Addressing Surgical Disparities at the Root; Working to improve diversity in the surgical workforce

从根本上解决手术差异；

• 批准号: 10639471
• 负责人: JULIE ANN SOSA
• 金额: $ 78.18万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-16 至 2027-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10639471
• 关键词: Academia; Academic Medical Centers; Accreditation; Address; Administrator; Ally; American; Area; Asian; Association of American Medical Colleges; Black Populations; Black race; COVID-19 pandemic; Caring; Certification; Characteristics; Client satisfaction; Clinical Trials; Collaborations; Complex; Data; Data Analyses; Disparity; Drops; Enabling Factors; Enrollment; Ethnic Origin; Faculty; Failure; Feedback; Female; Focus Groups; Future; Gender; General Population; Guidelines; Hispanic; Historically Black Colleges and Universities; Individual; Infrastructure; Institution; Intervention; Interview; Latino; Measures; Medical; Medical Students; Medicine; Mentorship; Methodology; Methods; Minority; Murder; Nature; Operative Surgical Procedures; Organizational Culture; Outcome; Patient Care; Patient advocacy; Patient-Focused Outcomes; Patients; Perioperative; Physicians; Pilot Projects; Play; Population; Practice Guidelines; Process; Qualifying; Quality of Care; Race; Records; Research; Research Personnel; Residencies; Risk; Running; Sex Orientation; Societies; Surgeon; Surgical Specialties; Surveys; Testing; Training; Training Programs; Underrepresented Minority; Uninsured; Universities; Woman; Work; black men; care outcomes; career; cohort; cultural competence; disparity reduction; equity, diversity, and inclusion; experience; faculty support; follow-up; gender disparity; graduate medical education; high risk; improved; improved outcome; male; medical schools; medical specialties; mid-career faculty; minority patient; novel; parity; patient advocacy group; patient population; professor; programs; racial disparity; racial population; satisfaction; senior faculty; sociodemographic factors; sociodemographics; statistics; success; surgery outcome; surgical disparities; treatment planning; underserved area; women faculty

Abstract Addressing Surgical Disparities at the Root: Improving Diversity in the Surgical Workforce The recent COVID-19 pandemic, racially motivated murders, and subsequent protests underscore what we already know--that racial disparities in medicine run far deeper than patient outcomes alone and must be addressed at all levels. Racial and gender disparities in surgical outcomes and satisfaction are well documented. From a pipeline perspective, surgery struggles to maintain and promote underrepresented minority (UIM) and women residents and faculty. Efforts to improve diversity in the workforce overtime have not kept pace with the increased diversity in our patient populations. There is evidence that improving diversity in the surgical workforce can improve the quality and outcomes of care for UIM and women patients. The proposed study involves a team of interdisciplinary investigators with complimentary expertise and a strong record of research in the topic area collaborating with multiple stakeholder societies. Our objective is to reduce disparities in surgical care using a novel, transdisciplinary, multi-institutional deviance approach to characterize disparities in the surgical workforce, set best practice guidelines, and develop a pilot intervention. Our central hypothesis is that by using deviance methodology we can identify best practices in retention and promotion of women and minority faculty and trainees in surgery that can be used to help increase diversity in the work force and ultimately patient quality of care. We will perform a secondary data analysis to measure diversity among surgical faculty across the U.S.; identify programs with the best and worst records of promotion and retention of UIM and women faculty; and document the range of promotion and retention among these groups at academic medical centers to identify predictors of successful diversity efforts Using AAMC data combined with ABS data and qualifying as well as certifying examination data, we will describe the sociodemographic profile of surgical trainees and current attrition rates for surgical residents in the U.S., identifying those programs with the best and worst records of graduating residents. We will utilize data on cultural competency and bias assessment surveys collected from our target programs as well as focus groups with the National Medical Association, the Association of Women Surgeons and the Historically Black Medical Colleges and Universities and in-depth, qualitative interviews with program administrators, UIM and women trainees, faculty, and department and division heads at programs that have been successful - or struggled at - retaining and promoting UIM and women faculty to study best and worst practices and organizational characteristics. Finally, we will take predictors from our quantitative analysis, themes from our qualitative analysis, and coordinate a Delphi panel of academic leaders and patient advocacy groups to create a set of best practice guidelines and develop a pilot study to test at poorly performing programs. By defining best practices for retention and promotion of residents and faculty, we can develop best practices and test these to help improve diversity, equity, and inclusion in the academic surgical workforce.

摘要 从根本上解决外科差异：改善外科劳动力的多样性 最近的新冠肺炎大流行，出于种族动机的谋杀，以及随后的抗议活动，强调了我们 已经知道--医学上的种族差异远远超过患者本身的结果，而且肯定是 解决了所有级别的问题。种族和性别差异在手术结果和满意度方面有很好的记录。 从渠道的角度来看，外科手术努力维持和促进代表不足的少数群体(UIM)和 女住院医生和教职员工。加班加点提高劳动力多样性的努力没有跟上 增加了我们患者群体的多样性。有证据表明，提高外科工作人员的多样性 可以改善UIM和女性患者的护理质量和结果。拟议中的研究涉及一个团队 具有丰富专业知识和在该主题领域有良好研究记录的跨学科调查人员 与多个利益相关者协会合作。我们的目标是减少外科护理方面的差距 新的，跨学科的，多机构的偏差方法来表征外科劳动力中的差异， 制定最佳实践指南，并制定试点干预措施。我们的中心假设是，通过使用偏差 方法我们可以确定留住和提拔女性和少数族裔教职员工的最佳做法 外科实习生，可用于帮助增加劳动力的多样性，并最终提高患者的质量 关心。我们将进行二次数据分析，以衡量全美外科教师的多样性； 确定在UIM和女性教员的晋升和留用方面记录最好和最差的项目；以及 记录学术医疗中心这些群体的晋升和保留范围，以确定 使用AAMC数据结合ABS数据和资格验证的成功多样性努力的预测因素 认证考试数据，我们将描述外科实习生的社会人口学概况和目前 美国外科住院医师的流失率，确定那些记录最好和最差的项目 即将毕业的实习医生。我们将利用从以下来源收集的文化能力和偏见评估调查数据 我们的目标方案以及与国家医学协会、妇女协会的焦点小组 与外科医生和历史上的黑人医学院校进行深入、定性的访谈 以下项目的项目管理员、UIM和女性实习生、教员以及部门和部门负责人 成功地-或在努力-留住和提拔UIM和女性教职员工学习最好和最差 实践和组织特征。最后，我们将从我们的定量分析中提取预测因素， 主题从我们的定性分析，并协调德尔福小组的学术领袖和患者倡导 小组创建了一套最佳实践指南，并开发了一项试点研究，以测试表现不佳的项目。 通过定义留住和提升住院医师和教师的最佳做法，我们可以制定最佳做法 并对这些进行测试，以帮助提高学术外科劳动力的多样性、公平性和包容性。