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Sharma S, Hillier T, Parsons M, Glanc P, Miller E, Nguyen ET, Doria AS, Dhillon S, Seely JM, Borgaonkar J, Yong-Hing CJ. Promoting Equity, Diversity, and Inclusion in Medicine: A Comprehensive Toolkit for Change in Radiology. Can Assoc Radiol J 2024; 75:323-329. [PMID: 38063367 DOI: 10.1177/08465371231214232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
This toolkit presents a comprehensive framework for a toolkit intended to increase equity, diversity, and inclusion (EDI) within the medical field and recommendations. We advocate for clear, comprehensive definitions and interpretations of fundamental EDI terms, laying the groundwork necessary for initiating and maintaining EDI initiatives. Furthermore, we offer a systematic approach to establishing EDI committees within medical departments, accentuating the pivotal role these committees play as they drive and steer EDI strategies. This toolkit also explores strategies tailored for the recruitment of a diverse workforce. This includes integral aspects such as developing inclusive job advertisements, implementing balanced search methods for candidates, conducting unbiased appraisals of applications, and structuring diverse hiring committees. The emphasis on these strategies not only augments the diversity within medical institutions but also sets the stage for a more holistic approach to healthcare delivery. Therefore, by adopting the recommended strategies and guidelines outlined in this framework, medical institutions and specifically radiology departments can foster an environment that embodies inclusivity and equity, thereby enhancing the quality of patient care and overall health outcomes.
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Affiliation(s)
- Sonali Sharma
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tracey Hillier
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | - Marlee Parsons
- Department of Diagnostic Radiology, McGill University Health Center, Montreal, QC, Canada
| | - Phyllis Glanc
- University of Toronto, Toronto, ON, Canada
- Obstetrical Ultrasound Centre at Sunnybrook, Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Elka Miller
- Department of Medical Imaging, University of Ottawa, CHEO, Ottawa, ON, Canada
| | - Elsie T Nguyen
- Joint Department of Medical Imaging, 33540 Toronto General Hospital, University of Toronto, Toronto, ON, Canada
| | - Andrea S Doria
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Sukhvinder Dhillon
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | - Jean M Seely
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Joy Borgaonkar
- Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada
| | - Charlotte J Yong-Hing
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Diagnostic Imaging, BC Cancer, Vancouver, BC, Canada
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Taranikanti M, Mudunuru AK, Chunchu SR, Guntuka RK, Maddur S, Yerra AK, Taranikanti SS. Selection of Medical Teachers: An Initiative for Ensuring a Fair and Transparent Selection Process. Cureus 2024; 16:e52837. [PMID: 38406028 PMCID: PMC10884714 DOI: 10.7759/cureus.52837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND The first step towards creating a sound educational environment and healthcare in a medical institute is employing medical teachers who maintain ethical behavior in their professional practice. A method where bias and subjectivity can be minimized is by making the recruitment process objective. MATERIAL AND METHODS The recruitment started as an offline process and was soon converted into an online form incorporating parameters for scoring. A total of 1,151 medical teachers had submitted their applications for posts in various departments, and 778 candidates were shortlisted and called for an interview. After the interview process, a unique symposium on the selection of medical teachers was organized. The feedback was incorporated into the online application that was released for the subsequent phases of recruitment. RESULTS The response rate of the study was 96.55%. Analysis of the feedback by the applicants showed that 47.59% of the applicants were of the opinion that the prevailing selection process in the country needs a change; 84.14% felt that the inclusion of objective criteria would make the selection process more transparent; and 91.03% were happy with the stratification of marks; 82.75% of the applicants and experts felt that knowledge of statistics for quality research and publications in indexed and institutional journals may be considered for the selection process; and 52.41% thought that all authors of an article should be given equal weightage. Adopting a fairly new concept of workplace-based assessment (WPBA) in India was acceptable to 83.45%. CONCLUSIONS Parameter-based, objective selection reduces bias, and merit alone is recognized.
