51
|
Manning M, Albrecht TL, Yilmaz-Saab Z, Shultz J, Purrington K. Influences of race and breast density on related cognitive and emotion outcomes before mandated breast density notification. Soc Sci Med 2016; 169:171-179. [PMID: 27733299 PMCID: PMC6816018 DOI: 10.1016/j.socscimed.2016.09.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/22/2016] [Accepted: 09/26/2016] [Indexed: 10/20/2022]
Abstract
RATIONALE Many states have adopted laws mandating breast density (BD) notification for applicable women; however, very little is known about what women knew or felt about BD and related breast cancer (BC) risk before implementation of BD notification laws. OBJECTIVE We examined between-race differences in the extent to which having dense breasts was associated with women's related BD cognition and emotion, and with health care providers' communication about BD. METHODS We received surveys between May and October of 2015 assessing health care provider (HCP) communication about BD, BD-related knowledge, BD-related anxiety and BC worry from 182 African American (AA) and 113 European American (EA) women in the state of Michigan for whom we had radiologists' assessments of BD. RESULTS Whereas having dense breasts was not associated with any BD-related cognition or emotion, there were robust effects of race as follows: EA women were more likely to have been told about BD by a HCP, more likely to know their BD status, had greater knowledge of BD and of BC risk, and had greater perceptions of BC risk and worry; AA women had greater BD-related anxieties. EA women's greater knowledge of their own BD status was directly related to the increased likelihood of HCP communication about BD. However, HCP communication about BD attenuated anxiety for AA women only. CONCLUSION We present the only data of which we are aware that examines between-race differences in the associations between actual BD, HCP communication and BD related cognition and emotion before the implementation of BD notification laws. Our findings suggest that the BD notification laws could yield positive benefits for disparities in BD-related knowledge and anxiety when the notifications are followed by discussions with health care providers.
Collapse
Affiliation(s)
- Mark Manning
- Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R Rd, Detroit, MI 48201, United States.
| | - Terrance L Albrecht
- Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R Rd, Detroit, MI 48201, United States
| | - Zeynep Yilmaz-Saab
- Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R Rd, Detroit, MI 48201, United States
| | - Julie Shultz
- Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R Rd, Detroit, MI 48201, United States
| | - Kristen Purrington
- Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R Rd, Detroit, MI 48201, United States
| |
Collapse
|
52
|
Setiloane KT. Beyond the Melting Pot and Salad Bowl Views of Cultural Diversity: Advancing Cultural Diversity Education of Nutrition Educators. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:664-668.e1. [PMID: 27324670 DOI: 10.1016/j.jneb.2016.05.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 05/19/2016] [Accepted: 05/19/2016] [Indexed: 06/06/2023]
Abstract
This article outlines how the melting pot and salad bowl views of cultural diversity have influenced the cultural training of nutrition educators and other health professionals. It explores how these views are changing in reaction to the changing demographics and health disparities seen in the US today and how the cultural training of nutrition educators has not kept up with these changing views. Suggestions for how this cultural education could be modified include placing a greater emphasis on both the cultural self-awareness of nutrition educators and the sociopolitical historical factors that influence the cultural orientation of nutrition educators and their clients.
Collapse
|
53
|
Hagan AM, Campbell HE, Gaither CA. The Racial and Ethnic Representation of Faculty in US Pharmacy Schools and Colleges. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2016; 80:108. [PMID: 27667845 PMCID: PMC5023979 DOI: 10.5688/ajpe806108] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 10/31/2015] [Indexed: 05/07/2023]
Abstract
Objective. To describe the representation of racial and ethnic minorities among faculty members (faculty) in schools and colleges of pharmacy (COP) compared to US Census Bureau data; to evaluate the representation of racial and ethnic minorities in historically black colleges and universities (HBCUs), newer doctor of pharmacy (PharmD) programs, and PharmD programs with a religious affiliation compared with all pharmacy programs; and to compare racial and ethnic pharmacy faculty data to trends in medical and dental schools, and all higher education. Methods. Information was obtained from national databases and published reports; data was comparatively evaluated. Results. Compared to the general population, Asians are overrepresented in pharmacy, while all other minority groups are underrepresented. The HBCUs, newer schools, and religious-affiliated institutions have greater numbers of African American/Black faculty. Newer schools also have better representation of Hispanic faculty. Pharmacy has been more successful than medicine and dentistry in recruiting African American/Black faculty, but lag behind dental schools in their representation of Hispanic faculty. Conclusion. To meet the health care needs of the population, we recommend the implementation of short-term and long-term diversity and inclusion strategies that address minority representation in COP.
Collapse
Affiliation(s)
- Angela M. Hagan
- Belmont University College of Pharmacy, Nashville, Tennessee
| | | | | |
Collapse
|
54
|
Tsai J, Ucik L, Baldwin N, Hasslinger C, George P. Race Matters? Examining and Rethinking Race Portrayal in Preclinical Medical Education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2016; 91:916-20. [PMID: 27166865 DOI: 10.1097/acm.0000000000001232] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Critical examination of "health disparities" is gaining consideration in medical schools across the United States, often as elective curricula that supplement required education. However, there is disconnect between discussions of race and disparities in these curricula and in core science courses. Specifically, required preclinical science lecturers often operationalize race as a biological concept, framing racialized disparities as inherent in bodies. A three- and five-month sampling of lecture slides at the authors' medical school demonstrated that race was almost always presented as a biological risk factor.This presentation of race as an essential component of epidemiology, risk, diagnosis, and treatment without social context is problematic, as a broad body of literature supports that race is not a robust biological category. The authors opine that current preclinical medical curricula inaccurately employ race as a definitive medical category without context, which may perpetuate misunderstanding of race as a bioscientific datum, increase bias among student-doctors, and ultimately contribute to worse patient outcomes.At the authors' institution, students approached the medical school administration with a letter addressing the current use of race, urging reform. The administration was receptive to proposals for further analysis of race in medical education and created a taskforce to examine curricular reform. Curricular changes were made as part of the construction of a longitudinal race-in-medicine curriculum. The authors seek to use their initiatives and this article to spark critical discussion on how to use teaching of race to work against racial inequality in health care.
