Leadership for change: how medical associations are working toward equity, diversity, and inclusion.
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ABSTRACT:
SUBMITTER: Johnson K
PROVIDER: S-EPMC9891743 | biostudies-literature | 2023 Apr
REPOSITORIES: biostudies-literature
Publications
Leadership for change: how medical associations are working toward equity, diversity, and inclusion.
Johnson Kirsten K Ali Huma H Bryan Jennifer J Kernick Aimee A Kitty Darlene D Primavesi Robert R McIlveen-Brown Emma E LeBlanc Constance C
CJEM 20230201 4
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Project description:BackgroundAcademic medicine needs more diverse leadership from racial/ethnic minorities, women, people with disabilities, and LGBTQIA+ physicians. Longitudinal structural support programs that bring together underrepresented in medicine (UiM) and non-UiM trainees are one approach to build leadership and scholarship capacity in diversity, equity, and inclusion (DEI).ObjectiveTo describe the creation, satisfaction with, and feasibility of a Leadership Education in Advancing Diversity (LEAD) Program and evaluate scholars' changes in self-efficacy, intended and actual behavior change, and outputs in leadership and DEI scholarship.MethodsIn 2017, we created the LEAD Program, a 10-month longitudinal, single institution program that provides residents and fellows ("scholars") across graduate medical education (GME) with leadership training and mentorship in creating DEI-focused scholarship. In the first 3 cohorts (2017-2020), we assessed scholars' self-efficacy, actual and planned behavior change, and program satisfaction using IRB-approved, de-identified retrospective pre-/post-surveys. We measured scholarship as the number of workshops presented and publications developed by the LEAD scholars. We used descriptive statistics and paired 2-tailed t tests to analyze the data.ResultsSeventy-five trainees completed LEAD; 99% (74 of 75) completed the retrospective pre-/post-surveys. There was statistically significant improvement in scholars' self-efficacy for all learning objectives. All trainees thought LEAD should continue. LEAD scholars have created workshops and presented at local, regional, and national conferences, as well published their findings. Scholars identified the greatest benefits as mentorship, developing friendships with UiM and ally peers outside of their subspecialty, and confidence in public speaking.ConclusionsLEAD is an innovative, feasible GME-wide model to improve resident and fellow self-efficacy and behaviors in DEI scholarship and leadership.
| S-EPMC8672828 | biostudies-literature
Project description:IntroductionTo achieve a healthier future for all, improving diversity through efforts such as diversifying faculty and leadership in academic medicine is imperative. Therefore, medical trainees (medical students, residents, fellows) from groups underrepresented in medicine (UiM) are encouraged to pursue academic careers and have opportunities to gain faculty leadership skills during their training. Trainees also need exposure to the leadership positions within various offices of an academic institution such as the Office of Diversity, Equity, and Inclusion (DEI). The goal of this module is to expose UiM trainees to the Office of DEI and leadership competencies that can be obtained via service and leadership opportunities with it.MethodsThe Kern model was used in the development, implementation, and evaluation of this 75-minute workshop. The workshop consisted of a PowerPoint presentation, reflection exercises, and case discussion to raise trainees' awareness of the Office of DEI and opportunities to become engaged with and develop faculty leadership competencies through the office.ResultsSixty-six diverse learners across three sites completed pre- and postworkshop surveys. Ninety-five percent of participants agreed or strongly agreed that the learning objectives of the workshop had been met.DiscussionOverall, this interactive workshop facilitated learners' awareness of the responsibilities of the Office of DEI and opportunities for learners to develop faculty leadership competencies through engagement. Although primarily evaluated among medical students, the module can be of use to learners and faculty of other health professions programs with an Office of DEI.
