Time to act: A rubric-based approach for institutionalizing justice, equity, diversity, and inclusion

Attacks on minoritized communities and increasing awareness of the societal causes of health disparities have combined to highlight deep systemic inequities. In response, academic health centers have prioritized justice, equity, diversity, and inclusion (JEDI) in their strategic goals. To have a sustained impact, JEDI efforts cannot be siloed; rather, they must be woven into the fabric of our work and systematically assessed to promote meaningful outcomes and accountability. To this end, the University of Pittsburgh's Institute for Clinical Research Education assembled a task force to create and apply a rubric to identify short and long-term JEDI goals, assess the current state of JEDI at our Institute, and make recommendations for immediate action. To ensure deep buy-in, we gathered input from diverse members of our academic community, who served on targeted subcommittees. We then applied a three-step process to ensure rapid forward progress. We emerged with concrete actions for priority focus and a plan for ongoing assessment of JEDI institutionalization. We believe our process and rubric offer a scalable and adaptable model for other institutions and departments to follow as we work together across academic medical institutions to put our justice, equity, diversity, and inclusion goals into meaningful action.

Shut Up & Write!® builds writing self-efficacy and self-regulation in early-career researchers

Introduction

High writing self-efficacy and self-regulation are tied to publication and grant submission. Writers with these attributes are more productive. We investigated whether participating in a Shut Up & Write!®-style intervention (SUAW) would produce statistically significant gains in writing self-efficacy and self-regulation when comparing pre-post-participation surveys.

Methods

Forty-seven medical students, TL1/KL2, and early-career faculty from across the USA expressed interest in participating, with 37 completing the pre-survey. We conducted (on Zoom) a 12-week SUAW series and measured the effect using a pre-post survey adapted from the Writer Self-Perception Scale. Paired t-tests (α = 0.05) were conducted on three subscales to test for significant differences between pre- and post-test means. The subscales reflected writing attitudes, writing strategies, and avoiding writing distractions. Subscales showed acceptable internal consistency with Cronbach's alphas of 0.80, 0.71, and 0.72, respectively.

Results

Twenty-seven participants attended at least one session. Of these, 81% presented as female, and 60% were from NIH-defined Underrepresented Backgrounds and/or were from Minority-Serving Institutions. Twenty-four completed both the pre- and post-surveys. Sixty percent previously participated in an activity similar to SUAW. We found significant improvements in writing attitudes (p = 0.020) and writing strategies (p = 0.041) for those who previously participated. For those who had not previously participated, we found improved writing strategies (p = 0.002). Eighty percent were very satisfied/satisfied with SUAW.

Discussion

Researchers have tied writing self-efficacy and self-regulation to timely publication and grant submission. We found significant gains in self-efficacy and self-regulation, suggesting that participation in a SUAW-style intervention may increase writing productivity.

A Mixed-Methods Analysis of Gender and Career Status Differences in the Impact of the COVID-19 Pandemic on Underrepresented Postdoctoral Fellows and Early-Career Faculty

PURPOSE

The lack of racial and ethnic diversity in the biomedical workforce is pronounced and those from underrepresented backgrounds encounter more challenges than their majority counterparts. The extent of the impact of the COVID-19 pandemic on early-career investigators from underrepresented backgrounds is not yet fully understood. To examine the impact of the pandemic on underrepresented early-career biomedical researchers, this study evaluated differences in productivity, research, and psychological well-being by gender and career status.

METHOD

This was a cross-sectional analysis of preintervention data, collected in September-October 2020, from 220 participants enrolled in the Building Up a Diverse Biomedical Research Workforce study. Participants were from 25 academic medical centers in the United States and were underrepresented early-career researchers. The primary outcomes were agreement on a 5-point Likert scale with pandemic impact statements (e.g., "The COVID-19 pandemic has impacted my ability to conduct research"). Thematic analysis was conducted on responses to 2 open-ended questions assessing the pandemic's impact.

RESULTS

Most participants were female (79.9%), of non-Hispanic/Latinx/Spanish origin Black/African American (33.2%) or Hispanic/Latinx/Spanish origin (34.1%), and early-career faculty (53.4%). Over half of participants agreed or strongly agreed that the COVID-19 pandemic impacted their ability to work (55.7%) and conduct research (70.7%). Themes from qualitative analysis suggested lower research productivity, concerns about the academic job market and funding, and psychological distress due to the pandemic. Women were more likely to attribute lost productivity and psychological distress to homeschooling and childcare responsibilities. Postdoctoral fellows were concerned about more competition for fewer academic positions.

CONCLUSIONS

In this study of early-career underrepresented biomedical researchers, the impact of the COVID-19 pandemic was widely felt by participants, varying by gender and career status. For those postdoctoral fellows and early-career faculty who are underrepresented, it is critical for institutions to offer flexibility in their positions.

Evaluation of two longitudinal faculty leadership training programs: behavioral change and institutional impact

Purpose

Building leadership skills among faculty in academic medicine is essential, yet professional development programs focused on leadership are not always attentive to the needs of faculty on diverse career pathways or at differing career stages—nor are they often rigorously assessed. Evaluations commonly focus on participant satisfaction and short-term learning but not behavior change and institutional impact, which are difficult to assess but arguably more meaningful. Given the substantial time and money invested in these programs, more rigorous evaluation is critical.

Design/methodology/approach

The authors evaluated an intensive, shared leadership-focused training program for early-career and mid-career faculty, offered by the University of Pittsburgh’s School of Medicine over the course of a year. They administered a pre/post-program assessment of confidence in key skill areas, and conducted semi-structured interviews with 21 participants between 1–4 years after program completion.

Findings

Participants in both programs showed statistically significant improvement (p < 0.001) on every item measured in the pre/post-test. Analysis of the interviews revealed indications of substantial behavior change as well as institutional impact. The evaluation also suggested particular benefits for female professionals.

Originality/value

The authors conducted a long-term assessment of leadership training focused on career pathway and career stage and found that it (a) prompted both positive behavioral change and institutional impact and (b) suggested benefits for female faculty in particular, which could potentially help to eliminate gender-based disparities in leadership in academic medical centers.

Reducing tensions and expediting manuscript submission via an authorship agreement for early-career researchers: A pilot study

Authorship can be a source of tension on research teams, in academic/industry collaborations, and between mentors/mentees. Authorship misconduct is prevalent among biomedical researchers, and disputes about authorship can generate tensions that have the potential to disrupt professional relationships and damage careers. Early-career researchers may experience particular challenges navigating authorship both because of inexperience and power differentials; in effect, they lack the language and confidence to have these conversations and may feel unwilling to challenge the status quo. The authors implemented an Authorship Agreement for use when collaborating on a manuscript and hypothesized that using this agreement would reduce authorship tensions and speed time to manuscript submission by helping early-career investigators manage authorship conversations more effectively. The authors surveyed trainees (n = 65) on the prevalence of authorship-related tensions and compared the results from the first survey in 2017 to the final survey in 2020. The decrease in tensions around meeting deadlines was significant (z = 2.59, p = 0.010). The authors believe the effect of an Authorship Agreement on authorship-related tensions has not previously been investigated. This work extends what is known about the prevalence of commonly cited authorship tensions, and provides evidence of the effectiveness of steps that can be taken to alleviate them.

The impact of the COVID-19 pandemic on underrepresented early-career PhD and physician scientists

Underrepresented minorities have higher attrition from the professoriate and have experienced greater negative impacts of the COVID-19 pandemic. The purpose of this study was to compare the impact of COVID-19 on the lives of 196 early-career physician-scientists versus PhD researchers who are underrepresented in biomedical research. Participants in the Building Up study answered questions on the impact of the COVID-19 pandemic on their personal and professional lives, and a mixed-methods approach was used to conduct the analysis. While most participants experienced increases in overall stress (72% of PhD researchers vs 76% of physician-scientists), physician-scientists reported that increased clinical demands, research delays, and the potential to expose family members to SARS-CoV-2 caused psychological distress, specifically. PhD researchers, more than physician-scientists, reported increased productivity (27% vs 9%), schedule flexibilities (49% vs 25%), and more quality time with friends and family (40% vs 24%). Future studies should consider assessing the effectiveness of programs addressing COVID-19-related challenges experienced by PhD researchers and physician-scientists, particularly those from underrepresented backgrounds.

