Ensuring Fairness in Clinical Assessment

Preview Letter of Intent Here

Ensuring Fairness in Clinical Assessment: 

A New RFA from the Josiah Macy Jr. Foundation

LOI Deadline: Monday, March 30, 2026

The Josiah Macy Jr. Foundation is seeking proposals for the 2026 request for applications (RFA) to support demonstration projects to develop, implement, and evaluate innovative strategies for enhancing fairness in clinical assessment in medical and nursing education programs. Funded projects will serve as exemplars for how schools of medicine and nursing can implement strategies that center the purpose of assessment, which is to ensure that everyone who graduates is fully prepared to provide the highest standard of care to their patients. This RFA will build upon the consensus recommendations that emanated from the Josiah Macy Jr. Foundation’s 2022 conference entitled Ensuring Fairness in Medical Education Assessment.

Rationale

Harmful bias and discrimination in learner assessment was the focus of the Josiah Macy Jr. Foundation’s 2022 conference, entitled Ensuring Fairness in Medical Education Assessment. The purpose of both the conference and its resulting consensus recommendations was to address documented bias and discrimination in assessment that impede learners’ opportunities to fulfill their potential as health professionals and, ultimately, improve quality of care for all patients. In addition, the importance of developing new systems of assessment aligns with the increasing emergence of competency-based educational frameworks in medicine and nursing education, which require new assessment programs and practices. Building on the Macy conference, there has been additional important scholarship on what this next era of assessment might look like, which has provided useful ideas for how to advance equitable and valuable assessment for learners.

The goal of this RFA is to provide support to projects who advance assessment approaches which empower learners to understand their own unique learning needs, position them as lifelong learners, and keep them focused on achieving the ultimate goal of their health professions education: namely, to provide the highest quality of care for their patients. 

The Josiah Macy Jr. Foundation proposes to support three innovative projects in medicine or nursing education programs. Each project would receive $200,000 over two years to design, implement, and evaluate innovative learner assessment programs aligned with the 2022 Macy Conference recommendations and additional scholarship in this field. This includes the use of data, learning analytics, and technology to develop and advance systems-based assessment approaches that ensure fairness for physicians and nurses in training.

Eligibility

This RFA is open to schools of medicine and nursing (both undergraduate and graduate). Projects should focus on interventions in the clinical learning environment, and should align with recommendations emanating from the 2022 Macy conference and/or align with additional scholarship in the field of the future of assessment. Collaborations across institutions and departments are strongly encouraged to support spread and replicability, as is co-creation with learners.  

Funding and Timeline

  • The Macy Foundation will provide up to $200,000 for 3 two-year projects.
  • The application portal will open on Wednesday, January 7, 2026, and accept letters of intent through Monday, March 30, 2026.
  • A preliminary review process will take place utilizing an external review team who are experts in this topic area.
  • No later than Monday, May 18, approximately six to eight projects will be invited to submit full Board Grant applications, with a due date of Friday, July 17, 2026.
  • Final review will take place over the summer, with three projects brought to the Macy Foundation Board at the October 21 meeting and announcements made to the applicants shortly thereafter.
  • Project period: November 1, 2026 – October 31, 2028.

FAQs

Q. Who is eligible to apply?

A. We welcome applications from faculty at medical and nursing schools (both at the undergraduate and graduate levels). Practitioners based at teaching hospitals who are in a role to assess learners in the clinical environment may also apply. While a learner may not serve as the sole principal investigator on a project, we encourage co-creation with learners as co-PIs or co-investigators.

Q. Is this a limited opportunity, or may an institution submit multiple LOIs?

A. This is not a limited opportunity. We will accept multiple LOIs from a single institution.

Q. What are the consensus recommendations from the 2022 Macy conference?

A. The five consensus recommendations from the 2022 Macy conference are available in the August 2023 special supplement of Academic Medicine.

Leaders of the Macy Foundation and the 2022 conference discuss these recommendations in greater detail in an August 2023 webinar hosted by the Macy Foundation, and during a September 2023 podcast hosted by the AAMC. Links to all 2022 conference-related content is available on the Macy Foundation website.

Q. What are you looking for in successful proposals?

A. We will consider many factors as we review proposals. These factors include:

  • Alignment with the recommendations emanating from the 2022 Macy conference and/or clear alignment with recent scholarship in the field of assessment
  • Focus on assessment in the clinical learning environment
  • Alignment of budget with programmatic goals
  • Evidence of co-creation with learners
  • Collaboration across institutions and departments considered favorably

Q. Is the $200K award inclusive of indirect costs?

A. Yes – proposed budgets may not exceed $200K over the two-year award period, including all indirect costs, capped at 10%. 

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