What Gets Lost in the Numbers: A Case Study of the Experiences and Perspectives of Black and Latino Faculty in Academic Medicine

The doctoral research examines the experiences and perceptions of underrepresented minority faculty in academic medicine through a case study approach. The study focuses on several stages as presented through a model referred to as the faculty life cycle. Specifically, the study addresses the socialization, mentoring, and professional development experiences of URM faculty in academic medicine. How do URM faculty experience their environment, culture, and climate in academic medicine? And what is their perception of the impact of diversity and inclusion initiatives and offices in academic medicine? This study utilizes the conceptual frameworks of Inclusive Excellence (IE} and Culturally Engaging Campus Environments (CECE}. Analysis of the experiences and perspectives is accomplished through an intentional view of the organization (IE} while simultaneously examining the importance of culturally relevant environments in academic medicine (CECE}. Findings demonstrate that socialization, mentoring and faculty development are of extreme importance to URM faculty in academic medicine in ways that affect their perspectives on diversity and inclusion, organizational structures, culture and climate, and academic advancement. The findings describe a win or lose academic medicine culture and institutional climate plagued with challenges and misalignment with URM faculty values. Moreover, socialization into academic medicine impacts URM faculty sense of belonging and identity, and demand extraordinary self-agency and resilience. Identity as URM faculty is forced upon by the institution and adversely adds another layer to already complex intersectionalities. URM faculty mentoring is enriched by informal mentoring and shapes their own identities as mentors. Furthermore, URM faculty need development programs that acknowledge the differences in experience and create spaces for networking, affirmation and accountability. Overall, these experiences relayed by URM faculty voices inform the institution and academic medicine about its environment. Conclusions and recommendations craft the next research and practical agendas in support of URM faculty in academic medicine

The Power of Social Media in the Promotion and Tenure of Clinician Educators

Introduction Social networking sites (or social media [SM]) are powerful web-based technologies used to bolster communication. SM have changed not only how information is communicated but also the dissemination and reception of a variety of topics. This workshop highlighted the benefits of SM for clinician educators. The use of SM was explored as a way to maximize opportunities for clinician educators to network, establish themselves as experts, and build a national reputation leading to promotion. The target audience for this submission is faculty developers who would like to implement a similar workshop, and clinician-educator faculty motivated by promotion and advancement. Methods The training workshop involved an interactive session, with approximately 20 minutes of content, 20 minutes of individual and small-group activities, and 15 minutes of large-group discussion. The effectiveness of the workshop was evaluated by asking participants to complete a postsession survey of SM knowledge, attitude, and action. Results Survey responses (n = 14) demonstrated an increase in participants’ knowledge of SM platforms, ability to identify benefits of SM, skills to disseminate their work, and eagerness to build their personal brand. Discussion This workshop provided a foundation for clinician educators to think strategically about SM use in ways that highlight access to a broader network of colleagues and potential collaborators and that influence the impact of publications and work

Increasing Hispanic/Latinx Healthcare Workforce via Academic Medicine-Community Health Partnership

As the Hispanic/Latino/x community grows exponentially and Hispanic/Latino/x physicians in academic medicine continue to be underrepresented, engagement in the community as learners and providers is needed to ensure a multiplying effort. In this article, the authors introduce a successful academic medicine-community health partnership to increase the Hispanic/Latinx healthcare workforce in Indiana and key curricular initiatives with proven outcomes in increasing the healthcare workforce serving this sector of the population

Leading with Wellness in Mind: Lessons in Academic Leadership During a Pandemic

PURPOSE: COVID-19 pandemic impact on healthcare providers has been immense, making it clear that the pandemic demands even more out of our leadership and wellness efforts. METHODS: We ground this work in the phenomenology of leadership. Our team evaluated programmatic interventions of virtual community wellness sessions. RESULTS: Ninety-eight percent of respondents strongly agreed that wellness initiatives in the department are critical. Qualitative results focus on one of the lessons learned; what it means to lead with wellness in mind. CONCLUSION: Now, more than ever, leading with wellness in mind becomes a high priority. We present its seven key domains

Moving Beyond Cultural Competence Toward Cultural Humility and the Delivery of Equitable Patient-Centered Care

In the Accreditation Council on Graduate Medical Education’s (ACGME) 2016 national report of the Clinical Learning Environment (CLE) Review, it was reported that across most CLEs, education and training on health care disparities and cultural competency was largely generic. A “generic approach” to cultural competency implies that sponsoring institutions where training programs are seated have not made an assessment of the specific needs of the patient population that they are serving. While a targeted approach is a laudable goal, it runs the risk of stereotyping the needs of individuals in a specific cultural group. We propose that the time has come to move beyond the goal of cultural competency toward cultural humility and the delivery of equitable patient centered care – care that is delivered that takes into consideration the specific needs of the patient and does not vary in quality based on personal characteristics like gender, ethnicity, geographic location, religion, sexuality, and socioeconomic status. Graduate medical education should ensure that learners develop skills critical to delivering patient- centered care that emphasize the core qualities of curiosity, empathy and respect

Health Equity Starts with Us: Recommendations from the IN-CTSI Racial Justice and Health Equity Task Force

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Latinidad y Antirracismo: Fostering Antiracist Conversations in Medical Education