Collapse
Affiliation(s)
- Jennifer Tsai
- J. Tsai is a second-year medical student, Warren Alpert Medical School of Brown University, Providence, Rhode Island. L. Ucik is a third-year medical student, Warren Alpert Medical School of Brown University, Providence, Rhode Island. N. Baldwin is a third-year medical student, Warren Alpert Medical School of Brown University, Providence, Rhode Island. C. Hasslinger is a third-year medical student, Warren Alpert Medical School of Brown University, Providence, Rhode Island. P. George is associate professor of family medicine and associate professor of medical science, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | | | | | | | | |
Collapse
|
55
|
Mader EM, Rodríguez JE, Campbell KM, Smilnak T, Bazemore AW, Petterson S, Morley CP. Status of underrepresented minority and female faculty at medical schools located within Historically Black Colleges and in Puerto Rico. MEDICAL EDUCATION ONLINE 2016; 21:29535. [PMID: 26968254 PMCID: PMC4788771 DOI: 10.3402/meo.v21.29535] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 02/17/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND AND OBJECTIVES To assess the impact of medical school location in Historically Black Colleges and Universities (HBCU) and Puerto Rico (PR) on the proportion of underrepresented minorities in medicine (URMM) and women hired in faculty and leadership positions at academic medical institutions. METHOD AAMC 2013 faculty roster data for allopathic medical schools were used to compare the racial/ethnic and gender composition of faculty and chair positions at medical schools located within HBCU and PR to that of other medical schools in the United States. Data were compared using independent sample t-tests. RESULTS Women were more highly represented in HBCU faculty (mean HBCU 43.5% vs. non-HBCU 36.5%, p=0.024) and chair (mean HBCU 30.1% vs. non-HBCU 15.6%, p=0.005) positions and in PR chair positions (mean PR 38.23% vs. non-PR 15.38%, p=0.016) compared with other allopathic institutions. HBCU were associated with increased African American representation in faculty (mean HBCU 59.5% vs. non-HBCU 2.6%, p=0.011) and chair (mean HBCU 73.1% vs. non-HBCU 2.2%, p≤0.001) positions. PR designation was associated with increased faculty (mean PR 75.40% vs. non-PR 3.72%, p≤0.001) and chair (mean PR 75.00% vs. non-PR 3.54%, p≤0.001) positions filled by Latinos/Hispanics. CONCLUSIONS Women and African Americans are better represented in faculty and leadership positions at HBCU, and women and Latino/Hispanics at PR medical schools, than they are at allopathic peer institutions.
Collapse
Affiliation(s)
- Emily M Mader
- Department of Family Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - José E Rodríguez
- Center for Underrepresented Minorities in Academic Medicine, Department of Family Medicine & Rural Health, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Kendall M Campbell
- Center for Underrepresented Minorities in Academic Medicine, Department of Family Medicine & Rural Health, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Timothy Smilnak
- College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
- Lerner Center for Public Health Promotion, Maxwell School of Citizenship & Public Affairs, Syracuse University, Syracuse, NY, USA
| | - Andrew W Bazemore
- Robert Graham Center, Washington, DC, USA
- Department of Family Medicine, University of Cincinnati, Cincinnati, OH, USA
- Department of Family Medicine, Georgetown University, Washington, DC, USA
- Department of Family Medicine, Virginia Commonwealth University, Virginia, USA
- Department of Health Policy, George Washington University School of Public Health, Washington, DC, USA
| | | | - Christopher P Morley
- Department of Family Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
- Department of Psychiatry & Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
- Department of Public Health & Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA;
| |
Collapse
|
56
|
Katz JR, Barbosa-Leiker C, Benavides-Vaello S. Measuring the Success of a Pipeline Program to Increase Nursing Workforce Diversity. J Prof Nurs 2016; 32:6-14. [PMID: 26802586 PMCID: PMC4724384 DOI: 10.1016/j.profnurs.2015.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to understand changes in knowledge and opinions of underserved American Indian and Hispanic high school students after attending a 2-week summer pipeline program using and testing a pre/postsurvey. The research aims were to (a) psychometrically analyze the survey to determine if scale items could be summed to create a total scale score or subscale scores; (b) assess change in scores pre/postprogram; and (c) examine the survey to make suggestions for modifications and further testing to develop a valid tool to measure changes in student perceptions about going to college and nursing as a result of pipeline programs. Psychometric analysis indicated poor model fit for a 1-factor model for the total scale and majority of subscales. Nonparametric tests indicated statistically significant increases in 13 items and decreases in 2 items. Therefore, while total scores or subscale scores cannot be used to assess changes in perceptions from pre- to postprogram, the survey can be used to examine changes over time in each item. Student did not have an accurate view of nursing and college and underestimated support needed to attend college. However students realized that nursing was a profession with autonomy, respect, and honor.
Collapse
Affiliation(s)
- Janet R Katz
- Professor (J.R. Katz), Assistant Professor (C. B-Leiker), Washington State University, College of Nursing
| | - Celestina Barbosa-Leiker
- Professor (J.R. Katz), Assistant Professor (C. B-Leiker), Washington State University, College of Nursing
| | | |
Collapse
|
57
|
Keshet Y, Popper-Giveon A, Liberman I. Intersectionality and underrepresentation among health care workforce: the case of Arab physicians in Israel. Isr J Health Policy Res 2015; 4:18. [PMID: 25878770 PMCID: PMC4397687 DOI: 10.1186/s13584-015-0004-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 02/08/2015] [Indexed: 11/24/2022] Open
Abstract
Background An intersectionality approach that addresses the non-additive influences of social categories and power structures, such as gender and ethnicity, is used as a research paradigm to further understanding the complexity of health inequities. While most researchers adopt an intersectionality approach to study patients’ health status, in this article we exemplify its usefulness and importance for studying underrepresentation in the health care workforce. Our research objectives were to examine gender patterns of underrepresentation in the medical profession among the Arab minority in Israel. Methods We used both quantitative and qualitative methodologies. The quantitative data were obtained from the 2011 Labor Force Survey conducted by the Israeli Central Bureau of Statistics, which encompassed some 24,000 households. The qualitative data were obtained through ten semi-structured, in-depth interviews conducted during 2013 with Arab physicians and with six nurses working in Israeli hospitals. Results The findings indicate that with respect to physicians, the Arab minority in Israel is underrepresented in the medical field, and that this is due to Arab women’s underrepresentation. Arab women’s employment and educational patterns impact their underrepresentation in medicine. Women are expected to enter traditional gender roles and conform to patriarchal and collectivist values, which makes it difficult for them to study medicine. Conclusions Using an intersectionality approach to study underrepresentation in medicine provides a foundation for action aimed at improving public health and reducing health disparities.
Collapse
Affiliation(s)
- Yael Keshet
- Western Galilee Academic College, POB 2125, Akko, 24121 Israel
| | | | - Ido Liberman
- Western Galilee Academic College, POB 2125, Akko, 24121 Israel
| |
Collapse
|
58
|
Deville C, Chapman CH, Burgos R, Hwang WT, Both S, Thomas CR. Diversity by race, Hispanic ethnicity, and sex of the United States medical oncology physician workforce over the past quarter century. J Oncol Pract 2014; 10:e328-34. [PMID: 25052501 DOI: 10.1200/jop.2014.001464] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To assess the medical oncology (MO) physician workforce diversity by race, Hispanic ethnicity, and sex, with attention to trainees. METHODS Public registries were used to assess 2010 differences among MO practicing physicians, academic faculty, and fellows; internal medicine (IM) residents; and the US population, using binomial tests with P < .001 significance adjusting for multiple comparisons. Significant changes in fellow representation from 1986 to 2011 were assessed. RESULTS Female representation as MO fellows (45.0%) was significantly increased compared with faculty (22.4%) and practicing physicians (27.4%); was no different than IM residents (44.7%, P = .853); and increased significantly, by 1.0% per year. Women were significantly underrepresented as practicing physicians, faculty, and fellows compared with the US population (50.8%). Traditionally underrepresented minorities in medicine (URM) were significantly underrepresented as practicing physicians (7.8%), faculty (5.7%), and fellows (10.9%), versus US population (30.0%). Hispanic MO fellows (7.5%) were increased compared with faculty (3.9%) and practicing physicians (4.1%); Black fellows (3.1%) were no different than faculty (1.8%, P = .0283) or practicing physicians (3.5%, P = .443). When comparing MO fellows versus IM residents, there were no differences for American Indians/Alaska Natives/Native Hawaiians/Pacific Islanders (0.3%, 0.6%, respectively, P = .137) and Hispanics (7.5%, 8.7%, P = .139), unlike Blacks (3.1%, 5.6%, P < .001). There has been no significant change in URM representation, with negligible changes every 5 years for American Indians/Alaska Natives/Native Hawaiians/Pacific Islanders (-0.1%), Blacks (-0.3%), and Hispanics (0.3%). CONCLUSIONS Female fellow representation increased 1% per year over the quarter century indicating historical gains, whereas URM diversity remains unchanged. For Blacks alone, representation as MO fellows is decreased compared with IM residents, suggesting greater disparity in MO training.
