Does appearance prejudice recruitment decisions – a review of an acute hospital in London

Research released today by Devine & Coulson examines the prevalence of ‘lookism’ in recruitment within the setting of an acute London hospital.

tattooed nurse image source:

The research looked at whether recruitment leaders’ experiences and opinions on a candidate’s appearance was a precursor to determining their suitability for a role.  In addition, the survey went on to explore whether aspects of how candidates looked had a positive or negative impact, in practice, on whether they would be appointed.

Appearance can influence perceptions

Research has long established that appearance can influence perceptions.   For example, attractive children and adults are at a significant advantage when compared with their unattractive counterpart, and this advantage can often result in favourable treatment and positive differences in behaviour.

Further research suggests that those in the position of making decisions in recruitment and selection exhibit a preference towards/identify more with people belonging to the same social group i.e. same sex, religion or race etc., with lots of other perceptions coming into play, such as  a masculine and well-built male may be perceived as more able to undertake a physically demanding role than a male with a small build, and so on.


How much ‘lookism’ takes place when hospitals recruit?

The researchers sought to determine how ‘Lookism’ affected recruiters in an acute London Hospital. The four main objectives were to discover:

  • The perception of recruiting managers with regard to both positive and negative appearance factors considered during a recruitment and selection episode.
  • What was recruiting managers experience of lookism in practice
  • What were the appearance factors that had a positive or negative impact on the appointment of candidates at the institution in question
  • To what extent, if any, could the findings be used to better support recruiting managers make sound and justifiable recruitment decisions

Respondents were asked to rank all factors – therefore it doesn’t necessarily mean than those attributes which scored lowest were actually factors that recruiting managers considered.


Key findings

1 in 5 admit to taking appearance into considerations about suitability

Nearly 20% of respondents scored ‘7’ when asked ‘how likely would you be to take appearance into consideration when assessing a candidates suitability for a role using a scale of 1 -10; 1 being ‘not likely’, to 10 being ‘very likely’’.

However, when asked using the same rating scale, to state how likely they would be to make a recruitment decision based on the appearance of a candidate. The most prominent ratings by respondents were one, and five, both with 18.2%. This indicates that although appearance is taken in to consideration, this doesn’t necessary translate to making a final recruitment decision.

13.9% Admit to favouring physically attractive candidates, but only if everything else is equal

When asked how likely they would be to appoint a physically attractive candidate, over a physically unattractive candidate where suitability for the role was the same for each of the two candidates, the highest score receives was one (not likely) with 44%, but it is equally interesting to note that the second highest score received was a five with 13.9%.

When respondents were asked how likely it was to appoint a physically attractive candidate, over a physically unattractive candidate where the unattractive candidates suitability for the role was better than the attractive candidates, there was a overwhelming response, 83.8% of respondents to the questionnaire scored a one (not likely), with only 1% of respondents recording a score above a five.

88% deny rejecting a candidate based on appearance, but nearly 80% admitted appearance was important

When asked directly whether they had ever not offered a suitable candidate a role based purely on their appearance, an overwhelming 88% responded that they had not done this, but later when given supplementary information and asked to what extent respondents believe a candidates appearance defines the outcome of a selection process (interview) the highest responses received were ‘a little’ (38.7%) and ‘some’ (39.7%).

The five biggest ‘turn-off’s for recruiters:

Respondents considered those characteristics that had a negative impact on decision making in the context of recruitment. The top five responses of those having a negative impact were recorded as (i) tattoos, (ii) smell, (iii) piercings, (iiii) clothing/shoes and (v) how much make-up a candidate wears. The five lowest responses recorded were (i) race, (ii) gender, (iii) assumed sexual orientation, (iiii) height and (v) age.

The five most positive characteristics

The characteristics considered to have the most positive impact were recorded as (i) clothing/shoes, (ii) teeth/smile, (iii) hairstyle/colour, (iiii) age). There were three physical characteristics scoring the same; weight, how much make-up a candidate wears and smell. Those scoring lowest in this ranking order were (i) assumed sexual orientation, (ii) race, (iii) piercings, (iiii) gender) and (v) height.

Is competence linked to gender and appearance?

When asked whether they believed a candidate’s competence for a role was defined by their gender and appearance; 80% of respondents did not believe that this was so – leaving 20% unsure or answering that it was, in fact, relevant to a candidate’s perceived competence.

Principal Researcher, James Devine, said:

“This research really looked to better understand the issue of Lookism, and whilst it focused on an acute hospital in London, the findings and recommendations could be applied to any organisation. We really valued the honesty from respondents, as it is this that allows an organisation to become a true learning organisation, and one that uses findings such as these to educate and inform recruiting managers. In addition, its right that I recognise the work and contribution of Paul Coulson as the Research Coordinator.

“There were strong findings in what recruiting managers viewed negatively, and this may be systematic of society and perceptions towards things like tattoos, and piercings. The conciliation service, ACAS have stated in their recent release that negative attitudes about visible tattoos are outdated, and fear that employers could be drastically reducing the pool of potential recruits because so many young people now have tattoos. It (ACAS) said employers should be thinking about relaxing dress codes in general, and these findings support that.

“It is encouraging that characteristics that are protected under the Equality Act 2010 did not feature negatively in respondents views when recruiting, yet equally, it is clear that training around Lookism requires further embedding in organisations, and taking the candid approach that this is about educating individuals and challenging perceptions, not taking a punitive approach.

The researchers recommends that the hospital reviews the results with the resourcing teams, however there are also implications for other NHS organisations and other recruiters.

They also recommended that a wider study be commissioned, possibly using a candidate feedback tool and that there should also be focus on particular staff groups to assess the extent of lookism in different groups.

More widely they recommend the use of terms such as ‘lookism’ and ‘unconscious bias’  to encourage a learning approach to perceptions; particularly around subjective perceptions that individuals may unknowingly exhibit verbally and/or non-verbally, and possibly more research into the negative and positive characteristics revealed by the research.

The full research is available on request – contact the researchers here.

Commenting on the research, diversity expert Kate Headley of The Clear Company said:

“It’s unsurprising that the vast majority of respondents said they believe a candidate’s appearance defines the outcome of a selection process to some extent. Unconscious bias and conscious bias are a fact of life; as human beings we are hard-wired to rapidly categorise people instinctively. Historically, people biases have been a natural and necessary process and because of this it is unreasonable to expect innate perceptions to vanish overnight. However, we can manage unconscious bias to limit its impact on hiring decisions.


“While it is uncomfortable reading that one in 10 respondents admitted that they would be ‘very likely’ to appoint a physically attractive candidate, over a physically unattractive candidate (where suitability for the role was the same for each of the two candidates), what is more shocking is the fact that one in five were ‘unsure’ if gender and appearance is relevant to competence.


“Clearly, there is need for education here. When determining who the best person for the role is, hirers must stick to the facts. A shortlist index works well. Before you even begin the recruitment process, define what competencies are really relevant so that you can tick them off when you match them. By limiting scope for subjectivity, an organisation stands the best chance of being truly inclusive.


“It’s incredibly valuable to offer the hiring population the opportunity to explore their biases. We run a light-hearted exercise on some of our courses where we ask attendees what comes to mind when they think of ‘older workers’. We invariably get a wonderful spectrum of responses from ‘experienced and knowledgeable’ to ‘slow to change’ and ‘traditional’. None of these assumptions are fact – all are biases. The exercise really gets people thinking.


“At the end of the day, organisations which fail to address unconscious biases in the hiring process risk missing out on the best talent – and in a sector such as healthcare, this is a chance they can ill afford to take.”



Author: Editorial Team

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