Factors associated with assessment bias for underrepresented minorities resident physicians training in family medicine and internal medicine

与代表性不足的少数族裔住院医师家庭医学和内科培训评估偏差相关的因素

• 批准号: 10589640
• 负责人: Jung G. Kim
• 金额: $ 22.68万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-03 至 2023-08-06
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10589640
• 关键词: Academy; Accreditation; Address; Age; Communities; Competence; County; Data; Data Set; Development; Disparity; Educational Assessment; Ethnic Origin; Faculty; Family Practice; Female; Fostering; Gender; Goals; Growth; Individual; Inequity; Internal Medicine; Learning; Licensing; Logistic Regressions; Measurable; Measurement; Measures; Medical Education; Medical Students; Medicine; Modeling; Outcome; Performance; Physicians; Policies; Population; Primary Care; Primary Care Physician; Provider; Quality of Care; Race; Reduce health disparities; Reporting; Residencies; Source; Strategic Planning; Testing; Training; Training Programs; Underrepresented Minority; Underserved Population; United States National Institutes of Health; Variant; Woman; data integration; design; educational atmosphere; ethnic disparity; experience; graduate medical education; health disparity; improve minority health; improved; medical specialties; minority health; patient population; programs; racial bias; racial disparity; recruit; response; standardize measure; underserved community; women faculty; workforce needs

Project Summary Health disparities persist in the U.S. with underserved populations suffering lower quality of care and worse outcomes. National leaders in medicine have called for widespread efforts to recruit and train underrepresented minorities in medicine (URM) to supply the physician workforce and who can serve underserved communities. Although the recruitment of URM medical students is increasing, their retention in the physician profession is less certain. For URM resident physicians, Graduate Medical Education (GME) learning environment factors that perpetuate biases due to race/ethnicity and gender have high potential to hinder their professional development and retention in medicine. These include required assessments on residents subjected to assessment bias within their training programs. Little is known nationally about the GME learning environment factors associated with URM physician assessment bias, particularly in their key formative years as residents and prior to becoming fully licensed physicians. Our overarching goal is to investigate the GME learning environment factors impacting the assessment of resident physicians training in primary care. The primary objective is to identify and test modifiable factors among URM resident physicians training in all family medicine and internal medicine GME programs using an integrated, multilevel dataset sourced from national bodies. Our hypotheses center on a multilevel conceptual model and preliminary data that includes the representation of URM and gender in the GME learning environment, and how program- related factors may impact the assessments of residents. Using multiple logistic regression and multi-level growth curve modeling, we will examine the degree to which URM representation, gender, and program factors are associated with assessment bias, and how these factors may impact the trajectory of measurements of resident learning in Accreditation Council of GME (ACGME) physician competencies for all U.S. residents training in accredited family medicine and internal medicine programs. The specific aims for this study are 1) examine whether assessment inequities for URM and women residents in the ACGME Milestone assessments are associated with representation of URM and women faculty, and 2) examine how measurements of learning trajectories for URM and women residents in the ACGME Milestone assessment ratings are associated with program factors. We have assembled a team of experts in medical education assessment, workforce diversity, medical education policy, and analytics, and expect our outcomes to inform national leaders in medical education and primary care physician workforce planning to better support URM physicians training in GME. This study also meets current demands to investigate the structural barriers that limit primary care physician workforce diversity and will align with the NIH Health Disparities Strategic Plan’s commitment to improving minority health and address their disparities.

项目概要 美国的健康差距依然存在，服务不足的人群的护理质量较低，情况更糟 国家医学领导人呼吁广泛努力招募和培训。 医学领域代表性不足的少数群体（URM），以提供医生队伍和可以服务的人 尽管 URM 医学生的招收人数不断增加，但他们仍留在服务不足的社区。 对于 URM 住院医生来说，医生职业不太确定。研究生医学教育 (GME) 因种族/族裔和性别而导致偏见长期存在的学习环境因素很可能会导致 阻碍他们在医学领域的专业发展和保留，其中包括所需的评估。 居民在培训计划中受到评估偏差，全国范围内对 GME 知之甚少。 与 URM 医生评估偏差相关的学习环境因素，特别是在关键方面 作为住院医师的形成期和成为正式执业医师之前，我们的首要目标是 调查影响住院医师培训评估的GME学习环境因素 初级保健的主要目标是确定和测试 URM 住院医生中可改变的因素。 使用集成的多级数据集对所有家庭医学和内科 GME 项目进行培训 我们的假设以多层次概念模型和初步数据为中心。 其中包括 URM 和性别在 GME 学习环境中的代表性，以及如何计划- 相关因素可能会影响居民的评估，使用多元逻辑回归和多水平。 增长曲线建模，我们将检查 URM 代表性、性别和计划因素的程度 与评估偏差相关，以及这些因素如何影响测量轨迹 为所有美国居民提供 GME (ACGME) 医师能力认证委员会的住院医师学习 认可的家庭医学和内科项目的培训 本研究的具体目标是 1) 检查 ACGME 里程碑评估中 URM 和女性居民的评估是否不平等 与 URM 和女性教师的代表性相关，并且 2) 研究如何衡量学习 URM 和 ACGME 里程碑评估评级中的女性居民的轨迹与 我们组建了一支医学教育评估、劳动力多元化、 医学教育政策和分析，并期望我们的成果能够为医学领域的国家领导人提供信息 教育和初级保健医生劳动力规划，以更好地支持 GME 中的 URM 医生培训。 这项研究还满足了当前调查限制初级保健医生的结构性障碍的要求 劳动力多样性，并将与 NIH 健康差异战略计划的承诺保持一致，以改善 少数民族的健康并解决他们的差异。