Diversity, Equity, and Inclusion: A strategic priority for the American Pediatric Surgical Association

نویسندگان

چکیده

The American Pediatric Surgical Association (APSA) is a professional organization composed of over 1500 members dedicated to providing high-quality surgical care infants and children. was founded in 1969 with the mission “ensure optimal pediatric patients their families, promote excellence field, foster vibrant viable community surgeons.” In collaboration other national international organizations, APSA creates educational guidelines standard policies for that influence public policy set best practices.[1]American Surgery Association. https://eapsa.org/apsa-info/about-us/, Accessed 21 July 2019.Google Scholar recognizes broad diversity United States population membership leadership our not reflective this diversity. Board Governors (BOG) has recently committed advance diversity, equity, inclusion (DEI) all aspects surgery. APSA's strategic prioritization DEI presented paper. (Table 1)Table 1Position statements endorsed by Association.Position on supported APSAAPSA acknowledges potential enhanced productivity, creativity, innovation within diverse organizations.APSA positive impact cadre surgeons may have healthcare outcomes, patient satisfaction, compliance.APSA adopts “Equity social justice” as fifth pillar its organizational statement “Inclusion, representation, participation all” foundation pillars.APSA endorses activities member committee study promotion surgery.APSA supports implicit bias assessment enhance awareness generate discussion reflection regarding existing disparities surgery patients.APSA urges medical schools, general residency programs, training programs enact measures targeted at increasing learners who will become surgeons.APSA encourages transparency intentional hiring practices are inclusive, fair, open women, underrepresented minority groups, disabilities, all.APSA champions establishment mentorship sponsorship specifically aimed retention recruitment women uniformly condemns discrimination, racism, verbal physical abuse, sexual harassment.APSA promotes importance wellness, mental health, work-life balance well-being health outcomes advocates efforts create workplaces conducive new parents levels practice.APSA pledges engage initiatives strategies address differential related determinants health.APSA commits achieving benchmarks quest increased among leadership. Open table tab All providers challenged urgent crisis childhood adolescent States.2Keppel K.G. Ten largest racial ethnic based Healthy People 2010 Objectives.Am J Epidemiol. 2007; 166: 97-103https://doi.org/10.1093/aje/kwm044Crossref PubMed Scopus (110) Google Scholar, 3Oberg C. Colianni S. King-Schultz L Child Health Disparities 21st Century.Curr Probl Pediatr Adolesc Care. 2016; 46: 291-312https://doi.org/10.1016/j.cppeds.2016.07.001Crossref (11) 4Haider A.H. Dankwa-Mullan I. Maragh-Bass A.C. et al.Setting National Agenda Research: recommendations From Institutes College Surgeons Summit.JAMA Surg. 151: 554-563https://doi.org/10.1001/jamasurg.2016.0014Crossref (68) Underrepresented low-income children experience poorer system. (Box 1) Healthcare been reported multiple specialties including surgery,[5]Akbilgic O. Langham Jr, M.R. Davis R.L Race, Preoperative Risk Factors, Death After Surgery.Pediatrics. 2018; 141e20172221https://doi.org/10.1542/peds.2017-2221Crossref (13) trauma,[6]LaPlant M.B. Hess D.J. A review racial/ethnic trauma care, treatment, outcomes.J Trauma Acute Care 2019; 86: 540-550https://doi.org/10.1097/TA.0000000000002160Crossref (9) urology,[7]Chu D.I. Canning D.A. Tasian G.E Race 30-day morbidity urologic surgery.Pediatrics. 138e20154574https://doi.org/10.1542/peds.2015-4574Crossref (19) otolaryngology,[8]Jabbour J. Robey T. Cunningham M.J otolaryngology: systematic review.Laryngoscope. 128: 1699-1713https://doi.org/10.1002/lary.26995Crossref (24) kidney transplantation,[9]Laster M. Soohoo Hall al.Racial-ethnic mortality transplant dialysis patients.Pediatr Nephrol. 2017; 32: 685-695https://doi.org/10.1007/s00467-016-3530-2Crossref (12) bariatric surgery,[10]Nunez Lopez Jupiter D.C. Bohanon F.J. al.Health surgery: nationwide utilization.J Health. 