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 从根本上解决外科手术差异：改善外科手术队伍的多样性 最近的 COVID-19 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所面临的问题 我们已经知道——医学上的种族差异比患者的治疗效果要严重得多，必须加以解决 在各个层面都得到解决。手术结果和满意度方面的种族和性别差异有据可查。 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群体（UIM）和 女性居民和教员。改善劳动力加班多样性的努力并没有跟上 增加我们患者群体的多样性。有证据表明，提高外科手术队伍的多样性 可以提高 UIM 和女性患者的护理质量和结果。拟议的研究涉及一个团队 跨学科研究人员在该主题领域拥有互补的专业知识和良好的研究记录 与多个利益相关者协会合作。我们的目标是通过使用 新颖的、跨学科的、多机构的偏差方法来描述外科劳动力的差异， 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 我们可以确定保留和晋升女性和少数族裔教师的最佳做法 外科受训人员可用于帮助提高劳动力的多样性，并最终提高患者的质量 关心。我们将进行二次数据分析，以衡量美国各地外科教师的多样性； 确定 UIM 和女教员晋升和保留方面记录最好和最差的项目；和 记录这些群体在学术医疗中心的晋升和保留范围，以确定 使用 AAMC 数据结合 ABS 数据和资格以及成功多元化努力的预测因素 验证检查数据，我们将描述外科受训者的社会人口特征和当前的情况 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 即将毕业的居民。我们将利用从以下网站收集的文化能力和偏见评估调查数据： 我们的目标计划以及与国家医学协会、妇女协会的焦点小组 外科医生和历史上的黑人医学院和大学以及对 项目管理人员、UIM 和女学员、教师以及项目的部门和部门负责人 已经成功地或在努力保留和促进 UIM 和女教师学习最好和最差的方面 实践和组织特征。最后，我们将从定量分析中得出预测因子， 我们的定性分析中的主题，并协调由学术领袖和患者倡导组成的德尔福小组 小组制定一套最佳实践指南并开展试点研究以测试表现不佳的项目。 通过定义保留和晋升住院医生和教职员工的最佳实践，我们可以开发最佳实践 并对这些进行测试，以帮助提高学术外科队伍的多样性、公平性和包容性。