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Affiliation(s)
- Madhuri Taranikanti
- Physiology, All India Institute of Medical Sciences, Bibinagar, Bibinagar, IND
| | - Aswin Kumar Mudunuru
- Physiology, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Hyderabad, IND
| | - Srinivasa Rao Chunchu
- Hematology, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Hyderabad, IND
| | - Rohith Kumar Guntuka
- Physiology, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Hyderabad, IND
| | - Srinivas Maddur
- Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Aruna Kumari Yerra
- Obstetrics and Gynaecology, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Faridabad, IND
| | - Sai Shriya Taranikanti
- Internal Medicine, Agartala Government Medical College and Govind Ballabh Pant Hospital, Agartala, IND
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Katz-Sidlow RJ, Roberts KL, Elliott DA, Conway EE. Implementation of a Chief Resident Selection Process Designed to Mitigate Bias: Lessons Learned. Cureus 2023; 15:e48116. [PMID: 38046738 PMCID: PMC10691740 DOI: 10.7759/cureus.48116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Chief residency selection processes are often opaque and beset by bias, which can result in disparities in who is selected for this important role. As a chief residency can lead to future academic and/or leadership positions, efforts to increase diversity in academic medicine and physician leadership may be aided by an inclusive chief resident (CR) selection process designed to mitigate bias. Objective: To implement and evaluate the acceptability of a CR selection process that is inclusive and designed to mitigate bias. Methods: In the 2021-2022 academic year, we designed and implemented a CR selection process aligned with published strategies known to mitigate bias in academic recruitment. The four-step opt-out CR selection process included a nomination survey, structured interviews, a clinical review, and a holistic review of each candidate. Each step was clearly delineated, assigned a specific number of points, and scored on a designated rubric. The candidates with the highest and second-highest number of points were awarded the two CR positions. Our selection process excluded examination scores and precluded consideration of "fit" between the selected CRs, as these are known sources of potential bias. In January 2023, we surveyed our department to obtain post-implementation feedback and to assess satisfaction with the process, before repeating the process for 2022-2023. RESULTS Survey response rates were 47% (14/30) for residents and 29% (18/63) for departmental faculty. The majority of responding residents (64%) and faculty (100%) were satisfied with the CR selection process, finding it fair and inclusive. Nearly 80% of residents and 100% of faculty wished to repeat the process in 2022-2023. Conclusions: An inclusive CR selection process utilizing strategies to mitigate bias was feasible, and acceptable to residents and faculty. We recommend that residency training programs make efforts to implement CR selection practices that are inclusive and aim to mitigate bias.
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Affiliation(s)
- Rachel J Katz-Sidlow
- Pediatrics, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, USA
| | - Kirsten L Roberts
- Pediatrics, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, USA
| | - Dacone A Elliott
- Pediatrics, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, USA
| | - Edward E Conway
- Pediatrics, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, USA
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Taylor J, Sharma S, Supersad A, Miller E, Lebel K, Zabihaylo J, Glanc P, Doria AS, Cashin P, Hillier T, Yong-Hing CJ. Recommendations for Improvement of Equity, Diversity, and Inclusion in the CaRMs Selection Process. Can Assoc Radiol J 2023; 74:624-628. [PMID: 37173872 DOI: 10.1177/08465371231174897] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
Equity, diversity and inclusion (EDI) in the medical field is crucial for meeting the healthcare needs of a progressively diverse society. A diverse physician workforce enables culturally sensitive care, promotes health equity, and enhances the comprehension of the various needs and viewpoints of patients, ultimately resulting in more effective treatments and improved patient outcomes. However, despite the recognized benefits of diversity in the medical field, certain specialties, such as Radiology, have struggled to achieve adequate equity, diversity and inclusion, which results in a discrepancy in the demographics of Canadian radiologists and the patients we serve. In this review, we propose strategies from a committee within the Canadian Association of Radiologists (CAR) EDI working group to improve EDI in the CaRMS selection process. By adopting these strategies, residency programs can foster a more diverse and inclusive environment that is better positioned to address the health needs of a progressively diverse patient population, leading to improved patient outcomes, greater patient satisfaction, and advancements in medical innovation.
