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Orr CJ, Leslie LK, Schaechter J, Williams XJ, Montez KG, Deen JF, Evans YN, Russell CJ, Webb J, Gaona AR, Mendoza FS. Diversity, Equity, and Inclusion, Child Health, and the Pediatric Subspecialty Workforce. Pediatrics 2024; 153:e2023063678S. [PMID: 38300010 PMCID: PMC10852199 DOI: 10.1542/peds.2023-063678s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 02/02/2024] Open
Abstract
Using multiple metrics, the diversity of the pediatric population in the United States is increasing. However, recent data suggest significant disparities in both the prevalence and management of child health conditions cared for by pediatric subspecialists. These inequities occur across multiple dimensions of diversity, including race and ethnicity, country of origin, socioeconomic status, sex and gender, and disability. Research also suggests that attending to diversity, equity, and inclusion in the medical workforce may positively affect health outcomes. High-quality pediatric subspecialty care thus requires knowledge of these data, attention to the effects of social drivers, including racism and discrimination, on health and wellbeing, and interventions to improve pediatric health equity through educational, practice, policy, and research innovations. In this article, we review data on the diversity of the pediatric population and pediatric subspecialty workforce, suggest potential strengths, weaknesses, opportunities, and threats of current diversity, equity, and inclusion initiatives in academic pediatrics, and provide recommendations across 4 domains: education and training, practice, policy, and future research. The ultimate goal of pediatrics is to improve health equity for all infants, children, adolescents, and young adults cared for in the United States by pediatric subspecialists.
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Affiliation(s)
- Colin J. Orr
- Department of Pediatrics
- Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | | | | | - Kimberly G. Montez
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Jason F. Deen
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Yolanda N. Evans
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | | | - Jonathan Webb
- American Board of Pediatrics, Chapel Hill, North Carolina
- Association of Women’s Health Obstetric and Neonatal Nurses, Washington, District of Columbia
| | | | - Fernando S. Mendoza
- Department of Pediatrics, Stanford School of Medicine, Palo Alto, California
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Robinson LA. American Pediatric Society 2023 Presidential Address-pathways and partnerships in academic pediatrics: the power of possibility. Pediatr Res 2023; 94:1916-1920. [PMID: 37573379 DOI: 10.1038/s41390-023-02771-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/17/2023] [Indexed: 08/14/2023]
Affiliation(s)
- Lisa A Robinson
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
- Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
- Division of Nephrology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
- Program in Cell Biology, The Hospital for Sick Children Research Institute, 686 Bay St, Toronto, ON, M5G 0A4, Canada.
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Avila AH, Weixelbaum JH, Goggans KR, Compton WM. The national institute on drug abuse diversity scholars network: success for a diverse addiction science workforce. Neuropsychopharmacology 2023; 48:1963-1967. [PMID: 37726356 PMCID: PMC10584943 DOI: 10.1038/s41386-023-01733-x] [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] [Received: 05/17/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/21/2023]
Abstract
There is a well-known lack of diversity in many Science, Technology, Engineering, and Mathematics (STEM) fields. The gap in awarded National Institutes of Health (NIH) grants for scientists from underrepresented populations at the early stages of their careers contributes significantly to this lack of diversity. The National Institute on Drug Abuse (NIDA) Diversity Scholars Network (NDSN) program implemented a new model in 2016 to provide support to underrepresented early-career investigators (ECIs) by equipping them to navigate the competitive NIH grant process. NDSN has a demonstrable track record of providing equity through educational opportunities by enhancing the grant funding success of participants. Of 59 participants from 2016 through 2021, 53% received funding within the first two years after completing the program and 69% by four years. NDSN scholars surmount systemic funding barriers by building relationships with scientific coaches, mentors, NIDA Program Officials and intentionally engaging in network building, which all contribute to the funding success of ECIs. NIDA's NDSN program provides a model for retaining underrepresented ECIs that not only benefits individual scholars, but also the institutions they serve and society as a whole.