EDUCATIONAL OBJECTIVES: By the end of this activity, learners will be able to: 1. Develop antiracist healthcare workforce by increasing foundational awareness of health equity issues specific to the Hispanic/Latino/x community. 2. Develop upstanders that choose to intervene in situations where racism, discrimination, and microaggressions are present. 3. Describe concepts associated with antiracism, equity, diversity, and inclusion so that trainees speak a foundational common language. 4. Practice antiracist terminology in Spanish and associate this language with medical Spanish skills. INTRODUCTION: The purpose of the lecture series was to create a space for Hispanic/Latino/x learners to share their experiences and critically examine their own culture. In addition, an open invitation created a space for other minoritized and majority students to learn and engage in conversation. This series engages on a topic that is less discussed, racism in Hispanic/Latino/x communities. METHODS: This project consisted of three (3) virtual interactive sessions. Learners did not require prerequisite knowledge; however, we created a discussion guide, Glosario de Términos Asociados con Racismo, that served as a point of reference for students to use throughout the series. Participants rated their familiarity pre and post each session via survey. RESULTS: In total, 22 responses were received to the post-survey (n = 22). After all the presentations, 100% of the participants reported acquiring new information. Ten out of 22 participants informed that they learned a ‘great deal of new information. Furthermore, 95.45% of participants would recommend participating in the interactive sessions with a colleague. DISCUSSION: Through these sessions, we reflected on what it means to be Hispanic/Latino/x, how discrimination exists within the cultures that fall under this umbrella term, how they fit (and often do not fit) in the U.S. social construct of the term regardless of our geographical location, and how their identities are further complicated by intersectionality. We have created the precedent for future medical students to continue having and expanding on these conversations, to further provide nuance as to what it really means to “be” Hispanic/Latino/x

A Survey of Internal Medicine Residents: Their Learning Environments, Bias and Discrimination Experiences, and Their Support Structures

Purpose: While there is an emerging body of literature that demonstrates how racism and bias negatively impact the experiences of physicians and trainees from underrepresented groups in medicine in the US, little is known about the experiences of internal medicine trainees and their learning environments. The purpose of this study was to examine these learning environments and explore trainees' perceptions of race/ethnicity-related topics. Methods: A 35-item confidential electronic survey was disseminated to trainees from 11 internal medicine training programs in the US. A total of 142 trainees participated. Purposive sampling ensured alignment with 2018 IM trainee demographics by sex, race and ethnicity. Analyses were performed including chi-square, Fisher's exact tests, and logistic regression. Results: Key findings reveal 63% of respondents perceived disparities in the care provided to diverse patients. Two in three respondents were confident that their institution would respond to discrimination, but only 1/3 of respondents perceived appropriate reporting mechanisms. Black/African American trainees reported needing to minimize aspects of their race and were less likely to perceive their institutions as being supportive to people of color. Conclusion: Access to timely information about trainees' experiences with discrimination and bias in graduate medical education is imperative to disrupt systemic racism and health inequities. Findings suggest a perceived difference in health care provided to minoritized groups, a gap in formal mechanisms for reporting racism and discrimination experienced by trainees, and environments that challenge a sense of belonging. Findings add to current literature exposing the experience of underrepresented trainees in the US

“I Didn't Know What to Say”: Responding to Racism, Discrimination, and Microaggressions With the OWTFD Approach

Introduction Academic medicine has long faced the challenge of addressing health inequities, reflecting on how these contribute to structural racism, and perpetuating negative social determinants of health. Most recently, we have constructed opportunities for dialogues about racism, discrimination, and microaggressions (RDM). As such, we created a professional development program that encouraged participants to (1) openly discuss RDM and the impact they have in academia, (2) learn about tools to address and respond to RDM, and (3) move towards the creation of inclusive environments. The target audience included institutional leaders, faculty, trainees, professional staff, and health care teams. Methods We sought to meet workshop goals by integrating anti-racist dramaturgical teaching, introducing concepts knowledge, and practicing communication tools. To assess learning and evaluate our workshops, participants completed a pre- and postsurvey. Results Results showed that 30 participants were more comfortable with discussing issues related to race/ethnicity, gender identity/expression, sexual orientation, and spirituality after participating in the workshops. Prior to the two workshops, the percentage of learners who felt confident initiating conversations ranged from 29% to 54%. After the workshops, the percentage of learners who felt confident ranged from 58% to 92%. The greatest increase, 100%, was observed in the levels of confidence in initiating conversations related to race/ethnicity. Discussion Despite medical education's commitment to cultural competence and institutional mission statements that value diversity, equity, inclusion, and justice, professional development opportunities are limited. Participants strongly agreed their participation in such a workshop was relevant and important to their professional work

Culturally Appropriate & Socially Responsive Care [CASRC] Thread

Medical Education Objectives for the Social Science Thread (Now:Culturally Appropriate & Socially Responsive Care [CASRC] Thread): 1) The primary goal of the CASRC Thread is not to develop specific sessions for presentation of thread material but to work on identifying gaps and working with course and clerkship management teams to integrate thread content to cover those gaps. 2) There is a need to add emotional behavioral health to the medical student curriculum to help students develop communication skills, rapport with patients, develop ways to interact with patients and how to understand, treat, and build a relationship with patients and those with chronic diseases. 3) Incorporate thread objectives into courses and clerkships from first year through fourth year