The Role of Inclusivity in DEI Initiatives: Cultivating an Inclusive Clinical Learning Environment for All
Main Article Content
Abstract
Many U.S. academic medical centers, medical societies, and accreditation bodies are committed to continuing initiatives of recruiting a diverse workforce. It is this focus of DEI that is often weighted towards diversity recruitment within undergraduate and graduate medical education. These recruitment initiatives result in an influx of an underrepresented in medicine (UIM) physician workforce into clinical learning environments that may not reflect inclusivity. The authors provide a brief introduction to the topic of inclusion, discuss its importance in the clinical environment, and suggest ways that medical education leaders can incorporate the tenets of inclusion into their curriculum and training. There are harms to having an exclusionary clinical learning environment that impact the clinical performance and well-being of all learners, particularly those coming from UIM backgrounds. There are also clear benefits to creating inclusion practices, however, there must be intention and strategic planning to work towards solutions to creating a safe, inclusive environment for all.
Keywords:
Medical education, Graduate Medical Education, Diversity, Equity, Inclusion, Inclusivity, Faculty Development
Article Details
How to Cite
SMITH, Teresa Y. et al.
The Role of Inclusivity in DEI Initiatives: Cultivating an Inclusive Clinical Learning Environment for All.
Medical Research Archives, [S.l.], v. 12, n. 10, oct. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5948>. Date accessed: 22 dec. 2024.
doi: https://doi.org/10.18103/mra.v12i10.5948.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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26. Youmans QR, Maldonado M, Essien UR, Lupton K. Building Inclusion and Belonging in Training Environments. Journal of Graduate Medical Education. 2022;14(3):333-334. doi:https://doi.org/10.4300/jgme-d-22-00307.1
2. Nasca TJ. Letter to the GME Community from Thomas J. Nasca, MD, MACP, President and Chief Executive Officer of the ACGME: Why Workforce Diversity Matters to Health Care and Graduate Medical Education. acgme.org. Published June 13, 2023. Accessed December 13, 2023. https://www.acgme.org/newsroom/2023/6/letter-to-the-gme-community-why-workforce-diversity-matters-to-GME/
3. Skorton, D. J., & Trinity, F. AAMC Deeply Disappointed by SCOTUS Decision on Race-Conscious Admissions. aamc.org. Published June 29, 2023. Accessed December 13, 2023, https://www.aamc.org/news/press-releases/aamc-deeply-disappointed-scotus-decision-race-conscious-admissions
4. Marrast LM, Zallman L, Woolhandler S, Bor DH, McCormick D. Minority Physicians’ Role in the Care of Underserved Patients. JAMA Internal Medicine. 2014;174(2):289. doi:https://doi.org/10.1001/jamainternmed.2013.12756
5. Liebschutz JM, Darko GO, Finley EP, Cawse JM, Bharel M, Orlander JD. In the minority: black physicians in residency and their experiences. Journal of the National Medical Association. 2006;98(9):1441-1448. PMID: 17019911; PMCID: PMC2569716
6. Smith TY, Terhune K, Caniano DA. Fostering Inclusivity in the Clinical Learning Environment. MedEdPublish. 2024;14:61. doi:https://doi.org/10.12688/mep.20515.1
7. Razack S, Philibert I. Inclusion in the clinical learning environment: Building the conditions for diverse human flourishing. Medical Teacher. 2019;41(4):380-384. doi:https://doi.org/10.1080/0142159x.2019.1566600
8. Youmans QR, Maldonado M, Essien UR, Lupton K. Building Inclusion and Belonging in Training Environments. Journal of Graduate Medical Education. 2022;14(3):333-334. doi:https://doi.org/10.4300/jgme-d-22-00307.1
9. Garrick JF, Perez B, Anaebere TC, Craine P, Lyons C, Lee T. The Diversity Snowball Effect: The Quest to Increase Diversity in Emergency Medicine: A Case Study of Highland’s Emergency Medicine Residency Program. Annals of Emergency Medicine. 2019;73(6):639-647. doi:https://doi.org/10.1016/j.annemergmed.2019.01.039
10. Coombs AA, King RK. Workplace discrimination: experiences of practicing physicians. Journal of the National Medical Association. 2005;97(4):467-77. PMID: 15868767; PMCID: PMC2568696.