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Affiliation(s)
- Albert H Avila
- National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
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Ziniel SI, Preciado D, Lee R, Kerschner JE, Ryan AF, Santos-Cortez RLP. Ensuring the future of otitis media research: Interest in and feasibility of a mentoring network program within the otitis media research community. Int J Pediatr Otorhinolaryngol 2023; 172:111693. [PMID: 37579520 PMCID: PMC10523683 DOI: 10.1016/j.ijporl.2023.111693] [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] [Received: 07/07/2023] [Accepted: 08/03/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVES The goal of this study was to assess the feasibility of the implementation of a mentoring network program based on expressed interest and the diverse composition of the otitis media research community in order to address attrition of the scientific workforce. METHODS An online survey was sent to basic, translational, and clinical researchers with a known interest in otitis media. RESULTS Of 509 eligible participants, 119 (23.4%) responded to the survey. Survey respondents had a diverse background by completed education, current job description, and membership in an underrepresented group in science. Most faculty respondents (76.4%) were willing to participate in the proposed program as mentors and faculty lecturers, or had early-career researchers or trainees in their research group who were willing to participate as mentees in the mentoring network. Scientific and non-scientific topics for inclusion in the training program were ranked, with immunology and inflammation, microbiology, science leadership and collaboration, mentoring, and grantsmanship as main foci of interest among respondents. CONCLUSION Our survey results showed enthusiastic participation among responding otitis media researchers, indicating the feasibility of implementing a mentoring network program that will address workforce attrition, particularly among underrepresented groups in science.
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Affiliation(s)
- Sonja I Ziniel
- Section of Pediatric Hospital Medicine, Children's Hospital Colorado, Aurora, CO, 80045, United States; Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, United States.
| | - Diego Preciado
- Departments of Pediatrics and Surgery, George Washington University School of Medicine, Washington D.C., District of Columbia, 20010, United States; Department of Pediatric Otolaryngology, Children's Research Institute, Children's National Health System, Washington D.C., District of Columbia, 20010, United States.
| | - Rita Lee
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, United States.
| | | | - Allen F Ryan
- Department of Otolaryngology, University of California San Diego School of Medicine and Veterans Affairs Medical Center, La Jolla, CA, 92093, United States.
| | - Regie Lyn P Santos-Cortez
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, United States; Center for Children's Surgery, Children's Hospital Colorado, Aurora, CO, 80045, United States.
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Guevara JP, Aysola J, Wade R, Nfonoyim B, Qiu M, Reece M, Carroll KN. Diversity in the pediatric research workforce: a scoping review of the literature. Pediatr Res 2023; 94:904-914. [PMID: 37185966 PMCID: PMC10129297 DOI: 10.1038/s41390-023-02603-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 12/22/2022] [Accepted: 03/30/2023] [Indexed: 05/17/2023]
Abstract
The purpose of this scoping review is to determine trends in racial and ethnic representation, identify barriers and facilitators to greater diversity, and assess strategies and interventions to advance diversity among those in the pediatric research workforce in the U.S. We conducted a scoping review of PubMed supplemented with the authors' personal library of papers published from January 1, 2010, to December 31, 2021. To be eligible, papers had to provide original data, be published in English, report information from a U.S. healthcare institution, and report on outcomes of interest relevant to the child health field. The diversity of faculty has modestly increased over the past decade but reflects a worsening representation compared to overall population trends. This slow increase reflects a loss of diverse faculty and has been referred to as a "leaky pipeline." Strategies to plug the "leaky pipeline" include greater investments in pipeline programs, implementation of holistic review and implicit bias training, development of mentoring and faculty programs targeted to diverse faculty and trainees, alleviation of burdensome administrative tasks, and creation of more inclusive institutional environments. Modest improvements in the racial and ethnic diversity of the pediatric research workforce were identified. However, this reflects worsening overall representation given changing U.S. population demographics. IMPACT: Racial and ethnic diversity in the pediatric research workforce has shown modest increases but worsening overall representation. This review identified barriers and facilitators at the intrapersonal, interpersonal, and institutional levels that impact BIPOC trainees and faculty career advancement. Strategies to improve the pathway for BIPOC individuals include greater investments in pipeline and educational programs, implementation of holistic review admissions and bias training, institution of mentoring and sponsorship, alleviation of burdensome administrative responsibilities, and creation of inclusive institutional climates. Future studies should rigorously test the effects of interventions and strategies designed to improve diversity in the pediatric research workforce.
