By Srividya Naganathan, M.D. | December 14, 2023 Article Citation: Seehusen DA, Kleinheksel AJ, Huang H, Harrison Z, Ledford CJW. The Power of One Word to Paint a Halo or a Horn: Demonstrating the Halo Effect in Learner Handover and Subsequent Evaluation. Acad Med 2023 Aug 1;98(8):929-933. DOI: 10.1097/ACM.0000000000005161 What is this article about? Direct observation of learners is an important component of competency-based medical education. However, it is important for evaluators to be aware of potential bias in their assessments in order to help mitigate the effects as much as possible. In this study, academic faculty attending a national educator conference (n=70) viewed a standardized video of a simulated encounter between a resident physician and a patient. A prompt shown to the evaluator prior to watching the video randomly referred to the resident as ‘above-average’ (halo) or ‘below-average’ (horn) while all other aspects of the encounter remained the same. Participants were asked to rate the resident’s performance in the video on a 10-item evaluation form. Results showed that there was a significant difference noted in the evaluation scores between the 2 groups. Participants rated the learner in a video encounter preceded by a horns statement significantly lower than the learner in a video encounter preceded by a halo statement, F (1,65) = 10.15, P < .01, η2 = .14, horns mean = 12.49 (CI 11.34, 13.63), halo mean = 15.10 (CI 13.93, 16.28). This represented a scoring difference of 2.61 points on a 30-point scale. Why should you read the article? Although this was an experimental study, it raises concern regarding unconscious bias in the evaluators when presented with learner handover. Medical educators should be aware of the ‘halo’ and ‘horn’ effect when making or hearing general comments about learners from other educators. These comments may influence the educator’s perceptions and evaluations unintentionally. How can you use this article? This article serves as a reminder for educators to reflect on unconscious bias and how it can affect learner evaluations. Educators should make a conscious effort to avoid labeling learners and transferring perceptions during handovers. Faculty development sessions focusing on recognizing and preventing bias could prevent this unforeseen effect on learner evaluations. Review Author: Srividya Naganathan, M.D.; Associate Professor of Pediatrics, Associate Chair of Education, K Hovnanian Children’s Hospital, Hackensack Meridian Health, Neptune City, NJ. Organization: Council on Medical Student Education in PediatricsYou Must Be an Angel–or Are You the Devil?