Antiracism in Academic Medicine: Fixing the Leak in the Pipeline of Black Physicians.
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ABSTRACT:
SUBMITTER: Avakame EF
PROVIDER: S-EPMC8357067 | biostudies-literature | 2021 Jun
REPOSITORIES: biostudies-literature
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Antiracism in Academic Medicine: Fixing the Leak in the Pipeline of Black Physicians.
Avakame Elorm F EF October Tessie W TW Dixon Gabrina L GL
ATS scholar 20210504 2
Black physicians remain severely underrepresented in academic medicine despite the documented benefits of a diverse medical faculty. Only 3.6% of academic medical faculty self-report as Black or African American. Efforts to improve faculty diversity at academic medical institutions nationwide have not made meaningful impacts. Sustained improvements in faculty diversity cannot be achieved without an actively antiracist approach, including the intentional transformation of policies, practices, and ...[more]
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Project description:BackgroundStructural health inequities and racism adversely affect patient health and the culture of academic medicine. Formal training to educate fellows and faculty on antiracism is lacking.ObjectiveOur objective was to design, implement, and assess the feasibility and preliminary efficacy of a year-long antiracism curriculum within a pulmonary, critical care, and sleep medicine division.MethodsThis was a pre- and postintervention observational study conducted between July 2020 and June 2021. The curriculum was offered during an allotted educational meeting time slot at a single-center pulmonary, critical care, and sleep medicine division at a large academic institution to fellows and faculty. The curriculum consisted of 13 1-hour virtual interactive workshops delivered by local experts in diversity, equity, and inclusion topics. Surveys assessed knowledge on racism in medicine; opinions, understanding, and comfort surrounding race and racism in medicine; as well as additional questions to solicit feedback on the curriculum itself via visual analog scale and write-in comments.ResultsBefore initiating the curriculum, 74% (n = 28) of respondents reported interest in an antiracism curriculum, and the majority (95%, n = 36) believed that discrimination affects medical staff and patients. Respondents reported only moderate comfort in talking about race (median, 58; interquartile range 41-70 on visual analog scale 0-100, where 100 is strongly agree with "I feel comfortable talking about race"). The postintervention survey demonstrated stability of the belief of the presence of racial discrimination and a 15% increase in self-directed learning about related topics. Although knowledge related to the use of race in medical algorithms improved, 14% fewer participants reported interest in continuing to engage in a division-wide structured antiracism curriculum.ConclusionImplementation of a curriculum on justice, equity, diversity, and inclusion within a fellowship program is feasible and addresses an unmet need within graduate medical education.
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Project description:The quickly developing drone technology can be used efficiently in the field of pipeline leak detection. The aim of this article is to provide drone mission concepts for detecting releases from pipelines. It provides an overview of the current applications of natural gas pipeline surveys, it considers environmental conditions by plume modelling, it discusses suitable commercially available sensors, and develops concepts for routine monitoring of pipelines and short term missions for localising and identifying a known leakage. Suitable platforms depend on the particular mission and requirements concerning sensors and legislation. As an illustration, a feasibility study during a release experiment is introduced. The main challenge of this study was the variability of wind direction on a time scale of minutes, which produces considerable differences to the plume simulations. Nevertheless, the leakage rates derived from the observations are in the same order of magnitude as the emission rates. Finally the results from the modeling, the release experiment and possible drone scenarios are combined and requirements for future application derived.
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Project description:Introduction Job satisfaction has a strong impact on the intention to stay which is an important aspect to counter skills shortage in academic medicine. The purpose of the three studies reported here is to find out what specific factors are relevant for the intention to stay and turnover intention of physicians in academic medicine –and what measures might have a positive impact on employee retention. Methods In an interview study combining qualitative and quantitative methods, we investigated how the individual mental representation of working conditions influences job satisfaction and its impact on the intention to stay. In total, 178 physicians from German university hospitals, residents, and physicians, in 15 departments of anesthesiology were interviewed and surveyed. In a first study, chief physicians participated in interviews about job satisfaction in academic hospitals. Answers were segmented into statements, ordered by topics, and rated according to their valence. In a second study, assistant physicians during and after their training period talked about strengths, weaknesses, and potential improvements of working conditions. Answers were segmented, ordered, rated, and used to develop a “satisfaction scale.” In a third study, physicians participated in a computer-led repertory grid procedure composing ‘mental maps’ of job satisfaction factors, filled in the job satisfaction scale and rated if they would recommend work and training in their clinic as well as their intention to stay. Results Comparing the interview results with recommendation rates and intention to stay show that high workload and poor career perspectives are linked to a negative attitude. A positive attitude towards work environment and high intention to stay is based on sufficient personnel and technical capacities, reliable duty scheduling and fair salaries. The third study using repertory grids showed that the perception of current teamwork and future developments concerning work environment were the main aspects to improve job satisfaction and the intention to stay. Discussion The results of the interview studies were used to develop an array of adaptive improvement measure. The results support prior findings that job dissatisfaction is mostly based on generally known “hygiene factors” and whereas job satisfaction is due to individual aspects.
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Project description:ObjectivesFew opportunities exist for postgraduate physicians to learn to address racism in their professional practice. We created a virtual, 5-session antiracism course that included the development of a formal action project to address racism at participants' home institution.MethodsWe delivered this curriculum virtually to 2 cohorts (2021 and 2022) of postgraduate physicians, nationally. The curriculum had 3 educational aims: (1) to increase knowledge on antiracism, (2) to increase comfort and engagement in discussing antiracism at home institutions, and (3) to increase self-efficacy to execute an institution-based project. Theory-informed practice, community building, and project-based learning were used to achieve our educational aims. We analyzed changes in these domains in addressing racism using matched 7-item Likert-scale questions from pre- and post-course surveys and the Wilcoxon signed rank test. We assessed perceptions and impacts of the course with post-course survey items using descriptive statistics.ResultsForty-three of 50 participants (86%) who completed pre- and post-course surveys were included in the analysis. We found pre-post course increases in mean scores (converted from Likert scales), for all 15 paired questions. For example, we found improvements in understanding the historical context of racism in medical institutions (mean score change: 5.12 [SD 1.00] to 6.42 [SD 0.76], P < .001), comfort in talking to colleagues about racism (5.21 [SD 1.08] to 6.19 [SD 0.70], P < .001), and capacity to address racism in patient care at their home institution (4.51 [SD 1.35] to 5.56 [SD 0.91], P < 0.001). 93% reported the course increased the likelihood of working to address racism at their institution.ConclusionThis project-based antiracism course for postgraduate learners increased self-reported knowledge of, comfort with, and self-efficacy in addressing racism and was well received by participants.
| S-EPMC11632890 | biostudies-literature