Collapse
Affiliation(s)
- Curtiland Deville
- University of Pennsylvania, Philadelphia, PA; University of Michigan, Ann Arbor, MI; and Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Christina H Chapman
- University of Pennsylvania, Philadelphia, PA; University of Michigan, Ann Arbor, MI; and Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Ramon Burgos
- University of Pennsylvania, Philadelphia, PA; University of Michigan, Ann Arbor, MI; and Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Wei-Ting Hwang
- University of Pennsylvania, Philadelphia, PA; University of Michigan, Ann Arbor, MI; and Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Stefan Both
- University of Pennsylvania, Philadelphia, PA; University of Michigan, Ann Arbor, MI; and Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Charles R Thomas
- University of Pennsylvania, Philadelphia, PA; University of Michigan, Ann Arbor, MI; and Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| |
Collapse
|
59
|
King CJ, Chen J, Dagher RK, Holt CL, Thomas SB. Decomposing differences in medical care access among cancer survivors by race and ethnicity. Am J Med Qual 2014; 30:459-69. [PMID: 24904178 DOI: 10.1177/1062860614537676] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
More research is needed to identify factors that explain why minority cancer survivors ages 18 to 64 are more likely to delay or forgo care when compared with whites. Data were merged from the 2000-2011 National Health Interview Survey to identify 12 125 adult survivors who delayed medical care. The Fairlie decomposition technique was applied to explore contributing factors that explain the differences. Compared with whites, Hispanics were more likely to delay care because of organizational barriers (odds ratio = 1.38; P < .05), and African Americans were more likely to delay medical care or treatment because of transportation barriers (odds ratio = 1.54; P < .001). The predicted probability of not receiving timely care because of each barrier was lowest among minorities. Age, insurance, perceived health, comorbidity, nativity, and year were significant factors that contributed to the disparities. Although expanded insurance coverage through the Affordable Care Act is expected to increase access, organizational factors and transportation play a major role.
Collapse
Affiliation(s)
| | - Jie Chen
- University of Maryland, College Park, MD
| | | | | | | |
Collapse
|
60
|
Benavides-Vaello S, Katz JR, Peterson JC, Allen CB, Paul R, Charette-Bluff AL, Morris P. Nursing and health sciences workforce diversity research using PhotoVoice: a college and high school student participatory project. J Nurs Educ 2014; 53:217-22. [PMID: 24654692 DOI: 10.3928/01484834-20130326-02] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 01/16/2014] [Indexed: 11/20/2022]
Abstract
This participatory study used PhotoVoice and qualitative description to (a) mentor baccalaureate nursing and college students in workforce diversity research; (b) explore barriers and facilitators encountered by rural American Indian, Hispanic, and other high school students when attending college and pursuing careers in nursing or the health sciences; and (c) model a process of social action to help existing and future students. Baccalaureate nursing and graduate students participated in all stages of research, including dissemination. Five themes emerged from analysis of PhotoVoice data: (a) being afraid; (b) believing; (c) taking small steps; (d) facing fears; and (e) using support systems. Findings underscore the importance of helping students participate in efforts to increase work-force diversity through research. Increasing nursing and health sciences workforce diversity may require strategies developed within and tailored to specific cultures and communities.
Collapse
|
61
|
Chapman CH, Hwang WT, Both S, Thomas CR, Deville C. Current Status of Diversity by Race, Hispanic Ethnicity, and Sex in Diagnostic Radiology. Radiology 2014; 270:232-40. [DOI: 10.1148/radiol.13130101] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
62
|
McKendall SB, Kasten K, Hanks S, Chester A. The Health Sciences and Technology Academy: an educational pipeline to address health care disparities in West Virginia. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2014; 89:37-42. [PMID: 24280836 PMCID: PMC3939059 DOI: 10.1097/acm.0000000000000047] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Health and educational disparities are national issues in the United States. Research has shown that health care professionals from underserved backgrounds are more likely than others to work in underserved areas. The Association of American Medical Colleges' Project 3000 by 2000, to increase the number of underrepresented minorities in medical schools, spurred the West Virginia School of Medicine to start the Health Sciences and Technology Academy (HSTA) in 1994 with the goal of supporting interested underrepresented high school students in pursuing college and health professions careers. The program was based on three beliefs: (1) if underrepresented high school students have potential and the desire to pursue a health professions career and are given the support, they can reach their goals, including obtaining a health professions degree; (2) underserved high school students are able to predict their own success if given the right resources; and (3) community engagement would be key to the program's success.In this Perspective, the authors describe the HSTA and its framework and philosophy, including the underlying theories and pedagogy from research in the fields of education and the behavioral/social sciences. They then offer evidence of the program's success, specifically for African American students, including graduates' high college-going rate and overwhelming intention to choose a health professions major. Finally, the authors describe the benefits of the HSTA's community partnerships, including providing mentors to students, adding legislative language providing tuition waivers and a budgetary line item devoted to the program, and securing program funding from outside sources.
Collapse
Affiliation(s)
- Sherron Benson McKendall
- Dr. McKendall is senior research associate, Health Sciences and Technology Academy, West Virginia University, Morgantown, West Virginia. Ms. Kasten is transitions and records coordinator, Health Sciences and Technology Academy, West Virginia University, Morgantown, West Virginia. Ms. Hanks is curriculum coordinator and community research associate, Health Sciences and Technology Academy, West Virginia University, Morgantown, West Virginia. Dr. Chester is assistant vice president for health sciences and director, Health Sciences and Technology Academy, West Virginia University, Morgantown, West Virginia
| | | | | | | |
Collapse
|
63
|
Orom H, Semalulu T, Underwood W. The social and learning environments experienced by underrepresented minority medical students: a narrative review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2013; 88:1765-77. [PMID: 24072111 DOI: 10.1097/acm.0b013e3182a7a3af] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
PURPOSE To review the literature on the social and learning environments experienced by underrepresented minority (URM) medical students to determine what type of interventions are needed to eliminate potential barriers to enrolling and retaining URM students. METHOD The authors searched MEDLINE, PubMed, Ovid HealthStar, and Web of Science, and the reference lists of included studies, published between January 1, 1980, and September 15, 2012. Studies of the learning and social environments and of students' satisfaction, experiences with discrimination or unfair practices, and academic performance or progress, as well as assessments of programs or interventions to improve URM students' academic performance, were eligible for inclusion. RESULTS The authors identified 28 studies (27 unique data sets) meeting the inclusion criteria. The results of the included studies indicated that URM students experienced less supportive social and less positive learning environments, were subjected to discrimination and racial harassment, and were more likely to see their race as having a negative impact on their medical school experiences than non-URM students. Academic performance on standardized exams was worse, progress less timely, and attrition higher for URM students as well. CONCLUSIONS For URM students, an adverse climate may be decreasing the attractiveness of careers in medicine, impairing their academic performance, and increasing attrition. Improvements to the social and learning environments experienced by URM students are needed to make medicine a more inclusive profession. The current environment of health care reform creates an opportunity for institutions to implement strategies to achieve this goal.
Collapse
Affiliation(s)
- Heather Orom
- Dr. Orom is assistant professor, Department of Community Health and Health Behavior, State University of New York at Buffalo, Buffalo, New York. Ms. Semalulu is practice facilitator, Primary Care Research Institute, Department of Family Medicine, State University of New York at Buffalo, Buffalo, New York. Dr. Underwood is associate professor, Department of Urology, Roswell Park Cancer Institute, Buffalo, New York
| | | | | |
Collapse
|
64
|
Frost HD, Regehr G. "I am a doctor": negotiating the discourses of standardization and diversity in professional identity construction. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2013; 88:1570-7. [PMID: 23969361 DOI: 10.1097/acm.0b013e3182a34b05] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
PURPOSE Medical educators have expressed concern that students' professional identities do not always align with their expectations or with professional standards. The authors propose that, in constructing appropriate professional identities, medical students today are affected by the competing discourses of diversity and standardization. METHOD Between March and May 2012, the authors conducted a critical review of seminal publications to highlight the discourses of diversity and standardization in the medical education literature. They surveyed the social sciences literature on identity construction and drew examples from medical education to demonstrate how a social constructionist approach could inform the discussion about how medical students' professional identities are affected by these discourses. RESULTS The discourse of diversity emphasizes individuality, difference, and a plurality of possibilities and advances the notion that heterogeneity is beneficial to medical education and to patients. In contrast, the discourse of standardization strives for homogeneity, sameness, and a limited range of possibilities and conveys that there is a single way to be a competent, professional physician. Thus, these discourses are in tension, a fact that medical educators largely have ignored. A social constructionist approach to identity suggests that medical students resolve this tension in different ways and construct different identities as a result. CONCLUSIONS To influence medical students' professional identity construction, the authors advocate that educators seek change across the profession-faculty must acknowledge and take advantage of the tension between the discourses of standardization and diversity.
Collapse
Affiliation(s)
- Heather D Frost
- Dr. Frost is a postdoctoral fellow, Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. Dr. Regehr is professor, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | | |
Collapse
|
65
|
Affiliation(s)
- Jesús Rivera-Nieves
- Inflammatory Bowel Disease Center, Division of Gastroenterology, University of California San Diego CA 92093, USA.
| | | |
Collapse
|
66
|
Dhaliwal JS, Crane LA, Valley MA, Lowenstein SR. Student perspectives on the diversity climate at a U.S. medical school: the need for a broader definition of diversity. BMC Res Notes 2013; 6:154. [PMID: 23595029 PMCID: PMC3684552 DOI: 10.1186/1756-0500-6-154] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 03/27/2013] [Indexed: 11/24/2022] Open
Abstract
Background Medical schools frequently experience challenges related to diversity and inclusiveness. The authors conducted this study to assess, from a student body’s perspective, the climate at one medical school with respect to diversity, inclusiveness and cross-cultural understanding. Methods In 2008 students in the doctor of medicine (MD), physical therapy (PT) and physician assistant programs at a public medical school were asked to complete a diversity climate survey consisting of 24 Likert-scale, short-answer and open-ended questions. Questions were designed to measure student experiences and attitudes in three domains: the general diversity environment and culture; witnessed negative speech or behaviors; and diversity and the learning environment. Students were also asked to comment on the effectiveness of strategies aimed at promoting diversity, including diversity and sensitivity training, pipeline programs, student scholarships and other interventions. Survey responses were summarized using proportions and 95 percent confidence intervals (95% CI), as well as inductive content analysis. Results Of 852 eligible students, 261 (31%) participated in the survey. Most participants agreed that the school of medicine (SOM) campus is friendly (90%, 95% CI 86 to 93) and welcoming to minority groups (82%, 95% CI 77 to 86). Ninety percent (95% CI 86 to 93) found educational value in a diverse faculty and student body. However, only 37 percent (95% CI 30 to 42) believed the medical school is diverse. Many survey participants reported they have witnessed other students or residents make disparaging remarks or exhibit offensive behaviors toward minority groups, most often targeting persons with strong religious beliefs (43%, 95% CI 37 to 49), low socioeconomic status (35%, 95% CI 28 to 40), non-English speakers (34%, 95% CI 28 to 40), women (30%, 95% CI 25 to 36), racial or ethnic minorities (28%, 95% CI 23 to 34), or gay, lesbian, bisexual or transgendered (GLBT) individuals (25%, 95% CI 20 to30). Students witnessed similar disparaging or offensive behavior by faculty members toward persons with strong religious beliefs (18%, 95% CI 14 to 24), persons of low socioeconomic status (12%, 95% CI 9 to 17), non-English speakers (10%, 95% CI 6 to 14), women (18%, 95% CI 14 to 24), racial or ethnic minorities (12%, 95% CI 8 to 16) and GLBT individuals (7%, 95% CI 4 to 11). Students’ open-ended comments reinforced the finding that persons holding strong religious beliefs or conservative values were the most common targets of disparaging or offensive behavior. Conclusions These data suggest that medical students believe that diversity and a climate of inclusiveness and respect are important to a medical school’s educational and clinical care missions. However, according to these students, the institution must embrace a broader definition of diversity, such that all minority groups are valued, including individuals with conservative viewpoints or strong religious beliefs, the poor and uninsured, GLBT individuals, women and non-English speakers.
Collapse
|
67
|
Banks J. Development of scholarly trajectories that reflect core values and priorities: a strategy for promoting faculty retention. J Prof Nurs 2012; 28:351-9. [PMID: 23158198 DOI: 10.1016/j.profnurs.2012.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Indexed: 11/16/2022]
Abstract
Development of scholarly trajectories that more adequately allow faculty to balance work-related goals with priorities in their larger lives may play an important role in the retention of nursing faculty. This article articulates a process for developing scholarly trajectories consistent with core values and priorities. The potential of Boyer's model of scholarship as a framework for such a trajectory is discussed. Attention is given to consciously think through competing priorities within and across the multiple facets of life as a critical component of staging academic pursuits. An exercise designed to enhance creation of scholarly trajectories that balance needs across different dimensions is presented. Challenges affecting development of scholarly trajectories, including increased scholarly demands, growing preference for doctorally prepared faculty, and tenure/promotion expectations and time frames, are addressed.
Collapse
Affiliation(s)
- Joanne Banks
- Winston-Salem State University, Winston-Salem, NC 27110, USA.
| |
Collapse
|
68
|
Tacconelli E, Poljak M, Cacace M, Caiati G, Benzonana N, Nagy E, Kortbeek T. Science without meritocracy. Discrimination among European specialists in infectious diseases and clinical microbiology: a questionnaire survey. BMJ Open 2012. [PMID: 23187971 PMCID: PMC3533068 DOI: 10.1136/bmjopen-2012-001993] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE In 2009, in a European survey, around a quarter of Europeans reported witnessing discrimination or harassment at their workplace. The parity committee from the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) designed a questionnaire survey to investigate forms of discrimination with respect to country, gender and ethnicity among medical professionals in hospitals and universities carrying out activities in the clinical microbiology (CM) and infectious diseases (ID) fields. DESIGN The survey consisted of 61 questions divided into five areas (sociodemographic, professional census and environment, leadership and generic) and ran anonymously for nearly 3 months on the ESCMID website. SUBJECTS European specialists in CM/ID. RESULTS Overall, we included 1274 professionals. The majority of respondents (68%) stated that discrimination is present in medical science. A quarter of them reported personal experience with discrimination, mainly associated with gender and geographic region. Specialists from South-Western Europe experienced events at a much higher rate (37%) than other European regions. The proportion of women among full professor was on average 46% in CM and 26% in ID. Participation in high-level decision-making committees was significantly (>10 percentage points) different by gender and geographic origin. Yearly gross salary among CM/ID professionals was significantly different among European countries and by gender, within the same country. More than one-third of respondents (38%) stated that international societies in CM/ID have an imbalance as for committee member distribution and speakers at international conferences. CONCLUSIONS A quarter of CM/ID specialists experienced career and research discrimination in European hospitals and universities, mainly related to gender and geographic origin. Implementing proactive policies to tackle discrimination and improve representativeness and balance in career among CM/ID professionals in Europe is urgently needed.
Collapse
Affiliation(s)
- Evelina Tacconelli
- Department of Infectious Diseases, Università Cattolica Sacro Cuore, Rome, Italy
- Division of Infectious Diseases, Dept. of Internal Medicine I, Universitätsklinikum Tübingen, Germany
| | - Mario Poljak
- Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Marina Cacace
- ASDO, Women Assembly for Combating against Social Exclusion, Rome, Italy
| | - Giovanni Caiati
- ASDO, Women Assembly for Combating against Social Exclusion, Rome, Italy
| | - Nur Benzonana
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey
| | - Elisabeth Nagy
- Institute of Clinical Microbiology, University of Szeged, Szeged, Hungary
| | - Titia Kortbeek
- Centre for Infectious Disease Control Netherlands, Laboratory for Infectious Diseases and Perinatal Screening, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| |
Collapse
|
69
|
Walker KO, Moreno G, Grumbach K. The association among specialty, race, ethnicity, and practice location among California physicians in diverse specialties. J Natl Med Assoc 2012; 104:46-52. [PMID: 22708247 PMCID: PMC3978451 DOI: 10.1016/s0027-9684(15)30126-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Minority physicians are more likely than their counterparts to work in underserved communities and care for minority, poor, and uninsured patients, but much of this research has examined primary care physicians alone. Few have investigated whether non-primary care specialists of minority backgrounds are more likely to serve the underserved than nonminority specialists. OBJECTIVE We examined whether underrepresented minority (URM) physicians from a wide variety of specialties are more likely than non-URM physicians to practice in underserved communities. METHODS Using California Medical Board Physician Licensure Survey (2007) data for 48388 physicians, we geo-coded practice zip codes to medically underserved areas (MUAs) and primary care health professional shortage areas (HPSAs). Logistic regression models adjusting for age, gender, specialty, and other characteristics were used to explore associations with race, ethnicity, specialty, and designated underserved areas. RESULTS We found that African American, Latino, and Pacific Islanders were more likely to work in MUAs and HPSAs than were white physicians (adjusted odds ratio, 1.22-2.25; p < .05). Similar patterns of practice in MUAs and HPSAs by physician race and ethnicity were found when performing the analyses separately among primary care physicians and physicians in non-primary care specialties. CONCLUSION In summary, our study underscores the importance of underrepresented minority physicians in all specialties for the physician workforce needs of disadvantaged communities. To improve health care for underserved communities, continued efforts to increase physician diversity are essential.