61: 649-656https://doi.org/10.1016/j.jadohealth.2017.05.028Abstract Full Text PDF neurosurgery,11Siegel Li Ding H. al.Racial differences survival brain central nervous system cancer States.Pediatr Blood Cancer. 66: e27501https://doi.org/10.1002/pbc.27501Crossref (14) 12Austin M.T. Hamilton E. Zebda D. primary solid tumors.J Neurosurg Pediatr. 18: 585-593https://doi.org/10.3171/2016.5.PEDS15704Crossref (34) 13Attenello Ng A. Wen socioeconomic following cerebrospinal fluid shunt procedures.J 2015; 15: 560-566https://doi.org/10.3171/2014.11.PEDS14451Crossref (33) oncology,[14]Jacobs A.J. Lindholm E.B. Levy C.F. treatment sarcoma.J Surg Res. 219: 43-49https://doi.org/10.1016/j.jss.2017.05.031Abstract anesthesia.[15]Rosenbloom J.M. Mekonnen Tron L.E. Ethnic Services Anesthesia Practice: Scoping Review [published online ahead print, 2020 Jun 12].J Racial Ethn Disparities. 2020; (10.1007/s40615-020-00792-w)https://doi.org/10.1007/s40615-020-00792-wCrossref (2) Scholar,[16]Baetzel A.E. Holman Dobija N. anesthesia.Anesthesiol Clin. 38: 327-339https://doi.org/10.1016/j.anclin.2020.01.010Abstract (6) large proportion vulnerable affected inequities States. Fewer than 40% were non-Hispanic White 2019.[17]A More nation. Census Bureau. https://www.census.gov/library/visualizations/2019/comm/age-race-distribution.html 10 January 2020.Google Twenty-three percent do use English language home.[18]Characteristics under 18 years, age, States, regions, states, Puerto Rico: 2000. https://www.census.gov/data/tables/2000/dec/phc-t-30.html. 13 August Nearly 20% youth ages 12–17 special needs.[19]Trends prevalence disabilities youth. US Department Human Services. https://www.hhs.gov/ash/oah/adolescent-development/physical-health-and-nutrition/chronic-conditions-and-disabilities/trends.html#:~:text=The%20National%20Survey%20of%20Children,16%2D20%20have%20a%20disability. 08/09/2020.Google Discrepant lower status populations be influenced demographic incongruity between patients. ethnicity concordance found significantly increase likelihood Hispanic, Black, Asian seek preventive care.[20]Ma Sanchez Ma M patient-provider race/ethnicity provider visits: updated evidence from expenditure panel survey.J 6: 1011-1020https://doi.org/10.1007/s40615-019-00602-yCrossref (28) Patients race-discordant relationships physician shorter office visits,[21]Cooper L.A. Roter D.L. Johnson R.L. Ford D.E. Steinwachs D.M. Powe N.R Patient-centered communication, ratings race.Ann Intern Med. 2003; 139: 907-915https://doi.org/10.7326/0003-4819-139-11-200312020-00009Crossref (826) rate visits less participatory,[22]Cooper-Patrick L. Gallo J.J. Gonzales Vu H.T. al.Race, gender, partnership patient-physician relationship.JAMA. 1999 Aug 11; 282: 583-589https://doi.org/10.1001/jama.282.6.583Crossref (1452) perception received.[23]Thornton N.R. Cooper L.A Patient-physician concordance, visit communication patients' perceptions quality.Patient Educ Couns. 2011; 85: e201-e208https://doi.org/10.1016/j.pec.2011.07.015Crossref (99) medicine, one Black halved if cared physicians.[24]Greenwood B.N. Hardeman R.R. Huang Sojourner Physician-patient birthing newborns.Proc Natl Acad Sci U S 117: 21194-21200https://doi.org/10.1073/pnas.1913405117Crossref (101) Hispanic physicians more likely practice communities higher proportions residents.[25]Komaromy Grumbach K. Drake al.The role black underserved populations.N Engl 1996; 334: 1305-1310https://doi.org/10.1056/NEJM199605163342006Crossref (593) Higher practitioner cultural competence shown result better adherence improved outcomes.[26]Henderson Horne Hills R. Kendall E Cultural community: concept analysis.Health Soc Commun. 26: 590-603https://doi.org/10.1111/hsc.12556Crossref (47) Language-concordant improve satisfaction understanding families patients.