Promoting Diversity, Equity, and Inclusion: Building Community for Underrepresented in Medicine Graduate Medical Education Trainees.
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SUBMITTER: Usoro A
PROVIDER: S-EPMC7901635 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BACKGROUND: Education in health policy and advocacy is recognized as an important component of health professional training. To date, curricula have only been assessed at the medical school level. OBJECTIVE: We sought to address the gap in these curricula for residents and other health professionals in primary care. INNOVATION: We created a health policy and advocacy curriculum for the VA Connecticut Healthcare System, Center of Excellence in Primary Care Education, an interprofessional, ambulatory-based, training program that includes internal medicine residents, nurse practitioner fellows, health psychology fellows, and pharmacy residents. The policy module focuses on health care finance and delivery, and the advocacy module emphasizes negotiation skills and opinion-based writing. Trainee attitudes were surveyed before and after the course, and using the Wilcoxon signed rank test, relative change was determined. Knowledge acquisition was evaluated with precourse and postcourse examinations using a paired sample t test. RESULTS: From July 2011 through June 2013, 16 trainees completed the course. In the postcourse survey, trainees demonstrated improved comfort with understanding health law and the American health care system (Likert mean increased from 2.1 to 3.0, P = .01), as well as with associated advocacy skills (Likert mean increased from 2.0 to 2.9, P = .04). Knowledge-based test scores also showed significant improvement (increasing from 55% to 78% correct, P ≤ .001). CONCLUSIONS: Our curriculum integrating core health policy knowledge with advocacy skills represents a novel approach in postgraduate health professional education and resulted in sustained improvement in knowledge and comfort with health policy and advocacy.
| S-EPMC4535222 | biostudies-other
Project description:Recent events prompted scientists in the United States and throughout the world to consider how systematic racism affects the scientific enterprise. This paper provides evidence of inequities related to race-ethnicity and gender in graduate school experiences and career plans of PhD students in the top 100 ranked departments in one science, technology, engineering, and math (STEM) discipline, chemistry. Mixed-model regression analyses were used to examine factors that might moderate these differences. The results show that graduate students who identified as a member of a racial/ethnic group traditionally underrepresented in chemistry (underrepresented minorities, URM) were significantly less likely than other students to report that their financial support was sufficient to meet their needs. They were also less likely to report having supportive relationships with peers and postdocs. Women, and especially URM women, were significantly less likely to report supportive relationships with advisors. Despite their more negative experiences in graduate school, students who identified as URM expressed greater commitment to finishing their degree and staying in the field. When there was at least one faculty member within their departments who also identified as URM they were also more likely than other students to aspire to a university professorship with an emphasis on research. Men were significantly more likely than women to express strong commitment to finishing the PhD and remaining in chemistry, but this difference was stronger in top-ranked departments. Men were also more likely than women to aspire to a professorship with an emphasis on research, and this difference remained when individual and departmental-level variables were controlled.
| S-EPMC7848687 | biostudies-literature
Project description:ObjectiveThe study aimed to assess the need of mental wellbeing services for post graduate medical (PGME) trainees working at the Aga Khan University Hospital in Karachi, Pakistan.MethodsA cross-sectional study was conducted among all PGME trainees working at Aga Khan University Hospital in Karachi, Pakistan. The study questionnaire was developed by the team of investigators. The data collection was done through online survey from April 2019 to May 2019 and it was analyzed using descriptive and inferential analyses.ResultsOut of total 623 PGME trainees, 334 trainees completed the online survey (response rate of 53.61%). A total of 292 participants (87.4%) perceived a need for mental health services. The major stressors identified were increase work hours (77.8%), excessive workload (75.1%), and difficulty balancing between work and personal life (72.8%). The perceived obstacles of utilizing mental services included lack of protected time (69.8%), fear of consequences (36.8%), lack of confidentiality (36.5%), and stigma (32.9%). The study participants indicated various suggestions to reduce their stressors such as separate relaxation space in hospital (91.3%), appreciation gestures like encouraging emails (65%), mentoring programs (43.4%), and regular surveys about resident needs (39.8%).ConclusionIt is evident that innovative strategies to address trainees' mental health needs, looking at limitations of developing countries like Pakistan with large population and limited resources, need to be explored.
| S-EPMC8368754 | biostudies-literature
Project description: Not available
| S-EPMC7301915 | biostudies-literature
Project description:BackgroundThough the USA is becoming increasingly diverse, the physician workforce contains a disproportionately low number of physicians from racial and ethnic groups that are described as underrepresented in medicine (URiM). Mentorship has been proposed as one way to improve the retention and experiences of URiM physicians and trainees. The objective of this systematic review was to identify and describe mentoring programs for URiM physicians in academic medicine and to describe important themes from existing literature that can aid in the development of URiM mentorship programs.MethodsThe authors searched PubMed, PsycINFO, ERIC, and Cochrane databases, and included original publications that described a US mentorship program involving academic medical doctors at the faculty or trainee level and were created for physicians who are URiM or provided results stratified by race/ethnicity.ResultsOur search yielded 4,548 unique citations and 31 publications met our inclusion criteria. Frequently cited objectives of these programs were to improve research skills, to diversify representation in specific fields, and to recruit and retain URiM participants. Subjective outcomes were primarily participant satisfaction with the program and/or work climate. The dyad model of mentoring was the most common, though several novel models were also described. Program evaluations were primarily subjective and reported high satisfaction, although some reported objective outcomes including publications, retention, and promotion. All showed satisfactory outcomes for the mentorship programs.DiscussionThis review describes a range of successful mentoring programs for URiM physicians. Our recommendations based on our review include the importance of institutional support for diversity, tailoring programs to local needs and resources, training mentors, and utilizing URiM and non-URiM mentors.
| S-EPMC7852467 | biostudies-literature
Project description:IntroductionLack of diversity impacts research, medical curricula, and medical trainees' ability to provide equitable patient care. The concept of allyship, defined as a supportive association between identities with power and privilege and marginalized identities, provides an optimal framework for enhancing education about health equity. Currently, there are no established curricula focused on allyship and limited mention within current medical training literature. We propose use of allyship to increase graduate medical trainee understanding of diversity and focus on health equity.MethodsWe developed a 1-hour workshop aimed at helping residents understand the definition of allyship, effective allyship to patients and colleagues, and allyship differences across communities. The workshop consisted of pre- and postassessment surveys, a didactic presentation module, and facilitated case study discussions. It was conducted locally on four occasions across pediatrics, family medicine, surgery, and emergency medicine residency programs.ResultsAn analysis of the 101 preassessment and 58 postassessment survey responses revealed an increased level of knowledge regarding allyship (p < .001) and increased comprehension of allyship competencies (p < .001). All workshop learning objectives demonstrated positive change postmodule.DiscussionWith an increasing need for curricula to address health equity in medical trainees, this workshop serves as a unique and effective approach to expanding cultural responsiveness skills under the lens of allyship. Specifically, the workshop functions as a constructive introduction to allyship principles and practices and can serve as a foundation on which residents can build more robust skills as a part of their allyship journey.
| S-EPMC8685188 | biostudies-literature
Project description:OBJECTIVES:Health systems are adopting electronic health records (EHRs). There are few studies on the effects of EHR implementation on graduate medical education. The authors sought to longitudinally assess perceptions of the impact of EHRs on graduate medical education during implementation and 2 years after implementation. METHODS:A survey was distributed to faculty and trainees during the first year (2013) of adoption of the EHR system. A follow-up survey was distributed 2 years later (2015). The ?2 test was used to compare the quantitative responses, and factor analysis was conducted to identify correlations between items. Free text responses were analyzed qualitatively. RESULTS:The initial survey (in 2013) included 290 faculty and 106 trainees; the follow-up survey (in 2015) included 353 faculty and 226 trainees. In 2013, respondents had a positive impression of EHRs. During the implementation phase, participants believed that face-to-face teaching was negatively affected (P = 0.001). Faculty believed EHRs had a negative effect on trainees' ability to take a history/conduct physical examinations (P = 0.002) and to formulate a differential diagnosis/plan independently (P = 0.003). In 2015, faculty opinions of the impact of the EHR remained unchanged; trainee responses were more positive than in 2013 in some areas. Qualitative analysis showed that the most frequent strategies to enhance the educational process were the development of EHR skills and improved chart access and note assistance. CONCLUSIONS:Respondents remain positive about the EHR 2 years after implementation. Faculty remain concerned about its effect on the educational process, whereas residents appear more positive regarding the potential for EHRs to enhance their education.