| S-EPMC9640356 | biostudies-literature
Project description:ObjectivesTo increase diversity and inclusion in graduate medical education (GME), the Accreditation Council for Graduate Medical Education (ACGME) issued new diversity standards requiring programs to engage in practices that focus on systematic recruitment and retention of a diverse workforce of trainees and faculty. The literature on how program directors (PDs) can incorporate and prepare for this standard is limited.MethodsWe developed a diversity, equity, and inclusion (DEI) toolkit for PDs as an example of an institutional GME-led effort to promote inclusive recruitment and DEI awareness among residency and fellowship programs at a large academic center.ResultsA survey was sent to 80 PDs before the launch of the toolkit and 6 months afterwards with response rates of 27% (22/80) and 97% (78/80), respectively. At baseline, 45% (10/22) anticipated that the DEI toolkit might provide better resources than those currently available to them and 41% (9/22) perceived that the toolkit might improve recruitment outcomes. At 6 months, 63% (49/78) found the toolkit helpful in the 2021-2022 recruitment season. By contrast, 2% (2/78) of PDs did not find the toolkit helpful, and 33% (26/78) said they did not access the toolkit. When asked if a PD changed their program's recruitment practices because of the toolkit, 31% (24/78) responded yes. Programs that changed recruitment practices started to require unconscious bias training for all faculty and residents involved in the residency interviews and ranking. Others worked on creating a standardized scoring rubric for interviews focused on four main domains: Experiences, Attributes, Competencies, and Academic Metrics.ConclusionThere is a need to support PDs in their DEI journey and their work to recruit a diverse workforce in medicine. Utilizing a DEI toolkit is one option to increase DEI knowledge, skills, awareness, and self-efficacy among PDs and can be adopted by other institutions and leaders in academic medicine.
| S-EPMC10563453 | biostudies-literature
Project description:At many research-intensive universities in North America, there is a disproportionate loss of minoritized undergraduate students from Science, Technology, Engineering, and Mathematics (STEM) majors. Efforts to confront this diversity, equity, and inclusion (DEI) challenge, such as faculty adoption of evidenced-based instructional approaches that promote student success, have been slow. Instructional and pedagogical change efforts at the academic department level have been demonstrated to be effective at enacting reform. One potential strategy is to embed change agent individuals within STEM departments that can drive change efforts. This study seeks to assess whether tenure-track, teaching-focused faculty housed in STEM departments are perceived as influential on the instructional and pedagogical domains of their colleagues. To answer this, individuals across five STEM departments at large, research-intensive campuses identified faculty who were influential upon six domains of their instruction and pedagogy. Social network analysis of individuals in these departments revealed heterogeneity across the instructional domains. Some, like the teaching strategies network, are highly connected and involve the majority of the department; while others, like the DEI influence network, comprise a significantly smaller population of faculty. Importantly, we demonstrate that tenure-track, teaching-focused faculty are influential across all domains of instruction, but are disproportionately so in the sparsely populated DEI influence networks.
| S-EPMC11440739 | biostudies-literature
Project description: Not available
| S-EPMC9879247 | biostudies-literature
Project description:Background Physician-patient racial and cultural concordance is essential to address health care disparities. Yet, limited literature on diversity, equity, and inclusion (DEI) outcomes in graduate medical education (GME) suggests the need for high-yield DEI resources. Objectives To describe and identify DEI efforts by US residency program director (PD) associations and areas for collaboration among the GME community. Methods Through bimonthly teleconferences and 5 iterative revisions from June to September 2022, the DEI workgroup of the US Organization of PD Associations developed a 17-question needs assessment survey to investigate DEI activities across residency PD associations, which was delivered twice electronically from September to November 2022 to 30 specialty PD association representatives. Results Survey response rate was 73% (22 of 30). Specialties track resident demographics more than PD demographics (11 of 22, 50% vs 7 of 22, 32%). Tracked demographics vary and include race, gender, and sexual orientation. Most PD associations have DEI committees (16 of 22, 73%) implementing various initiatives, the most common of which was providing resources to ensure diverse representation (11 of 16, 69%). Most specialties provide residency recruitment resources (14 of 22, 64%) and funding for visiting rotations or mentorship for underrepresented trainees (12 of 22, 54%). Resources for pipeline programs (7 of 22, 32%) and retention of diverse residents (7 of 22, 32%) were less common. Faculty development training focused more on teaching DEI to residents (14 of 22, 64%) than on teaching health disparities (7 of 22, 32%). Conclusions Our study demonstrates substantial DEI interventions among specialty PD associations. Yet, educational gaps exist in specific DEI content, faculty development, and curricular dissemination.