[27]Dunlap J.L. Jaramillo J.D. Koppolu Wright Mendoza F. Bruzoni effects concordant clinical patients.J 50: 1586-1589https://doi.org/10.1016/j.jpedsurg.2014.12.020Abstract culturally-competent workforce necessary mitigate disadvantages these Groups strategically rich identity cognitive produce results-oriented bonuses greater regularity homogenous groups.28Page bonus: how great teams pay off knowledge economy. Princeton University Press, 2017Crossref 29Hunt V. Prince Dixon-Fyle Yee Delivering through McKinsey & Company, 2018Google 30Kersley R., Klerk E., Boussie A., al. Gender good business. CS 3000 report 2019. https://www.credit-suisse.com/about-us-news/en/articles/news-and-expertise/cs-gender-3000-report-2019-201910.html; 2019 [accessed Jan 10, 2020].Google 2) part, because groups access wider range information, knowledge, models, frameworks, heuristics. Diverse repertoires thinking innovation, profit. [31]Hewlett Marshall Sherbin How can drive innovation.Harvard Bus Rev. 2013; ([accessed 2020])https://static1.squarespace.com/static/5ae89190aa49a17d6e450047/t/5b0d92c4aa4a99c9a42ddd3c/1527616197302/How+Diversity+Can+Drive+Innovation+_HBR.pdfGoogle Scholar,[32]Florida economic geography talent.Ann Am Assoc Geographers. 2020])https://onlinelibrary.wiley.com/doi/abs/10.1111/1467-8306.00314Google also tendency focus facts, expectation acceptance differing opinions, an individual biases.[33]Rock Why smarter.Psychology Today. (Mar 9 Aug) 2020])https://www.psychologytoday.com/us/blog/your-brain-work/201703/why-diverse-teams-are-smarterGoogle field specifically, topics. school student bodies enrich students.[34]Whitla D.K. Orfield G. Silen W. al.Educational benefits school: survey students.Acad 78: 460-466https://doi.org/10.1097/00001888-200305000-00007Crossref (145) An additional example bonus finding NIH funding rankings departments professors.[35]Valsangkar Fecher Rozycki G.S. al.Understanding barriers promoting subspecialties.J Coll 223: 387-398Abstract 72% male 70% surgeons.[36]Newman E.A. “Advancing excellence: leveraging strengths.” Annual Meeting. May Boston, MA.Google 1937–2019, 26 (11.5%) fellowship directors first 50 six (12.8%) BOG four presidents (8.0%) women.[37]Glick P.L., Chen M.K., Escobar M.A., Genealogy North Surgery: Ladd Until Now, Ed 2.0. 19 President presided 2017 2018.[38]APSA Past Presidents, website. https://eapsa.org/apsa-info/about-us/our-heritage/apsa-past-presidents/ 31 December 2019].Google This problem underrepresentation exclusive fact remains prevalent throughout most specialties.39Aziz H.A. Ducoin Welsh al.2018 ACS survey: gender inequality harassment remain challenge surgery.Bull 4 September 2019])http://bulletin.facs.org/2019/09/2018-acs-governors-survey-gender-inequality-and-harassment-remain-a-challenge-in-surgery/Google 40Association Medical Colleges. Women majority applicants 2018, https://news.aamc.org/press-releases/article/applicant-data-2018/; 2018 41Abelson J.S. Symer M.M. Yeo H.L. Butler P.D. al.Surgical time out: counts still short academic surgery.Am 215: 542-548https://doi.org/10.1016/j.amjsurg.2017.06.028Abstract (54) 42Deville Chapman C.H. Burgos Hwang W.T. Both Jr Thomas CR Diversity race, ethnicity, sex oncology past quarter century.J Oncol Pract. 2014; 10: e328-e334https://doi.org/10.1200/JOP.2014.001464Crossref (21) 43Kane Rosero Clagett G.P. Adams-Huet B. Timaran C.H Trends vascular States.J Vasc 2009; 49: 1514-1519https://doi.org/10.1016/j.jvs.2009.02.003Abstract 44Lane-Fall Miano T.A. Aysola Augoustides J.G.T emerging critical workforce: analysis trends fellows 2004 2014.Crit 45: 822-827https://doi.org/10.1097/CCM.0000000000002322Crossref (15) 45Lett Orji W.U. Sebro R Declining representation medicine: longitudinal 16 specialties.PLoS ONE. (Published Nov 16)e0207274https://doi.org/10.1371/journal.pone.0207274Crossref (74) These data highlight fundamental relevant current delivery It seems lack practicing negatively affect limit innovation. Now ever before, perspectives creative solutions required fulfill missions ensuring field. extending ideas realm surgery, we assert complex served active, engaged repertoires, backgrounds. seeks talents group surest way achieve highest quality next generation challenges task requires multi-faceted approach designed organization's performance, support members, position us accomplish aspirational goal work force those serve. To comprehensively build factors, created termed Social Justice” modified pillars read all.” (Fig. Diversity, