A Framework for Commitment to Social Justice and Antiracism in Academic Medicine.
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ABSTRACT:
SUBMITTER: Chesley C
PROVIDER: S-EPMC8357068 | biostudies-literature | 2021 Jun
REPOSITORIES: biostudies-literature
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A Framework for Commitment to Social Justice and Antiracism in Academic Medicine.
Chesley Christopher C Lee Jessica T JT Clancy Caitlin B CB
ATS scholar 20210312 2
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Project description: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 systems that persistently produce worse outcomes for Black medical students, trainees, and faculty.
| S-EPMC8357067 | biostudies-literature
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.
| S-EPMC9590586 | biostudies-literature
Project description:AbstractThis mixed-methods study aims to understand what the perceptions of leaders and healthcare professionals are regarding causes of disparities, cultural competence, and motivation before launching a disparity reduction project in hypertension care, contrasting perceptions in Federally Qualified Health Centers (FQHCs), and in a non-FQHC system. We interviewed leaders of six participating primary care systems and surveyed providers and staff. FQHC respondents reported more positive cultural competence attitudes and behavior, higher motivation to implement the project, and less concern about barriers to caring for disadvantaged patients than those in the non-FQHC practices; however, egalitarian beliefs were similar among all. Qualitative analysis suggested that the organizational missions of the FQHCs reflect their critical role in serving vulnerable populations. All system leaders were aware of the challenges of provider care to underserved groups, but comprehensive initiatives to address social determinants of health and improve cultural competence were still needed in both system types. The study provides insights into the perceptions and motivations of primary care organizational leaders and providers who are interested in improving chronic care. It also offers an example for care disparity programs to understand commitment and values of the participants for tailoring interventions and setting baseline for progress.
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Project description:ObjectivesLeadership within medical academic institutions often adheres to hierarchical structures, relying on factors like seniority and context, with limited focus on leadership development. This study aims to develop a structured framework by examining the traits, aspirations, and pre-requisites of academic leaders within medical school faculties.MethodsA cross-sectional study collected input from regular medical faculty and those in leadership roles through an online questionnaire, followed by quantitative and qualitative analyses. Data was curated, analyzed, and triangulated to establish subdomains, domains, and themes for the framework.ResultsAmong 229 respondents, 121 held formal academic leadership roles, the remaining 108 were regular medical faculty. And 92% of regular faculty cited lack of experience and training as significant barriers to effective leadership. Both groups agreed on the need for intensive leadership training, as 85% of leaders and 66% of regular faculty lacked formal academic leadership training. The concept of affiliative leadership was favored by 45% of leaders. Qualitative analysis and subtheme triangulation led to the development of the 6 Es Framework for Leadership in Academic Medicine (FLAM). This framework encompasses: ethics (accountability and role modeling), education (structured curriculum and training), envision (clear path and talent identification), engagement (structural foundation and attainable goals), empowerment (fostering passion), and encouragement (financial incentives).ConclusionThis research reinforces the necessity of structured leadership development in academic medicine. The unique attributes of the 6Es FLAM have the potential to enhance leadership in this field.
| S-EPMC11536381 | biostudies-literature
Project description:BackgroundIn recent decades, increasing social and health inequalities all over the world has highlighted the importance of social justice as a core nursing value. Therefore, proper education of nursing students is necessary for preparing them to comply with social justice in health systems. This study is aimed to identify the main factors for teaching the concept of social justice in the nursing curriculum.MethodThis is a qualitative study, in which the conventional content analysis approach was employed to analyze a sample of 13 participants selected using purposive sampling method. Semi-structured interviews were conducted to collect and analyze the data.ResultsAnalysis of the interviews indicated that insufficient education content, incompetency of educators, and inappropriate education approaches made social justice a neglected component in the academic nursing education. These factors were the main sub-categories of the study and showed the negligence of social justice in academic nursing education.ConclusionResearch findings revealed the weaknesses in teaching the concept of social justice in the nursing education. Accordingly, it is necessary to modify the content of nursing curriculum and education approaches in order to convey this core value. Since nursing educators act as role models for students, especially in practical and ethical areas, more attention should be paid to competency of nursing educators, specially training in the area of ethical ideology and social justice.
| S-EPMC7802265 | biostudies-literature
Project description:This article contains four data tables: 1 and 2: A content analysis framework for evaluating the degree to which urban resilience plans emphasize issues of justice and equity in plan content, and associated point rubric for scoring criteria; 3. The raw numerical data collected for a plan evaluation where we deployed this framework to analyze a sample of 31 strategies from the "100 Resilient Cities - Pioneered by the Rockefeller Foundation" (100RC) initiative; and, 4. Inter-rater reliability scores for this plan evaluation. This dataset accompanies a 2019 article submitted to the journal World Development titled: Just urban futures? Exploring equity in "100 Resilient Cities".
| S-EPMC6743002 | biostudies-literature
Project description:BackgroundDespite decades of anti-racism and equity, diversity, and inclusion (EDI) interventions in academic medicine, medical racism continues to harm patients and healthcare providers. We sought to deeply explore experiences and beliefs about medical racism among academic clinicians to understand the drivers of persistent medical racism and to inform intervention design.MethodsWe interviewed academically-affiliated clinicians with any racial identity from the Departments of Family Medicine, Cardiac Sciences, Emergency Medicine, and Medicine to understand their experiences and perceptions of medical racism. We performed thematic content analysis of semi-structured interview data to understand the barriers and facilitators of ongoing medical racism. Based on participant narratives, we developed a logic framework that demonstrates the necessary steps in the process of addressing racism using if/then logic. This framework was then applied to all narratives and the barriers to addressing medical racism were aligned with each step in the logic framework. Proposed interventions, as suggested by participants or study team members and/or identified in the literature, were matched to these identified barriers to addressing racism.ResultsParticipant narratives of their experiences of medical racism demonstrated multiple barriers to addressing racism, such as a perceived lack of empathy from white colleagues. Few potential facilitators to addressing racism were also identified, including shared language to understand racism. The logic framework suggested that addressing racism requires individuals to understand, recognize, name, and confront medical racism.ConclusionsOrganizations can use this logic framework to understand their local context and select targeted anti-racism or EDI interventions. Theory-informed approaches to medical racism may be more effective than interventions that do not address local barriers or facilitators for persistent medical racism.
| S-EPMC11017534 | biostudies-literature
Project description:Grit has recently been challenged for its weak predictive power and the incompleteness of its measurement. This study addressed these issues by taking a developmental, person-oriented approach to study academic-related goal commitment and grit and their effects on academic achievement. Using longitudinal data among Finnish eighth and ninth graders (n = 549, 59.4% female, age = 14-16), the longitudinal changes in grit and academic goal commitment profiles were investigated through latent profile and latent transition analyses. Four profiles were identified across two grades: High committed-persistent and moderate consistency (~17%), Moderate (~60%), Low committed-persistent and moderate-low consistency (~8%) and Extremely low committed-persistent and moderate-low consistency (~12%). The students in the High committed-persistent and moderate consistency profile had the highest academic achievement of all the profiles when controlled for gender, socioeconomic status, conscientiousness, and academic persistence. The results revealed that students' profiles changed between the eighth and ninth grades, with more than one-third of the High committed-persistent and moderate consistency adolescents dropping from this group. Further analysis showed that the profiles varied by educational aspiration, gender, and socioeconomic status. These findings imply that the combination of grit and academic goal commitment influences academic achievement; however, this combination is less common, unstable, and affected by internal and external factors. The study provided important implications on the weak grit effect and the ways to improve it.
| S-EPMC7910368 | biostudies-literature
Project description:Retention among academic medicine faculty is problematic, and there has been a decline in the number of physicians pursuing careers in academia. The education of future physicians relies upon physicians who pursue careers in academic medicine. Therefore, efforts must be taken to increase the percentage of physicians who conduct research and/or teach medical trainees. Recognizing this need, the New York Institute of Technology College of Osteopathic Medicine (NYITCOM) established the Academic Medicine Scholars Program ("Scholars Program"), which was designed to prepare outstanding osteopathic medical students for a career in academic medicine. Here we aim to determine the extent to which participants in NYITCOM's Scholars Program go on to pursue research and teaching endeavors during their residency and/or fellowship programs. An anonymous survey was administered to participants in the Scholars Program from 2012 through 2018 and asked about the participants' research and teaching experiences at the following time points: during the Scholars Program, residency, and fellowship, if applicable. Participation in the program led to a significant increase in survey respondents' teaching and research skills and an increased participation in scholarly activity as compared with the national average. The results also demonstrated that the program assisted alumni in securing positions in competitive residency and fellowship programs. As residents and fellows, alumni continued to pursue scholarly endeavors, primarily by publishing abstracts and posters, attending both regional and national conferences, and delivering lectures. We are hopeful that other medical schools will take part in producing capable academic medicine physicians by incorporating a similar program into their curriculum.
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Project description:IntroductionDigital health, the use of apps, text-messaging, and online interventions, can revolutionize healthcare and make care more equitable. Currently, digital health interventions are often not designed for those who could benefit most and may have unintended consequences. In this paper, we explain how privacy vulnerabilities and power imbalances, including racism and sexism, continue to influence health app design and research. We provide guidelines for researchers to design, report and evaluate digital health studies to maximize social justice in health.MethodsFrom September 2020 to April 2021, we held five discussion and brainstorming sessions with researchers, students, and community partners to develop the guide and the key questions. We additionally conducted an informal literature review, invited experts to review our guide, and identified examples from our own digital health study and other studies.ResultsWe identified five overarching topics with key questions and subquestions to guide researchers in designing or evaluating a digital health research study. The overarching topics are: 1. Equitable distribution; 2. Equitable design; 3. Privacy and data return; 4. Stereotype and bias; 5. Structural racism.ConclusionWe provide a guide with five key topics and questions for social justice digital health research. Encouraging researchers and practitioners to ask these questions will help to spark a transformation in digital health toward more equitable and ethical research. Future work needs to determine if the quality of studies can improve when researchers use this guide.
| S-EPMC8918521 | biostudies-literature