| S-EPMC6395275 | biostudies-literature
Project description:The COVID-19 crisis has had an unprecedented impact on resident education and well-being: social distancing guidelines have limited patient volumes and forced virtual learning, while personal protective equipment (PPE) shortages, school/daycare closures, and visa restrictions have served as additional stressors. Our study aimed to analyze the effects of COVID-19 crisis-related stressors on residents' professional and personal lives. In April 2020, we administered a survey to residents at a large academic hospital system in order to assess the impact of the pandemic on residency training after >6 weeks of a modified schedule. The primary outcome was to determine which factors or resident characteristics were related to stress during the pandemic. Our secondary goals were to examine which resident characteristics were related to survey responses. Data were analyzed with regression analyses. Ninety-six of 205 residents completed the survey (47% response rate). For our primary outcome, anxiety about PPE (P < 0.001), female gender (P = 0.03), and the interaction between female gender and anxiety about PPE (P = 0.04) were significantly related to increased stress during the COVID-19 pandemic. Secondary analyses suggested that medicine residents were more comfortable than surgical residents using telemedicine (P > 0.001). Additionally, compared to juniors, seniors believed that the pandemic was more disruptive, modified schedules were effective, and virtual meetings were less effective while virtual lectures were more effective (all P ≤ 0.05) Furthermore, the pandemic experience has allowed seniors in particular to feel more confident to lead in future health crises (P ≤ 0.05). Medicine and surgery residency programs should be cognizant of and closely monitor the effects of COVID-19 crisis-related factors on residents' stress and anxiety levels. Transparent communication, telemedicine, online lectures/meetings, procedure simulations, advocacy groups, and wellness resources may help to mitigate some of the challenges posed by the pandemic.
| S-EPMC7534325 | biostudies-literature
Project description:BackgroundMedical student learning experiences should facilitate progressive development of competencies required for practice. Medical school training opportunities have traditionally focused on acquiring medical knowledge and patient care competencies while affording less opportunity to receive feedback on practice-based improvement and system-based practice competencies. The Prematriculation program at the University of Minnesota Medical School Duluth Campus (UM MSD) utilized near-peer mentors to support the transition of students underrepresented in medicine, including American Indian/ Alaska Natives (AI/AN) and those from rural backgrounds, into medical school. The purpose of this study is to better define the role of near-peer mentors and explore the alignment of near-peer mentorship with the ACGME core competencies.MethodsAn important component of the Prematriculation program, designed to prepare incoming under-represented students for medical school, was the inclusion of near-peer mentors. The six near-peer mentors participated in semi-structured interviews or focus groups within 1 year of serving as a near-peer mentor. Themes emerged from open-coding of the transcripts.ResultsThe near-peer mentors drew on their own experiences to transmit information that supported the socialization of the matriculating students into medical school. Direct benefits to the mentors included solidifying their own understanding of medical knowledge and execution of procedural skills. Mentors provided examples of benefits related to their own development of interpersonal communication and professionalism skills. Operating in the context of the program provided opportunities to engage mentors in practice-based improvement and system-based practice.ConclusionsServing as a near-peer mentor offers significant benefits to medical students from backgrounds underrepresented in medicine. By taking on the peer mentoring leadership role, students progressed toward the competencies required of an effective physician. Given the importance of acquiring these competencies, it is worth considering how near-peer mentoring can be applied more broadly across the medical school curriculum.
| S-EPMC6849195 | biostudies-literature
Project description:The German graduate medical education system is going through an important phase of changes. Besides the ongoing reform of the national guidelines for graduate medical education (Musterweiterbildungsordnung), other factors like societal and demographic changes, health and research policy reforms also play a central role for the future and competitiveness of graduate medical education. With this position paper, the committee on graduate medical education of the Society for Medical Education (GMA) would like to point out some central questions for this process and support the current discourse. As an interprofessional and interdisciplinary scientific society, the GMA has the resources to contribute in a meaningful way to an evidence-based and future-oriented graduate medical education strategy. In this position paper, we use four key questions with regards to educational goals, quality assurance, teaching competence and policy requirements to address the core issues for the future of graduate medical education in Germany. The GMA sees its task in contributing to the necessary reform processes as the only German speaking scientific society in the field of medical education.
| S-EPMC3671322 | biostudies-other