| S-EPMC11475428 | biostudies-literature
Project description:BackgroundDiversity, equity, and inclusion (DEI) in health care fosters many positive outcomes including improved patient care. DEI initiatives are often created by or require buy-in from departmental leaders with low DEI literacy. Book clubs are one way to develop DEI literacy. The purpose of this paper is to describe how leaders in the department of emergency medicine (DEM) process the information gained from reading a DEI book through discussion in a book club setting and explore how participation enhances their DEI literacy and fosters self-reflection.MethodsThis was a qualitative exploratory study based on a constructivist approach. Data were analyzed by four researchers using inductive thematic analysis techniques.ResultsSixty-eight leaders within the DEM participated in 11 book clubs. Nine themes were identified (examination of privilege, initial reaction to discussion about racism, discomfort, worry, self-reflection, release, role recognition, readiness, and education). After prompted examination of their own privilege participants moved through a model of perceived readiness to act. Participants started with feeling paralyzed by the work's enormity or becoming defensive. They then moved toward discomfort with discussions of racism and systemic racism and progressed to discussions around worrying that they were contributing to noninclusive environments. After a period of self-reflection, participants tended to release their paralysis, push aside their defensiveness, accept the role of discomfort, and express the importance of education on these issues. Participants then recognized their role in creating inclusive environments and started discussing what they can do about it, which, for many, was to show up to the conversation. An underlying driver of movement through this model was the education that was provided through the book.ConclusionsBy addressing privilege and systemic inequities through the reflective practice and dialogue of a book club, participants demonstrated a growing commitment and perceived readiness to advancing inclusive practices within medicine.
| S-EPMC11816006 | biostudies-literature
Project description:BackgroundHistorically in medicine, women and minorities have been underrepresented. This trend is especially significant in the anesthesiology workforce.ObjectiveThe goals of this study were to quantify the current state of diversity by race/ethnicity, gender, and sexual orientation among anesthesiology residents.MethodsAn institutionally reviewed and validated survey was delivered through Qualtrics to 130 anesthesiology program directors. Topics addressed included gender identity, sexual orientation, racial and ethnic background, rationale for pursuing anesthesiology, and medical training experiences. The study was administered from February to April 2021; 135 anesthesiology residents responded to the survey.ResultsThe sample was 44.4% white (n = 60), 54.1% male (n = 73), and 83.7% (n = 113) of respondents self-reported as straight or heterosexual. Respondents indicated that role models/mentors were somewhat or very important in their desire to pursue anesthesiology (n = 85; 67.2%), 42% reported that having women/diverse faculty was somewhat or very important in their decision to pursue anesthesiology. Discrimination during the anesthesiology residency application process or as a resident ranged from 4.4% due to sexual orientation to 18.7% due to gender/gender identity and race/ethnicity.ConclusionsExperiences of discrimination based on race/ethnicity, gender, and gender identity continues to be a concern among anesthesiology trainees. Creating an environment that is inclusive and supportive of all trainees regardless of race/ethnicity, gender/gender identity, and sexual orientation is needed. Interventions and strategies to create an inclusive environment may improve diversity within anesthesiology.
| S-EPMC9081057 | biostudies-literature
Project description: Not available
| S-EPMC7901635 | biostudies-literature
Project description:BackgroundAs the Accreditation Council for Graduate Medical Education (ACGME) began to ask programs to report their efforts surrounding diversity, equity, and inclusion (DEI), program directors felt ill prepared to evaluate their programs and measure change.ObjectiveTo develop a tool that would allow graduate medical education (GME) programs to evaluate the current state of DEI within their residencies, identify areas of need, and track progress; to evaluate feasibility of using this assessment method within family medicine training programs; and to analyze and report pilot data from implementation of these milestones within family medicine residency programs.MethodsThe Association of Family Medicine Residency Directors (AFMRD) Diversity and Health Equity (DHE) Task Force developed a tool for program DEI evaluation modeled after the ACGME Milestones. These milestones focus on DEI assessment in 5 key domains: Institution, Curriculum, Evaluation, Resident Personnel, and Faculty Personnel. After finalizing a draft, a pilot implementation of the milestones was conducted by a convenience sample of 10 AFMRD DHE Task Force members for their own programs.ResultsScores varied widely across surveyed programs for all milestones. Highest average scores were seen for the Curriculum milestone (2.65) and the lowest for the Faculty Personnel milestone (2.0). Milestone assessments were completed within 10 to 40 minutes using various methods.ConclusionsThe AFMRD DEI Milestones were developed for program assessment, goal setting, and tracking of progress related to DEI within residency programs. The pilot implementation showed these milestones were easily used by family medicine faculty members in diverse settings.
| S-EPMC9017255 | biostudies-literature