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Affiliation(s)
- Jana Taylor
- Department of Diagnostic Radiology, McGill University Health Centre, Montreal, QC, Canada
| | - Sonali Sharma
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Alanna Supersad
- Department of Radiology and Diagnostic Imaging, 2A2.41 WC Mackenzie Health Sciences Centre, Edmonton, AB, Canada
| | - Elka Miller
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Kiana Lebel
- Department of Radiology, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Joanne Zabihaylo
- Department of Medical Imaging, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Phyllis Glanc
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Andrea S Doria
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Paula Cashin
- EDI Oversight Committee Member, Canadian Association Radiologists, Ottawa, ON, Canada
| | - Tracey Hillier
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | - Charlotte J Yong-Hing
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Diagnostic Imaging, BC Cancer Vancouver, Vancouver, BC, Canada
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Pinder RJ, Bury F, Sathyamoorthy G, Majeed A, Rao M. Differential attainment in specialty training recruitment in the UK: an observational analysis of the impact of psychometric testing assessment in Public Health postgraduate selection. BMJ Open 2023; 13:e069738. [PMID: 36894198 PMCID: PMC10008157 DOI: 10.1136/bmjopen-2022-069738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVES To determine how current psychometric testing approaches used in selection of postgraduate training in UK Public Health are associated with socioeconomic and sociocultural background of applicants (including ethnicity). DESIGN Observational study using contemporaneous data collected during recruitment and psychometric test scores. SETTING Assessment centre of UK national Public Health recruitment for postgraduate Public Health training. The assessment centre element of selection comprises three psychometric assessments: Rust Advanced Numerical Reasoning, Watson-Glaser Critical Thinking Assessment II and Public Health situational judgement test. PARTICIPANTS 629 applicants completed the assessment centre in 2021. 219 (34.8%) were UK medical graduates, 73 (116%) were international medical graduates and 337 (53.6%) were from backgrounds other than medicine. MAIN OUTCOME MEASURE Multivariable-adjusted progression statistics in the form of adjusted OR (aOR), accounting for age, sex, ethnicity, professional background and surrogate measures of familial socioeconomic and sociocultural status. RESULTS 357 (56.8%) candidates passed all three psychometric tests. Candidate characteristics negatively associated with progression were black ethnicity (aOR 0.19, 0.08 to 0.44), Asian ethnicity (aOR 0.35, 0.16 to 0.71) and coming from a non-UK medical graduate background (aOR 0.05, 0.03 to 0.12); similar differential attainment was observed in each of the psychometric tests. Even within the UK-trained medical cohort, candidates from white British backgrounds were more likely to progress than those from ethnic minorities (89.2% vs 75.0%, p=0.003). CONCLUSION Although perceived to mitigate the risks of conscious and unconscious bias in selection to medical postgraduate training, these psychometric tests demonstrate unexplained variation that suggests differential attainment. Other specialties should enhance their data collection to evaluate the impact of differential attainment on current selection processes and take forward opportunities to mitigate differential attainment where possible.
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Affiliation(s)
- Richard J Pinder
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
- NIHR Northwest London Applied Research Collaboration, Imperial College London, London, UK
| | - Fran Bury
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Ganesh Sathyamoorthy
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
- NIHR Northwest London Applied Research Collaboration, Imperial College London, London, UK
- Ethnicity and Health Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
- NIHR Northwest London Applied Research Collaboration, Imperial College London, London, UK
| | - Mala Rao
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
- NIHR Northwest London Applied Research Collaboration, Imperial College London, London, UK
- Ethnicity and Health Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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Cyphers ED, Lightfoote JB, Kagetsu NJ. Inclusive Resident Selection in Radiology: Practices for Interviewers. J Am Coll Radiol 2023; 20:265-267. [PMID: 36368462 DOI: 10.1016/j.jacr.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/14/2022] [Accepted: 10/14/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Eric D Cyphers
- Department of Bioethics, Columbia University, New York, New York; Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania; ACR RFS Bioethics and Humanities Committee Member
| | - Johnson B Lightfoote
- Department of Radiology, Pomona Valley Hospital Medical Center, Pomona, California; Chair, Commission for Women and Diversity, and editor and collator for JACR's periodic column entitled "Diversity Matters" since 2018
| | - Nolan J Kagetsu
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York; ACR Council Steering Committee, ACR Council on International Relations (member), ACR Governance Committee, ACR Commission for Women and Diversity (member).