11. Teshome BG, Desai MM, Gross CP, et al. Marginalized identities, mistreatment, discrimination, and burnout among US medical students: cross sectional survey and retrospective cohort study. BMJ. 2022;376:e065984. doi:https://doi.org/10.1136/bmj-2021-065984
12. Liebschutz JM, Darko GO, Finley EP, Cawse JM, Bharel M, Orlander JD. In the minority: black physicians in residency and their experiences. Journal of the National Medical Association. 2006;98(9):1441-8. PMID: 17019911; PMCID: PMC2569716.
13. Tsai, J. Diversity and Inclusion in Medical Schools: The Reality. scientificamerican.com. Published July 12, 2018. Accessed September 20, 2024, https://www.scientificamerican.com/blog/voices/diversity-and-inclusion-in-medical-schools-the-reality/
14. Ellis J, Otugo O, Landry A, Landry A. Interviewed while Black. New England Journal of Medicine. 2020;383(25):2401-2404. doi:https://doi.org/10.1056/nejmp2023999
15. Martin ML, Heron S, Moreno-Walton L, Strickland M, Springerlink (Online Service. Diversity and Inclusion in Quality Patient Care: Your Story/Our Story - a Case-Based Compendium. Springer International Publishing; 2019.
16. Bullock JL, Lockspeiser T, del Pino-Jones A, Richards R, Teherani A, Hauer KE. They Don’t See a Lot of People My Color: A Mixed Methods Study of Racial/Ethnic Stereotype Threat Among Medical Students on Core Clerkships. Academic Medicine. 2020;95(11S):S58. doi:https://doi.org/10.1097/ACM.0000000000003628
17. Lee McFarling, U. ‘It was stolen from me’: Black doctors are forced out of training programs at far higher rates than white residents. Statnews.com. Published June 20, 2022. Accessed September 30, 2024, https://www.statnews.com/2022/06/20/black-doctors-forced-out-of-training-programs-at-far-higher-rates-than-white-residents/
18. Klein R, Ufere NN, Schaeffer S, et al. Association Between Resident Race and Ethnicity and Clinical Performance Assessment Scores in Graduate Medical Education. Academic Medicine. 2022;97(9):1351-1359. doi:https://doi.org/10.1097/acm.0000000000004743
19. McDade, W. Diversity and Inclusion in Graduate Medical Education. sourthernhospitalmedicine.org. Published 2019. Accessed December 4, 2023, https://southernhospitalmedicine.org/wp-content/uploads/2019/10/McDade-ACGME-SHM-Presentation-McDade-Final.pdf
20. Ellis J, Onyeka Otugo, Landry A, Landry A. Dismantling the Overpolicing of Black Residents. The New England Journal of Medicine. 2023;389(14):1258-1261. doi:https://doi.org/10.1056/nejmp2304559
21. McDade W, Mason BS. Making the Case for Equity in Graduate Medical Education. Journal of the National Medical Association. 2021;113(1):3-5. doi:https://doi.org/10.1016/j.jnma.2021.01.004
22. Landry A, Boatright D, Smith TY. Call to action in academic emergency medicine: Going beyond the appreciation of diversity, equity, and inclusion to true practice. AEM Education and Training. 2021;5(S1). doi:https://doi.org/10.1002/aet2.10671
23. Smith TY, Landry A, Schneider JI. Addressing diversity in the physician workforce through social determinants of medical education. 2023;7(S1). doi:https://doi.org/10.1002/aet2.10874
24. Roberts SE, Nehemiah A, Butler PD, Terhune K, Aarons CB. Mentoring Residents Underrepresented in Medicine: Strategies to Ensure Success. Journal of Surgical Education. Published online August 2020. doi:https://doi.org/10.1016/j.jsurg.2020.08.002
25. Caniano DA, Bernstein CA, Carter W, Mitchell SR, Nasca TJ. Transactional Competence, Reliability, and Trustworthiness: Essential Attributes of the Successful Program Director. Journal of Graduate Medical Education. 2023;15(1):134-139. doi:https://doi.org/10.4300/JGME-D-22-00950.1. PMID: 36817543; PMCID: PMC9934824.
26. Youmans QR, Maldonado M, Essien UR, Lupton K. Building Inclusion and Belonging in Training Environments. Journal of Graduate Medical Education. 2022;14(3):333-334. doi:https://doi.org/10.4300/jgme-d-22-00307.1