Promoting Diversity, Equity, and Inclusion: Building Community for Underrepresented in Medicine Graduate Medical Education Trainees.
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ABSTRACT:
SUBMITTER: Usoro A
PROVIDER: S-EPMC7901635 | biostudies-literature |
REPOSITORIES: biostudies-literature
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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
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:PurposeA better understanding of how communication skills education impacts trainees' communication skills is important for continual improvement in graduate medical education (GME). Guided by the Kirkpatrick Model, this review focused on studies that measured communication skills in either simulated or clinical settings. The aim of this systematic review was to examine the effect of experiential communication skills education on GME trainees' communication behaviors.MethodFive databases were searched for studies published between 2001 and 2021 using terms representing the concepts of medical trainees, communication, training, and skills and/or behaviors. Included studies had an intervention design, focused only on GME trainees as learners, used experiential methods, and had an outcome measure of communication skills behavior that was assessed by a simulated or standardized patient (SP), patient, family member, or outside observer. Studies were examined for differences in outcomes based on study design; simulated versus clinical evaluation setting; outside observer versus SP, patient, or family member evaluator; and length of training.ResultsSeventy-seven studies were ultimately included. Overall, 54 (70%) studies reported some positive findings (i.e., change in behavior). There were 44 (57%) single-group pre-post studies, 13 (17%) nonrandomized control studies, and 20 (26%) randomized control studies. Positive findings were frequent in single-group designs (80%) and were likely in nonrandomized (62%) and randomized (55%) control trials. Positive findings were likely in studies evaluating communication behavior in simulated (67%) and clinical (78%) settings as well as in studies with outside observer (63%) and SP, patient, and family member (64%) evaluators.ConclusionsThis review demonstrates strong support that experiential communication skills education can impact GME trainees' communication behaviors. Marked heterogeneity in communication trainings and evaluation measures, even among subgroups, did not allow for meta-analysis or comparative efficacy evaluation of different studies. Future studies would benefit from homogeneity in curricular and evaluation measures.
| S-EPMC9712157 | biostudies-literature
Project description:ObjectivesOur program implemented East EMWars, a year-long, longitudinal game that added competition to our existing curricular content. We surveyed residents to investigate the impact of gamification in emergency medicine residency training. We hypothesized that residents would report higher levels of motivation, engagement, and challenge with gamification compared to traditional didactics. Furthermore, we hypothesized that residents would exhibit generally positive perceptions about gamification as a learning tool and that it would translate to improved performance on the annual in-training examination.MethodsThis was a single-center, prospective pre- and post-intervention survey study at a community-based emergency medicine residency program. Given the multiplicity of research questions and inherent nature of educational research, a mixed methods approach was utilized. We utilized nonparametric testing for quantitative data with paired responses pre- and post-intervention. We solicited comments on the post-intervention that were categorized under thematic approach and presented in complete and unedited form in the results.ResultsEighteen (100%) of eligible residents in our program participated in both surveys. There were statistically significant increases in reported levels of motivation, engagement, and challenge with gamification compared to traditional didactic methods. Residents also reported overwhelmingly positive general perceptions about gamification and its broader generalizability and applicability. We did not reach statistical significance in determining if in-training exam scores were associated with our gamification initiative.ConclusionsThis study was a first-of-its-kind look into a longitudinal game in an emergency medicine residency program. Although our results are encouraging, medical educators need further research to determine if this increase in motivation, engagement, and challenge will be associated with an increase in examination scores or, more importantly, healthcare outcomes. Theory-based, broader-scale, prospective studies are needed to further explore and help establish these associations and outcomes.
| S-EPMC9425934 | biostudies-literature
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:BackgroundAlthough women comprise the majority of medical students, gender disparities emerge early and remain at the highest levels of academia. Most leadership courses focus on faculty or students rather than women graduate medical education (GME) trainees.AimTo promote the leadership development of women GME trainees through empowerment, community building, networking and mentorship, and concrete leadership skills development.SettingUniversity of California, San Francisco.Participants359 women residents and fellows from 41 specialties.Program descriptionA longitudinal curriculum of monthly workshops designed to support leadership development for women trainees. Sessions and learning objectives were designed via needs assessments and literature review.Program evaluationA mixed-methods evaluation was performed for 3 years of WILD programming. Quantitative surveys assessed participant satisfaction and fulfillment of learning objectives. Structured interview questions were asked in focus groups and analyzed qualitatively.Discussion23% of invited participants attended at least one session from 2018 to 2021, despite challenging trainee schedules. Surveys demonstrated acceptability and satisfaction of all sessions, and learning objectives were met at 100% of matched sessions. Focus groups highlighted positive impact in domains of community-building, leadership skills, mentorship, and empowerment. This program has demonstrated WILD's longitudinal sustainability and impact for women trainees.
| S-EPMC10996076 | 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: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: 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