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Williams MS, Myers AK, Finuf KD, Patel VH, Marrast LM, Pekmezaris R, Martinez J. Black Physicians' Experiences with Anti-Black Racism in Healthcare Systems Explored Through An Attraction-Selection-Attrition Lens. JOURNAL OF BUSINESS AND PSYCHOLOGY 2023; 38:75-88. [PMID: 35702386 PMCID: PMC9184355 DOI: 10.1007/s10869-022-09825-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 05/05/2023]
Abstract
Anti-Black racism is a specific form of racism directed at Black people. In healthcare, there are poignant examples of anti-Black racism in the recruitment, selection, and retention stages of the job cycle. Research shows that anti-Black racism is associated with inequitable work outcomes and the under-representation of Black physicians. However, empirical findings are scattered with no organizing framework to consolidate these findings. To add to the literature, in this paper we present the attraction-selection-attrition (ASA) model (Schneider, 1987) as an organizing framework to discuss Black physicians' experiences with anti-Black racism and discrimination throughout their careers. We draw from previous literature to highlight specific experiences of Black physicians at each stage of the job cycle (i.e., attraction, selection, retention), and we offer considerations on how practitioners can mitigate anti-Black racism throughout the job cycle. In the wake of COVID-19 and highly publicized social justice movements, healthcare systems are seeking ways to increase the recruitment, selection, and retention of Black physicians to ensure health equity. We believe this guide will be valuable to practitioners, leaders, researchers, and program directions seeking to advance diversity, equity, and inclusion of Black physicians in their healthcare systems. We conclude by providing practical implications and directions for future research.
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Affiliation(s)
- Myia S. Williams
- Department of Medicine, Northwell Health, Manhasset, NY USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
- Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY USA
- Department of Medicine, Northwell Health, 600 Community Drive 4th Floor, Manhasset, NY 11030 USA
| | - Alyson K. Myers
- Department of Medicine, Northwell Health, Manhasset, NY USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
- Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY USA
- Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY USA
| | - Kayla D. Finuf
- Department of Medicine, Northwell Health, Manhasset, NY USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
| | - Vidhi H. Patel
- Department of Medicine, Northwell Health, Manhasset, NY USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
| | - Lyndonna M. Marrast
- Department of Medicine, Northwell Health, Manhasset, NY USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
- Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY USA
| | - Renee Pekmezaris
- Department of Medicine, Northwell Health, Manhasset, NY USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
- Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY USA
| | - Johanna Martinez
- Department of Medicine, Northwell Health, Manhasset, NY USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
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Parikh JR, Van Moore A, Mead L, Bassett R, Rubin E. Prevalence of burnout in private practice radiology leaders. Clin Imaging 2022; 92:1-6. [PMID: 36126440 PMCID: PMC10139836 DOI: 10.1016/j.clinimag.2022.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/07/2022] [Accepted: 08/15/2022] [Indexed: 11/03/2022]
Abstract
RATIONALE AND OBJECTIVES To evaluate prevalence and demographic factors associated with both burnout and fulfillment of private practice radiologist leaders within the United States. MATERIALS AND METHODS The study cohort was the largest coalition of wholly radiologist owned, independently practicing radiology groups within the United States. Two designated leaders within each of the 30 radiology private practices within the organization Strategic Radiology were electronically mailed a weblink to a confidential IRB-approved survey in July 2021. Surveys included questions from the Stanford Professional Fulfillment Index, individual and practice demographics, and self-care. RESULTS The overall response rate was 67% (40/60). Fulfillment and burnout scores were calculated from the individual questions, and radiologists were classified as being fulfilled or not and burned out or not based upon score cutoffs previously validated from the Stanford Professional Fulfillment Index (PFI). The overall professional fulfillment rate of staff was 43% and the overall burnout rate was 33%. (Cronbach's α = 0.90 for fulfillment and 0.91 for burnout). The inverse correlation between professional fulfillment and burnout was highly significant (r = -0.42, p = 0.007). No statistically significant association was seen between either burnout or fulfillment and age, gender, ethnicity, practice geography or practice size. CONCLUSION Utilizing the validated Stanford PFI for assessment, the prevalence of burnout in private practice radiologist leaders was 33%. The prevalence of professional fulfillment was 43%, with a mild inverse association between professional fulfillment and burnout. SUMMARY In private practice leaders, the prevalence of burnout was 33% and the prevalence of professional fulfillment was 43%.
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Affiliation(s)
- Jay R Parikh
- Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, USA.
| | | | - Lisa Mead
- Strategic Radiology, Palmetto, FL, USA.
| | - Roland Bassett
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, USA.
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Bradford HM, Grady K, Kennedy MB, Johnson RL. Advancing faculty diversity in nursing education: Strategies for success. J Prof Nurs 2022; 42:239-249. [DOI: 10.1016/j.profnurs.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 06/30/2022] [Accepted: 07/10/2022] [Indexed: 10/16/2022]
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The State of Private Practice. J Am Coll Radiol 2021; 18:767-768. [PMID: 33930335 DOI: 10.1016/j.jacr.2021.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 03/27/2021] [Indexed: 11/21/2022]
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