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.

抽象的 解决根源的手术差异：改善手术劳动力的多样性 最近的COVID-19大流行，种族动机的谋杀案以及随后的抗议活动强调了我们的一切 已经知道 - 医学的种族差异比仅患者的结果要深得多，必须是 在各个级别上解决。有充分的文献记载了手术结果和满意度中的种族和性别差异。 从管道的角度来看，手术努力维持和促进代表性不足的少数民族（UIM）和 妇女居民和教师。努力改善劳动力多样性的加班时间并没有跟上 我们患者人群的多样性增加。有证据表明，改善了手术劳动力的多样性 可以改善UIM和女性患者的护理质量和结果。拟议的研究涉及团队 具有免费专业知识的跨学科研究人员的研究 与多个利益相关社会合作。我们的目标是使用A减少手术护理的差异 新颖的，跨学科的，多机构的偏差方法来表征外科劳动力中的差异， 设定最佳实践指南，并制定试点干预。我们的中心假设是使用偏差 方法论我们可以确定在保留和促进妇女和少数族裔教师以及 可以用来帮助增加劳动力多样性的手术学员 关心。我们将执行二级数据分析，以衡量整个美国手术教师之间的多样性； 确定促进和保留UIM和妇女教师的最佳和最差记录的计划；和 记录学术医疗中心这些小组之间的晋升和保留范围，以确定 使用AAMC数据与ABS数据和合格的AAMC数据进行成功的多样性努力的预测指标 认证检查数据，我们将描述外科学员和当前的社会人口统计学概况 美国手术居民的流失率，以最佳和最差的记录确定这些计划 毕业的居民。我们将利用有关从根据文化能力和偏见评估调查的数据 我们的目标计划以及国家医学协会，妇女协会的焦点小组 外科医生和历史悠久的黑人医学院和大学以及深入的，定性的访谈 计划管理人员，UIM和女学员，教职员工以及部门的负责人 一直在保留和促进UIM和妇女教职员工学习最佳和最差 实践和组织特征。最后，我们将从我们的定量分析中获取预测因素， 来自我们定性分析的主题，并协调一个学术领导者和患者倡导的Delphi小组 小组创建一组最佳实践指南，并制定一项试点研究，以测试表现不佳的计划。 通过定义保留和促进居民和教师的最佳实践，我们可以开发最佳实践 并测试这些以帮助改善学术外科劳动力中的多样性，公平性和包容性。