hyperactivity disorder, and asthma. American Journal of Public Health. May 2012;102(5):988-995. 
  4. van Ryn M, Burke J. The effect of patient race and socio-economic status on physicians’ perceptions of patients. Social Science in Medicine. Mar 2000;50(6):813-828. 
  5. Sabin J, Riskind R, Nosek B. Health care providers’ implicit and explicit attitudes toward lesbain women and gay men. American Journal of Public Health. 2015;105:1831-1841. 
  6. Williams R, Romney C, Kano M, et al. Racial, gender, and socialeconomic status bias in senior medical student clinical decision-making: A national survey. J Gen Intern Med. 2015;6:758-767.
  7. Ruiz J, Andrade A, Anam R, et al. Group-based differences in anti-aging bias among medical students. Gerontology and Geriatrics Education. 2015;36:58-78.
  8. Carnes M, Devine PG, Baier Manwell L, et al. The effect of an intervention to break the gender bias habit for faculty at one institution: a cluster randomized, controlled trial. Academic Medicine. Feb 2015;90(2):221-230. 
  9. Carnes M, Devine PG, Isaac C, et al. Promoting institutional change through bias literacy. Journal of diversity in higher education. Jun 2012;5(2):63-77. 
The UW Bias Reduction in Internal Medicine (BRIM) Team

Molly Carnes, MD, MS 
Center for Women’s Health Research Co-Director, Women in Science and Engineering Leadership Institute (WISELI) 
BRIM Initiative PI 
University of Wisconsin-Madison 

Jennifer Sheridan, PhD 
Executive & Research Director 
Women in Science and Engineering Leadership Institute (WISELI) 
BRIM Initiative Co-investigator 
University of Wisconsin-Madison 

Eve Fine, PhD 
Associate Scientist and Director 
Curriculum Development and Implementation for Women in Science and Engineering Leadership Institute (WISELI) 
University of Wisconsin-Madison 

Sharon Topp
BRIM Initiative Coordinator 
University of Wisconsin-Madison

Washington University School of Medicine – DOM Division Leads

Lynn Cornelius, MD – PI 
Winfred A. and Emma R. Showman Professor of Dermatology 
Chief, Division of Dermatology, Department of Medicine 

Joe Pangelinan, PhD, LPC, NCC – Lead 
Assistant Professor 
Director of Cultural Awareness & Diversity, Equity, and Inclusion
Department of Orthopaedic Surgery

Maya Jerath, MD, PhD 
Division of Allergy & Immunology 

Sharon Cresci, MD 
Associate Professor 
Division of Cardiology, Department of Medicine 

Lisa de las Fuentes, MD, MS 
Division of Cardiology, Department of Medicine 

Kara Sternhell-Blackwell, MD 
Associate Professor 
Division of Dermatology, Department of Medicine 

Cristina Strong, PhD 
Assistant Professor 
Division of Dermatology, Department of Medicine 

Anne Goldberg, MD, FACP, FAHA 
Division of Endocrinology, Metabolism and Lipid Research, Department of Medicine 

Deborah Rubin, MD, AGAF 
William B. Kountz Professor of Medicine 
Division of Gastroenterology, Department of Medicine 

Jane Garbutt, MB, ChB 
Division of General Medical Sciences, Department of Medicine 

Lenise Cummings-Vaughn, MD, CMD 
Associate Professor 
Division of Geriatrics and Nutritional Science, Department of Medicine 

Amy Zhao, MD 
Assistant Professor 
Division of Hematology, Department of Medicine 

Wenners Ballard III, MD 
Division of Hospital Medicine, Department of Medicine 

Hilary Babcock, MD, MPH 
Division of Infectious Diseases, Department of Medicine 

Rakhee Bhayani, MD
Division of General Medicine, Department of Medicine 

Will Ross, MD, MPH 
Division of Nephrology, Department of Medicine 

George Ansstas, MD 
Assistant Professor 
Division of Oncology, Department of Medicine 

Maria Dans, MD 
Associate Professor 
Division of Palliative Care, Department of Medicine 

Chad Witt, MD 
Assistant Professor 
Division of Pulmonary and Critical Care, Department of Medicine Christine Pham, MD
Division of Rheumatology, Department of Medicine 

Washington University School of Medicine Implementers

Dominique Cosco, MD, FACP 

Joel Dalton 

Angeline DeiSanti, MD

Lisa de las Fuentes, MD, MS 

Cynthia Herrick, MD, FACP 

Steven Lawrence, MD, MSc 

Jennifer Mosher, MA 

Joe Pangelinan, PhD, LPC, NCC 

Erin Stampp, MPP 

Sherree Wilson, PhD