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Affiliation(s)
- James P Guevara
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania & Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Biostatics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Jaya Aysola
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania & Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Roy Wade
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania & Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Bianca Nfonoyim
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania & Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Maylene Qiu
- Biotech Commons Library, University of Pennsylvania, Philadelphia, PA, USA
| | - Michelle Reece
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania & Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kecia N Carroll
- Department of Pediatrics, Mt Sinai School of Medicine, New York, NY, USA
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Freeman BK, Smith TK. Clinical and Educational Training About Diversity, Equity, Inclusion, and Justice for Pediatric Residents. Pediatr Ann 2023; 52:e256-e260. [PMID: 37427970 DOI: 10.3928/19382359-20230516-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Education and clinical training about diversity, equity, inclusion, and justice (DEIJ) is essential for the personal and professional development of pediatric residents in preparation for a career providing health care to diverse pediatric populations. The ability of pediatric residents to reflect on their lived experiences while gaining perspectives about their patients has the potential to positively affect the health care of patients and decrease health inequities. Clinical rotations were established for students from underrepresented populations in medicine as a pathway for matching and diversifying pediatric residency programs with the potential to help diversify the pediatric workforce. The Accreditation Council for Graduate Medical Education formulated standards about DEIJ in pediatric residency training. Curricula, internships, and mentoring programs have been created by medical institutions and professional medical organizations to provide learning experiences about DEIJ and foster a sense of belonging. This review article highlights the multifactorial approach needed to achieve the goal of diversifying the pediatric workforce through DEIJ instruction in pediatric residency training. [Pediatr Ann. 2023;52(7):e256-e260.].
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Poncelet A, Collins S, Fiore D, Rosenbluth G, Loeser H, Sawaya GF, Teherani A, Chang A. Identifying Value Factors in Institutional Leaders' Perspectives on Investing in Health Professions Educators. JAMA Netw Open 2023; 6:e2256193. [PMID: 36795413 PMCID: PMC9936339 DOI: 10.1001/jamanetworkopen.2022.56193] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
IMPORTANCE Investing in educators, educational innovation, and scholarship is essential for excellence in health professions education and health care. Funds for education innovations and educator development remain at significant risk because they virtually never generate offsetting revenue. A broader shared framework is needed to determine the value of such investments. OBJECTIVE To explore the value factors using the value measurement methodology domains (individual, financial, operational, social or societal, strategic or political) that health professions leaders placed on educator investment programs, including intramural grants and endowed chairs. DESIGN, SETTING, AND PARTICIPANTS This qualitative study used semi-structured interviews with participants from an urban academic health professions institution and its affiliated systems that were conducted between June and September 2019 and were audio recorded and transcribed. Thematic analysis was used to identify themes with a constructivist orientation. Participants included 31 leaders at multiple levels of the organization (eg, deans, department chairs, and health system leaders) and with a range of experience. Individuals who did not respond initially were followed up with until a sufficient representation of leader roles was achieved. MAIN OUTCOMES AND MEASURES Outcomes include value factors defined by the leaders for educator investment programs across the 5 value measurement methodology domains: individual, financial, operational, social or societal, and strategic or political. RESULTS This study included 29 leaders (5 [17%] campus or university leaders; 3 [10%] health systems leaders; 6 [21%] health professions school leaders; 15 [52%] department leaders). They identified value factors across the 5 value measurement methods domains. Individual factors emphasized the impact on faculty career, stature, and personal and professional development. Financial factors included tangible support, the ability to attract additional resources, and the importance of these investments as a monetary input rather than output. Operational factors identified educational programs and faculty recruitment or retention. Social and societal factors showcased scholarship and dissemination benefits to the external community beyond the organization and to the internal community of faculty, learners, and patients. Strategic and political factors highlighted impact on culture and symbolism, innovation, and organizational success. CONCLUSIONS AND RELEVANCE These findings suggest that health sciences and health system leaders find value in funding educator investment programs in multiple domains beyond direct financial return on investment. These value factors can inform program design and evaluation, effective feedback to leaders, and advocacy for future investments. This approach can be used by other institutions to identify context-specific value factors.
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Affiliation(s)
- Ann Poncelet
- University of California, San Francisco, San Francisco, California
| | - Sally Collins
- University of California, San Francisco, San Francisco, California
| | - Darren Fiore
- University of California, San Francisco, San Francisco, California
| | - Glenn Rosenbluth
- University of California, San Francisco, San Francisco, California
| | - Helen Loeser
- University of California, San Francisco, San Francisco, California
| | - George F. Sawaya
- University of California, San Francisco, San Francisco, California
| | - Arianne Teherani
- University of California, San Francisco, School of Medicine, San Francisco, California
| | - Anna Chang
- University of California, San Francisco, San Francisco, California
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8
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Flores AR, Tan TQ, Bryant KA. Creating a Diverse and Inclusive Pediatric Infectious Diseases Workforce. J Pediatric Infect Dis Soc 2022; 11:S125-S126. [PMID: 36099364 PMCID: PMC9494389 DOI: 10.1093/jpids/piac103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Anthony R Flores
- To whom correspondence should be addressed: Anthony R. Flores, MD, MPH, PhD, UTHealth Houston, 6431 Fannin St, MSB 3.130, Houston, TX 77030;
| | - Tina Q Tan
- Department of Pediatrics, Ann and Robert H. Lurie Children’s Hospital of Chicago and Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Kristina A Bryant
- Alternate corresponding author: Kristina A. Bryant, MD, University of Louisville Pediatric Infectious Diseases, 571 South Floyd Street, Suite 321, Louisville, KY 40202;
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Dovat S, Gowda C, Mailman RB, Parent LJ, Huang X. Clinician-Scientist Faculty Mentoring Program (FAME) - A New Inclusive Training Model at Penn State Increases Scholarly Productivity and Extramural Grant Funding. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:1039-1050. [PMID: 36120395 PMCID: PMC9480202 DOI: 10.2147/amep.s365953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Clinician-scientists have a high attrition rate at the junior-faculty level, before they gain independent funding. We identified the lack of skill set, clinician-scientist community and collaboration between clinician-scientists and clinicians with predominantly clinical duties, as key problems in our medium-size college of medicine. METHODS We designed a novel two-year educational program, the Clinician-scientist Faculty Mentoring program (FAME) specifically to target junior clinician-scientists. The program enrollment included both lab-based, "traditional" and "non-traditional" clinician-scientists, with predominantly clinical duties and limited time for research. The curriculum included the novel educational tools: Emerging technology seminars and mentored work-in-progress research seminars, integrated with mock grant review. RESULTS The first class enrolled 17 clinician-scientists with diverse clinical subspecialty, previous research training, and protected research time. After two years in the program, the self-assessment of FAME scholars demonstrated strong improvement in grantsmanship skills, career development, emerging technologies, and the sense of community and collaboration. Compared to the period before initiating FAME, scholars increased annual scholarly output by 65% and new extramural funding by >20-fold ($0.189 vs $4.0 million) following completion of FAME. The "traditional" clinician-scientists, who had >50% research time, increased new extramural funding by ~25-fold ($0.134 vs $3.336 million), whereas "non-traditional" clinician-scientists who had ≤50% research time increased new extramural funding by >13-fold. CONCLUSION Results suggest that a training program tailored specifically to clinician-scientists leads to increased scholarly productivity and grant funding regardless of research background. Implementing this type of training program nationally, with inclusion of clinician-scientists with various amounts of protected time for research, will help both "traditional" and "non-traditional" clinician-scientists to obtain a substantial independent extramural funding, fulfill their scholarly potential, and enhance their sense of community. Our model would be particularly useful for small-to-medium sized academic institutions, who have a limited clinician-scientist workforce facing competing health care system needs.
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Affiliation(s)
- Sinisa Dovat
- Department of Pediatrics, Penn State Milton S. Hershey Medical Center and College of Medicine, Hershey, PA, USA
| | - Chandrika Gowda
- Department of Pediatrics, Penn State Milton S. Hershey Medical Center and College of Medicine, Hershey, PA, USA
| | - Richard B Mailman
- Department of Pharmacology, Penn State Milton S. Hershey Medical Center and College of Medicine, Hershey, PA, USA
- Department of Neurology, Penn State Milton S. Hershey Medical Center and College of Medicine, Hershey, PA, USA
| | - Leslie J Parent
- Department of Medicine and Microbiology and Immunology, Penn State Milton S. Hershey Medical Center and College of Medicine, Hershey, PA, USA
| | - Xuemei Huang
- Department of Pharmacology, Penn State Milton S. Hershey Medical Center and College of Medicine, Hershey, PA, USA
- Department of Neurology, Penn State Milton S. Hershey Medical Center and College of Medicine, Hershey, PA, USA