Collapse
Affiliation(s)
- Kara Odom Walker
- Department of Family and Community Medicine, University of California, 995 Potrero Ave, W 83, San Francisco, CA 94110, USA.
| | | | | |
Collapse
|
70
|
Age-related differences in doctor-patient interaction and patient satisfaction. Curr Gerontol Geriatr Res 2011; 2011:137492. [PMID: 22007206 PMCID: PMC3189462 DOI: 10.1155/2011/137492] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 07/22/2011] [Accepted: 08/10/2011] [Indexed: 11/17/2022] Open
Abstract
Background. Relatively little is known about patient characteristics associated with doctor-patient interaction style and satisfaction with the medical visit. Objective. The primary study objectives are to assess: whether doctors interact in a more or less patient-centered style with elderly patients and whether patient age moderates the relationship between interaction style and satisfaction, that is, whether elderly patients are more or less satisfied with patient-centered medical encounters. Methods. We collected pre- and post-visit questionnaire data from 177 patients at a large family medicine clinic. We audiotaped the encounters between doctors and patients. Patient-centered interaction style was measured from coding from the audiotapes of the doctor-patient interactions. Patient satisfaction was measured using the Patient Satisfaction Questionnaire. Results. We found physicians were more likely to have patient-centered encounters with patients over age 65. We also found patient age moderated the association between interaction style and patient satisfaction: older patients were more satisfied with patient-centered encounters. Conclusion. Patient age is associated with style of interaction, which is, in turn, associated with patient satisfaction. Understanding the factors and processes by which doctors and patients interact has the potential to improve many facets of health care delivery.
Collapse
|
71
|
Forming state collaborations to diversify the nation's health workforce: the experience of the sullivan alliance to transform the health professions. J Genet Couns 2011; 20:547-55. [PMID: 21845492 DOI: 10.1007/s10897-011-9402-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Accepted: 08/01/2011] [Indexed: 11/27/2022]
Abstract
Diversifying the nation's health professions is essential in order to maintain a vigorous health workforce, able to respond to the needs of all Americans. The inability of the health workforce to keep pace with the changing demographics of the nation is a major cause of the persistent inequities in access to quality health care for ethnic and racial minorities in the U.S. Ethnic and racial minorities have been underrepresented in the genetic counseling profession since its inception, despite vigorous professional initiatives to remedy this situation. Mittman and Downs published a critical review of these initiatives detailing recommendations for change in this journal in 2008. One of their major recommendations was the need to learn from, and join, efforts with other health professions in seeking to increase professional diversity in genetic counseling. This paper reviews new findings on issues impacting health workforce diversity in the nation, presents a case study of a national best practice to diversify the health workforce and illuminates actions that can be taken by the genetic counseling profession. The Sullivan Alliance to Diversify the Health Professions is a culmination of two historic initiatives for addressing the dearth of minority health professionals and is a national catalyst for increasing diversity within the health professions by forging state collaborations among institutions of higher education, health professions schools and other key stakeholders.
Collapse
|
72
|
Meehan TP, Van Hoof TJ, Galusha D, Barr JK, Curry M, Kelvey-Albert M, Meehan TP. Challenges in Recruiting Minority-Serving Private Practice Primary Care Physicians to a Quality Improvement Project. Am J Med Qual 2011; 26:357-63. [DOI: 10.1177/1062860611401011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Thomas J. Van Hoof
- Qualidigm, Rocky Hill, CT
- University of Connecticut School of Nursing, Storrs, CT
- University of Connecticut School of Medicine, Farmington, CT
| | - Deron Galusha
- Qualidigm, Rocky Hill, CT
- Yale University School of Medicine, New Haven, CT
| | - Judith K. Barr
- Qualidigm, Rocky Hill, CT
- Southern Connecticut State University, New Haven, CT
| | | | | | - Thomas P. Meehan
- Qualidigm, Rocky Hill, CT
- Yale University School of Medicine, New Haven, CT
| |
Collapse
|
73
|
Sullivan LW, Mittman IS. Keynote address: The need for greater racial and ethnic diversity in orthopaedic surgery. Clin Orthop Relat Res 2011; 469:1809-12. [PMID: 21222063 PMCID: PMC3111787 DOI: 10.1007/s11999-010-1708-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Advances in medicine in the past century have resulted in substantial reductions in morbidity and mortality in the United States. However, despite these improvements, ethnic and racial minorities continue to experience health status and healthcare disparities. There is inadequate national awareness of musculoskeletal health disparities, which results in greater chronic pain and disability for members of ethnic and racial minority groups. The Sullivan Commission concluded in 2004 the inability of the health professions to keep pace with the US population is a greater contributor to health disparities than lack of insurance. WHERE ARE WE NOW?: While African Americans, Hispanic Americans, and Native Americans constitute more than one-third of the US population, they make up less than 10% of physicians, dentists, and nurses and less than 4% of orthopaedists in the United States. WHERE DO WE NEED TO GO?: Increasing the representation of women and ethnic and racial minorities in orthopaedics will help to increase trust between patients and their providers and will improve the quality of these interactions by enhancing culturally and linguistically appropriate orthopaedic care. HOW DO WE GET THERE?: Pipeline enrichment programs along the educational spectrum are important in the academic preparation of underrepresented minorities. Collaborations between health professions schools and postsecondary educational institutions will increase awareness about careers in the health professions. Ongoing mentorships and career counseling by orthopaedists should enhance the interest of underrepresented minority students in careers as orthopaedists.