The Highly Structured Physician Scientist Training Program (PSTP) for Medical Students at the University of Pittsburgh

The University of Pittsburgh School of Medicine Physician Scientist Training Program (PSTP) is a 5-year medical student training program designed to prepare the next generation of MD-only physician-scientists engaging in preclinical research. This article provides an overview of the program, including the novel longitudinal structure and competency goals, which facilitate success and persistence in a laboratory-based physician-scientist career. The authors present data on 81 medical students accepted to the program from academic year 2007-2008 through 2018-2019. Extrinsic outcomes, such as publications, grant funding, and residency matching, indicate that PSTP trainees have actively generated research deliverables. A majority of eligible PSTP trainees have earned Howard Hughes Medical Institute Medical Research Fellow funding. PSTP students have produced a mean of 1.6 first-authored publications (median, 1.0) and a mean of 5.1 total publications (median, 4.0) while in medical school and have authored 0.9 publications per year as residents/fellows, excluding internship. Nearly 60% of PSTP students (26/46) have matched to top-10 National Institutes of Health-funded residency programs in their specialty (based on Blue Ridge Institute rankings). PSTP alumni are twice as likely as their classmates to match into research-heavy departments and to publish first-authored papers. Results of a 2018 program evaluation survey indicate that intrinsic outcomes, such as confidence in research skills, significantly correlate with extrinsic outcomes. The program continues to evolve to maximize both scientific agency and career navigation skills in participants. This medical student PSTP model has potential to expand the pool of physician-scientist researchers in preclinical research beyond the capacity of dedicated MD-PhD and postgraduate training programs.

Developing a team science workshop for early-career investigators

INTRODUCTION

High impact biomedical research is increasingly conducted by large, transdisciplinary, multisite teams in an increasingly collaborative environment. Thriving in this environment requires robust teamwork skills, which are not acquired automatically in the course of traditional scientific education. Team science skills training does exist, but most is directed at clinical care teams, not research teams, and little is focused on the specific training needs of early-career investigators, whose early team leadership experiences may shape their career trajectories positively or negatively. Our research indicated a need for team science training designed specifically for early-career investigators.

METHODS

To address this need, we designed and delivered a 2-day workshop focused on teaching team science skills to early-career investigators. We operationalized team science competencies, sought the advice of team science experts, and performed a needs assessment composed of a survey and a qualitative study. Through these multiple approaches, we identified and grouped training priorities into three broad training areas and developed four robust, hands-on workshop sessions.

RESULTS

Attendees comprised 30 pre- and post-doc fellows (TL1) and early-career faculty (KL2 and K12). We assessed impact with a pre- and post-workshop survey adapted from the Team Skills Scale. Results from the pre- and post-test Wilcoxon signed-rank analysis (n = 25) showed statistically significant improvement in team science skills and confidence. Open-ended responses indicated that the workshop focus was appropriate and well targeted to the trainees' needs.

CONCLUSIONS

Although team science education is still very much in its infancy, these results suggest that training targeted to early-career investigators improves team skills and may foster improved collaboration.

Associations of Lesbian, Gay, Bisexual, Transgender, and Questioning-Inclusive Sex Education With Mental Health Outcomes and School-Based Victimization in U.S. High School Students

PURPOSE

Homophobic school climates are related to increased victimization for sexual minority youth (SMY), leading to increased risk of adverse mental health outcomes. Interventions that promote positive school climate may reduce the risk of victimization and adverse mental health outcomes in SMY. This study explored whether lesbian, gay, bisexual, transgender, and questioning (LGBTQ)-inclusive sex education is associated with adverse mental health and school-based victimization in U.S. youth.

METHODS

Data analysis of representative data from the 2015 Youth Risk Behavior Survey and the 2014 School Health Profiles was conducted using multilevel logistic models testing whether youth in states with higher proportions of schools teaching LGBTQ-inclusive sex education had lower odds of reporting being bullied in school and experiencing adverse mental health outcomes, including depressive symptoms and suicidality.

RESULTS

After controlling for covariates, protective effects for all youth were found for suicidal thoughts (adjusted odds ratio [AOR]: .91, 95% confidence interval [CI]: .89-.93) and making a suicide plan (AOR: .79; 95% CI: .77-.80). Lesbian and gay youth had lower odds of experiencing bullying in school as the proportion of schools within a state teaching LGBTQ-inclusive sex education increased (AOR: .83; CI: .71-.97). Bisexual youth had significantly lower odds of reporting depressive symptoms (AOR: .92; 95% CI: .87-.98).

CONCLUSIONS

Students in states with a greater proportion of LGBTQ-inclusive sex education have lower odds of experiencing school-based victimization and adverse mental health. These findings can be used to guide intervention development at the school and state levels.