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Lopez KN, Baker-Smith C, Flores G, Gurvitz M, Karamlou T, Nunez Gallegos F, Pasquali S, Patel A, Peterson JK, Salemi JL, Yancy C, Peyvandi S. Addressing Social Determinants of Health and Mitigating Health Disparities Across the Lifespan in Congenital Heart Disease: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2022; 11:e025358. [PMID: 35389228 PMCID: PMC9238447 DOI: 10.1161/jaha.122.025358] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite the overall improvement in life expectancy of patients living with congenital heart disease (congenital HD), disparities in morbidity and mortality remain throughout the lifespan. Longstanding systemic inequities, disparities in the social determinants of health, and the inability to obtain quality lifelong care contribute to poorer outcomes. To work toward health equity in populations with congenital HD, we must recognize the existence and strategize the elimination of inequities in overall congenital HD morbidity and mortality, disparate health care access, and overall quality of health services in the context of varying social determinants of health, systemic inequities, and structural racism. This requires critically examining multilevel contributions that continue to facilitate health inequities in the natural history and consequences of congenital HD. In this scientific statement, we focus on population, systemic, institutional, and individual‐level contributions to health inequities from prenatal to adult congenital HD care. We review opportunities and strategies for improvement in lifelong congenital HD care based on current public health and scientific evidence, surgical data, experiences from other patient populations, and recognition of implicit bias and microaggressions. Furthermore, we review directions and goals for both quantitative and qualitative research approaches to understanding and mitigating health inequities in congenital HD care. Finally, we assess ways to improve the diversity of the congenital HD workforce as well as ethical guidance on addressing social determinants of health in the context of clinical care and research.
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Cohen A, Montez K, Orr C, Konrath J, Oddiri U, Russell CJ, Gambill L, Nesiama JA, Chung PJ, McNeal-Trice K. Changing Who Has a Seat and Voice at the Table: How the Academic Pediatric Association is Responding to Systemic Racism. Acad Pediatr 2022; 22:352-355. [PMID: 35032709 DOI: 10.1016/j.acap.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 11/28/2022]
Abstract
The Academic Pediatrics Association has taken multiple steps over the last 2 years to incorporate the lenses of anti-racism and social justice into our mission and work. In this commentary, we discuss the creation and work of the Anti-Racism and Diversity Task Force, which was charged by the Academic Pediatrics Association's Board of Directors with identifying strategies to promote anti-racism and advance the diversity, equity and inclusion agenda.
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Affiliation(s)
- Adam Cohen
- Division of Hospital Medicine, (Adam Cohen), Baylor College of Medicine and Texas Children's Hospital, Houston, Tex.
| | - Kimberly Montez
- Department of Pediatrics, (Kimberly Montez), Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC
| | - Colin Orr
- Division of General Pediatrics and Adolescent Medicine, (Colin Orr), Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Jessica Konrath
- Academic Pediatrics Association, (Jessica Konrath), McLean, Va
| | - Uchechi Oddiri
- Division of Pediatric Critical Care Medicine, (Uchechi Oddiri), Stony Brook University Renaissance School of Medicine, Stony Brook, NY
| | - Christopher J Russell
- Division of Hospital Medicine, (Christopher J. Russell), Children's Hospital Los Angeles, Los Angeles Calif; Department of Pediatrics, (Christopher J. Russell), Keck School of Medicine, University of Southern California, Los Angeles Calif
| | - Lauren Gambill
- Pediatrics University of Texas at Austin Dell Medical School, (Lauren Gambill), Pediatric Hospitalist Dell Children's Medical Center of Central, Austin, Tex
| | - Jo-Ann Nesiama
- Division of Emergency Medicine, (Jo-Ann Nesiama), UT Southwestern Medical Center, Dallas, Tex
| | - Paul J Chung
- Kaiser Permanente Bernard J. Tyson School of Medicine, (Paul J. Chung), Pasadena, CA; University of California Los Angeles, Los Angeles, Calif
| | - Kenya McNeal-Trice
- Department of Pediatrics, (Kenya McNeal-Trice), Division of Hospital Medicine and Division of General Pediatrics and Adolescent Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
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Davenport D, Alvarez A, Natesan S, Caldwell M, Gallegos M, Landry A, Parsons M, Gottlieb M. Faculty Recruitment, Retention, and Representation in Leadership: An Evidence-Based Guide to Best Practices for Diversity, Equity, and Inclusion from the Council of Residency Directors in Emergency Medicine. West J Emerg Med 2022; 23:62-71. [PMID: 35060865 PMCID: PMC8782137 DOI: 10.5811/westjem.2021.8.53754] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 08/02/2021] [Indexed: 12/17/2022] Open
Abstract
Improving the recruitment, retention, and leadership advancement of faculty who are under-represented in medicine is a priority at many academic institutions to ensure excellence in patient care, research, and health equity. Here we provide a critical review of the literature and offer evidence-based guidelines for faculty recruitment, retention, and representation in leadership. Recommendations for recruitment include targeted recruitment to expand the candidate pool with diverse candidates, holistic review of applications, and incentivizing stakeholders for success with diversity efforts. Retention efforts should establish a culture of inclusivity, promote faculty development, and evaluate for biases in the promotion and tenure process. We believe this guide will be valuable for all leaders and faculty members seeking to advance diversity, equity, and inclusion in their institutions.