Collapse
Affiliation(s)
- Louis W Sullivan
- Transform America's Health Professions, Office of Louis W Sullivan, MD, 133 Peachtree Street NE Suite 4040, Atlanta, GA 30303, USA.
| | | |
Collapse
|
74
|
Shaw SJ, Armin J. The ethical self-fashioning of physicians and health care systems in culturally appropriate health care. Cult Med Psychiatry 2011; 35:236-61. [PMID: 21553151 PMCID: PMC6360944 DOI: 10.1007/s11013-011-9215-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Diverse advocacy groups have pushed for the recognition of cultural differences in health care as a means to redress inequalities in the U.S., elaborating a form of biocitizenship that draws on evidence of racial and ethnic health disparities to make claims on both the state and health care providers. These efforts led to federal regulations developed by the U.S. Office of Minority Health requiring health care organizations to provide Culturally and Linguistically Appropriate Services. Based on ethnographic research at workshops and conferences, in-depth interviews with cultural competence trainers, and an analysis of postings to a moderated listserv with 2,000 members, we explore cultural competence trainings as a new type of social technology in which health care providers and institutions are urged to engage in ethical self-fashioning to eliminate prejudice and embody the values of cultural relativism. Health care providers are called on to re-orient their practice (such as habits of gaze, touch, and decision-making) and to act on their own subjectivities to develop an orientation toward Others that is "culturally competent." We explore the diverse methods that cultural competence trainings use to foster a health care provider's ability to be self-reflexive, including face-to-face workshops and classes and self-guided on-line modules. We argue that the hybrid formation of culturally appropriate health care is becoming detached from its social justice origins as it becomes rationalized by and more firmly embedded in the operations of the health care marketplace.
Collapse
Affiliation(s)
- Susan J Shaw
- School of Anthropology, University of Arizona, P.O. Box 210030, Tucson, AZ 85721-0030, USA.
| | | |
Collapse
|
75
|
Sinkford JC, Valachovic RW, Weaver RG, West JF. Minority Dental Faculty Development: Responsibility and Challenge. J Dent Educ 2010. [DOI: 10.1002/j.0022-0337.2010.74.12.tb05014.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | - Richard G. Weaver
- Center for Educational Policy and Research; American Dental Education Association
| | - Joseph F. West
- Sinai Urban Health Institute and External Evaluator for the W.K. Kellogg/American Dental Education; Association Minority Dental Faculty Development Program grant
| |
Collapse
|
76
|
Shaw-Ridley M, Ridley CR. The health disparities industry: is it an ethical conundrum? Health Promot Pract 2010; 11:454-64. [PMID: 20689052 DOI: 10.1177/1524839910375612] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Reducing health disparities is the purported mission of a huge network of professionals representing many specialties and organizations offering a variety of products and services. Given its elaborate infrastructure and specialized set of activities, we identity the network as the health disparities industry. In this article, we question the ethics of this industry. Specifically, we ask whether the public mission is trumped by questionable industry leadership, ethics, and quality assurances. Drawing on general principles of ethics and differentiating ethical concerns from ethical problems, we conclude that the collective behaviors within the industry may represent an ethical conundrum. The article concludes with a call for the cross-examination of the industry practices.
Collapse
Affiliation(s)
- Mary Shaw-Ridley
- Center for the Study of Health Disparities, Department of Health & Kinesiology, Texas A&M University, College Station, Texas, USA.
| | | |
Collapse
|
77
|
Nora LM. The 21st century faculty member in the educational process--what should be on the horizon? ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2010; 85:S45-S55. [PMID: 20736605 DOI: 10.1097/acm.0b013e3181f13618] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
One of Abraham Flexner's legacies was the concept of a professional faculty community responsible for teaching, scholarly work, and the creation and nurturing of the academic environment in medical schools. Dramatic shifts in society, health care, and educational practice have occurred over the century since Flexner's report, and these shifts have resulted in changes and challenges for medical school faculty. Fundamental principles that were articulated in Flexner's work remain relevant today: medicine is a profession, and as such is responsible for the education of the next generation of physicians; and the essential work of the medical school is the education of current and future generations of physicians. Medical schools must reconsider and restate the required characteristics and work of faculty members. Furthermore, we must develop a core faculty with primary responsibility for the educational program, the teaching of students, and the creation and nurturing of the academic environment. Enhancing the diversity of the faculty community, providing necessary faculty development, and further clarifying the forms of scholarly work in medicine are three ways that individual schools and national organizations can advance the educational mission through support of the faculty.
Collapse
Affiliation(s)
- Lois Margaret Nora
- Department of Behavioral and Community Health Sciences, NEOUCOM, Rootstown, Ohio 44272, USA.
| |
Collapse
|