Improving Inclusion in Surgical Residency to Advance Workforce Diversity and Health Equity

提高外科住院医师的包容性，促进劳动力多样性和健康公平

• 批准号: 10724085
• 负责人: Yue-Yung Hu
• 金额: $ 14.94万
• 依托单位: LURIE CHILDREN'S HOSPITAL OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2028-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10724085
• 关键词: Improving; Inclusion; Surgical; Residency; Advance

PROJECT SUMMARY Physician diversity reduces health disparities. Yet, despite powerful pro-diversity statements from the Institute of Medicine, the American Medical Association, the Association of American Medical Colleges, the Accreditation Council for Graduate Medical Education, the American College of Surgeons, and the American Surgical Association, diversity remains elusive at all levels in surgery. Lack of inclusion in surgical residency underlies this lack of workforce diversity. To date, efforts to improve inclusion in healthcare have focused on individual beliefs or skills, such as implicit bias training. However, data from organizational psychology, the scientific field that applies sociocultural psychology to understand human behavior in the workplace, demonstrate that such training does not result in sustained behavioral change. Rather, behavior is understood to reflect organizational culture. Culture, the shared and fundamental beliefs, normative values, and related social practices of a workplace, profoundly impacts work engagement, relationships with colleagues, and the ability to collaborate to achieve common goals. In order to meaningfully increase inclusion, interventions must address organizational culture. The candidate, a pediatric surgeon, is seeking to develop, contextually adapt, and implement theoretically driven, evidence-based interventions to improve inclusion in surgical residency programs. To accomplish the aims of the proposed project, the candidate needs to acquire knowledge, skills, and experience in (1) organizational psychology; (2) user-centered design, and (3) applied implementation science. The project proposes to (1) examine the features of organizational culture (e.g., policies, practices) that support or detract from inclusion in both high- and low-performing US general surgery residency programs; (2) develop targeted, user-informed interventions to address the organizational culture of low-inclusion programs; and (3) implement and conduct a pilot study of the interventions in low-inclusion programs to dually assess implementation (feasibility, scalability, acceptability) and preliminary effectiveness (perceptions of inclusion, diversity, well-being, explicit and implicit biases; surgical patient satisfaction). This field of research is important for surgeons and their patients. Inclusive work and learning environments are expected to improve the recruitment and retention of a diverse workforce, as well as work engagement for all; this work has implications for reducing disparities and improving quality. This proposal is responsive to AHRQ’s Special Emphasis Notice of Interest in Health Services Research to Advance Health Equity (NOT-HS-21-014). The career development plan and research project capitalize on the many strengths of the principal investigator’s research and the research environment at Northwestern University, including access to world-class mentors and experts in innovative methods at the Kellogg School of Management, the Segal Design Institute, and the Surgical Outcomes and Quality Improvement Center, as well as a large, well-established learning collaborative of 212 US general surgery residency programs.

项目摘要 医生的多样性减少了健康差距。然而，尽管来自世界各地的强大的支持多样性的声明， 医学研究所，美国医学协会，美国医学院协会， 研究生医学教育认证理事会、美国外科医生学院和美国 外科协会，多样性仍然难以捉摸的各级外科。手术中缺乏包容性 居住地是劳动力缺乏多样性的根源。迄今为止，改善医疗保健包容性的努力 专注于个人信仰或技能，例如内隐偏见训练。然而，来自组织的数据 心理学，应用社会文化心理学来理解人类行为的科学领域， 工作场所，证明这种培训不会导致持续的行为改变。相反，行为是 它反映了组织文化。文化、共同的基本信仰、规范性价值观， 以及工作场所的相关社会实践，深刻地影响着工作参与， 同事，以及协作以实现共同目标的能力。为了有意义地增加包容性， 干预措施必须涉及组织文化。这位候选人是一名儿科外科医生，他正在寻求发展， 根据具体情况调整，并实施理论驱动的循证干预措施，以改善 纳入外科住院医师计划。为了实现拟议项目的目标，候选人 需要获得以下方面的知识、技能和经验：（1）组织心理学;（2）以用户为中心的设计， （3）应用实施科学。该项目建议（1）研究组织的特征 培养物（例如，支持或减损高绩效和低绩效美国 普通外科住院医师计划;（2）制定有针对性的，用户知情的干预措施，以解决 低包容性方案的组织文化;（3）实施和进行试点研究， 对低包容性方案进行干预，以双重评估实施情况（可行性、可扩展性、可接受性） 和初步有效性（对包容性、多样性、福祉、显性和隐性偏见的看法; 手术患者满意度）。这一研究领域对外科医生和他们的病人都很重要。包容性工作 和学习环境，预计将改善招聘和留住多元化的劳动力， 以及所有人的工作参与;这项工作对减少差距和提高质量具有影响。这 该提案是对AHRQ关于卫生服务研究兴趣的特别强调通知的回应， 推进健康公平（NOT-HS-21-014）。职业发展计划和研究项目利用了 首席研究员的研究和西北大学的研究环境的许多优势 大学，包括获得世界一流的导师和专家在创新方法的凯洛格学院 管理，西格尔设计研究所，以及手术结果和质量改进中心，以及 作为一个大型的，完善的学习协作212美国普通外科住院医师计划。