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Affiliation(s)
- Dayle Davenport
- Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois
| | - Al’ai Alvarez
- Stanford University School of Medicine, Department of Emergency Medicine, Stanford, California
| | - Sreeja Natesan
- Duke University School of Medicine, Division of Emergency Medicine, Durham, North Carolina
| | - Martina Caldwell
- Henry Ford Health System, Department of Emergency Medicine, Detroit, Michigan
| | - Moises Gallegos
- Stanford University School of Medicine, Department of Emergency Medicine, Stanford, California
| | - Adaira Landry
- Harvard University School of Medicine, Division of Emergency Medicine, Boston, Massachusetts
| | - Melissa Parsons
- University of Florida School of Medicine, Department of Emergency Medicine, Jacksonville, Florida
| | - Michael Gottlieb
- Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois
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Tagge R, Lackland DT, Gorelick PB, Litvan I, Cruz-Flores S, Merino JG, Ovbiagele B. Career Development Program for Underrepresented in Medicine Scholars in Academic Neurology: TRANSCENDS. Neurology 2021; 97:125-133. [PMID: 33893201 PMCID: PMC8302150 DOI: 10.1212/wnl.0000000000012058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/02/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The Training in Research for Academic Neurologists to Sustain Careers and Enhance the Numbers of Diverse Scholars (TRANSCENDS) program is a career advancement opportunity for individuals underrepresented in biomedical research funded by the National Institute of Neurologic Disorders and Stroke and American Academy of Neurology (AAN). OBJECTIVE To report on qualitative and quantitative outcomes in TRANSCENDS. DESIGN Early career individuals (neurology fellows and junior faculty) from groups underrepresented in medicine (UIM) were competitively selected from a national pool of applicants (2016-2019). TRANSCENDS activities comprised an online Clinical Research degree program, monthly webinars, AAN meeting activities, and mentoring. Participants were surveyed during and after completion of TRANSCENDS to evaluate program components. OUTCOMES Of 23 accepted scholars (comprising 4 successive cohorts), 56% were women, 61% Hispanic/Latinx, 30% Black/African American, and 30% assistant professors. To date, 48% have graduated the TRANSCENDS program and participants have published 180 peer-reviewed articles. Mentees' feedback noted that professional skills development (i.e., manuscript and grant writing), networking opportunities, and mentoring were the most beneficial elements of the program. Stated opportunities for improvement included incorporating a mentor-the-mentor workshop, providing more transitional support for mentees in the next stage of their careers, and requiring mentees to provide quarterly reports. CONCLUSIONS TRANSCENDS is a feasible program for supporting UIM neurologists towards careers in research and faculty academic appointments attained thus far have been sustained. Although longer-term outcomes and process enhancements are warranted, programs like this may help increase the numbers of diverse academic neurologists and further drive neurologic innovation.
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Affiliation(s)
- Raelle Tagge
- From the Northern California Institute for Research and Education (R.T.), San Francisco; Department of Neurology (D.T.L.), Medical University of South Carolina, Charleston; Davee Department of Neurology (P.B.G.), Northwestern University School of Medicine, Chicago, IL; Department of Neurosciences (I.L.), University of California San Diego; Department of Neurology (S.C.-F.), Texas Tech, El Paso; Department of Neurology (J.G.M.), Georgetown University, Washington, DC; and Department of Neurology (B.O.), University of California, San Francisco
| | - Daniel T Lackland
- From the Northern California Institute for Research and Education (R.T.), San Francisco; Department of Neurology (D.T.L.), Medical University of South Carolina, Charleston; Davee Department of Neurology (P.B.G.), Northwestern University School of Medicine, Chicago, IL; Department of Neurosciences (I.L.), University of California San Diego; Department of Neurology (S.C.-F.), Texas Tech, El Paso; Department of Neurology (J.G.M.), Georgetown University, Washington, DC; and Department of Neurology (B.O.), University of California, San Francisco
| | - Philip B Gorelick
- From the Northern California Institute for Research and Education (R.T.), San Francisco; Department of Neurology (D.T.L.), Medical University of South Carolina, Charleston; Davee Department of Neurology (P.B.G.), Northwestern University School of Medicine, Chicago, IL; Department of Neurosciences (I.L.), University of California San Diego; Department of Neurology (S.C.-F.), Texas Tech, El Paso; Department of Neurology (J.G.M.), Georgetown University, Washington, DC; and Department of Neurology (B.O.), University of California, San Francisco
| | - Irene Litvan
- From the Northern California Institute for Research and Education (R.T.), San Francisco; Department of Neurology (D.T.L.), Medical University of South Carolina, Charleston; Davee Department of Neurology (P.B.G.), Northwestern University School of Medicine, Chicago, IL; Department of Neurosciences (I.L.), University of California San Diego; Department of Neurology (S.C.-F.), Texas Tech, El Paso; Department of Neurology (J.G.M.), Georgetown University, Washington, DC; and Department of Neurology (B.O.), University of California, San Francisco
| | - Salvador Cruz-Flores
- From the Northern California Institute for Research and Education (R.T.), San Francisco; Department of Neurology (D.T.L.), Medical University of South Carolina, Charleston; Davee Department of Neurology (P.B.G.), Northwestern University School of Medicine, Chicago, IL; Department of Neurosciences (I.L.), University of California San Diego; Department of Neurology (S.C.-F.), Texas Tech, El Paso; Department of Neurology (J.G.M.), Georgetown University, Washington, DC; and Department of Neurology (B.O.), University of California, San Francisco
| | - José G Merino
- From the Northern California Institute for Research and Education (R.T.), San Francisco; Department of Neurology (D.T.L.), Medical University of South Carolina, Charleston; Davee Department of Neurology (P.B.G.), Northwestern University School of Medicine, Chicago, IL; Department of Neurosciences (I.L.), University of California San Diego; Department of Neurology (S.C.-F.), Texas Tech, El Paso; Department of Neurology (J.G.M.), Georgetown University, Washington, DC; and Department of Neurology (B.O.), University of California, San Francisco
| | - Bruce Ovbiagele
- From the Northern California Institute for Research and Education (R.T.), San Francisco; Department of Neurology (D.T.L.), Medical University of South Carolina, Charleston; Davee Department of Neurology (P.B.G.), Northwestern University School of Medicine, Chicago, IL; Department of Neurosciences (I.L.), University of California San Diego; Department of Neurology (S.C.-F.), Texas Tech, El Paso; Department of Neurology (J.G.M.), Georgetown University, Washington, DC; and Department of Neurology (B.O.), University of California, San Francisco.
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14
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Roberts LW. Going Extraordinary Distances With Physician-Scientists. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:477-478. [PMID: 33782227 DOI: 10.1097/acm.0000000000003923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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15
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Andriole DA, Wolfson RK. The Physician-Investigator Workforce: Looking Ahead. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:486-489. [PMID: 33496430 DOI: 10.1097/acm.0000000000003944] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Support of the U.S. health professions investigator workforce is critically important to the continued advancement of health care nationally. Physician-investigators comprise one segment of this health professions investigator workforce, which also includes investigators in the nursing, pharmacy, and dentistry professions, and others. Among physician health professionals in particular, the term "physician-investigator" has been described as encompassing physicians engaged in research in various ways including "clinical researchers" (physicians with clinical duties who do clinical, patient-centered research), "clinician-scientists" (physicians with clinical roles who perform research in laboratories or using computational tools), and "physician-scientists" (physicians focused on research with little or no clinical activity). Broadly defined, physician-investigators are included in various groups of researchers described in several articles recently published in Academic Medicine; these articles provide details on a range of approaches, with supporting outcomes data, being taken to train, support, and retain physicians in the health professions investigator workforce. The authors of this commentary examine selected literature, including several articles in this issue among others, along with Association of American Medical Colleges data, to offer observations about programs that train physician-investigators. Evidence-informed single-program approaches for early-career researchers can sustain continued research interest and foster the career development of the emerging physician-investigator workforce. Collaborative multi-institutional approaches offer the benefit of multisite work to power outcomes studies and to increase generalizability beyond a specific institutional program. System-wide institutional approaches may be particularly critical in supporting physician-investigators across all career stages. Although the articles discussed in this commentary are largely (although not exclusively) focused on various initiatives and programs designed to develop and sustain the physician-investigator workforce, such initiatives and programs may have value in addressing shared challenges of developing, supporting, and retaining the broader investigator workforce across all health professions.
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Affiliation(s)
- Dorothy A Andriole
- D.A. Andriole is senior director, Medical Education Research, Association of American Medical Colleges, Washington, DC; ORCID: https://orcid.org/0000-0001-8902-1227
| | - Rachel K Wolfson
- R.K. Wolfson is associate professor, Department of Pediatrics, and co-director, Scholarship & Discovery, University of Chicago Pritzker School of Medicine, Chicago, Illinois; ORCID: https://orcid.org/0000-0003-0326-1540
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16
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Ransdell LB, Lane TS, Schwartz AL, Wayment HA, Baldwin JA. Mentoring New and Early-Stage Investigators and Underrepresented Minority Faculty for Research Success in Health-Related Fields: An Integrative Literature Review (2010-2020). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020432. [PMID: 33430479 PMCID: PMC7826619 DOI: 10.3390/ijerph18020432] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 12/12/2022]
Abstract
Mentoring to develop research skills is an important strategy for facilitating faculty success. The purpose of this study was to conduct an integrative literature review to examine the barriers and facilitators to mentoring in health-related research, particularly for three categories: new investigators (NI), early-stage investigators (ESI) and underrepresented minority faculty (UMF). PsychINFO, CINAHL and PubMed were searched for papers published in English from 2010 to 2020, and 46 papers were reviewed. Most papers recommended having multiple mentors and many recommended assessing baseline research skills. Barriers and facilitators were both individual and institutional. Individual barriers mentioned most frequently were a lack of time and finding work-life balance. UMF mentioned barriers related to bias, discrimination and isolation. Institutional barriers included lack of mentors, lack of access to resources, and heavy teaching and service loads. UMF experienced institutional barriers such as devaluation of experience or expertise. Individual facilitators were subdivided and included writing and synthesis as technical skills, networking and collaborating as interpersonal skills, and accountability, leadership, time management, and resilience/grit as personal skills. Institutional facilitators included access to mentoring, professional development opportunities, and workload assigned to research. Advocacy for diversity and cultural humility were included as unique interpersonal and institutional facilitators for UMF. Several overlapping and unique barriers and facilitators to mentoring for research success for NI, ESI and UMF in the health-related disciplines are presented.
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Affiliation(s)
- Lynda B. Ransdell
- Center for Health Equity Research, Northern Arizona University, 1395 S Knoles Drive, Suite 140, Flagstaff, AZ 86011, USA; (T.S.L.); (A.L.S.); (H.A.W.); (J.A.B.)
- Department of Health Sciences, Northern Arizona University, 1100 S Beaver St, Flagstaff, AZ 86011, USA
- Correspondence:
| | - Taylor S. Lane
- Center for Health Equity Research, Northern Arizona University, 1395 S Knoles Drive, Suite 140, Flagstaff, AZ 86011, USA; (T.S.L.); (A.L.S.); (H.A.W.); (J.A.B.)
| | - Anna L. Schwartz
- Center for Health Equity Research, Northern Arizona University, 1395 S Knoles Drive, Suite 140, Flagstaff, AZ 86011, USA; (T.S.L.); (A.L.S.); (H.A.W.); (J.A.B.)
- School of Nursing, Northern Arizona University, 202 E Pine Knoll Dr, Flagstaff, AZ 86011, USA
| | - Heidi A. Wayment
- Center for Health Equity Research, Northern Arizona University, 1395 S Knoles Drive, Suite 140, Flagstaff, AZ 86011, USA; (T.S.L.); (A.L.S.); (H.A.W.); (J.A.B.)
- Department of Psychological Sciences, Northern Arizona University, 1100 S Beaver St, Flagstaff, AZ 86011, USA
| | - Julie A. Baldwin
- Center for Health Equity Research, Northern Arizona University, 1395 S Knoles Drive, Suite 140, Flagstaff, AZ 86011, USA; (T.S.L.); (A.L.S.); (H.A.W.); (J.A.B.)
- Department of Health Sciences, Northern Arizona University, 1100 S Beaver St, Flagstaff, AZ 86011, USA
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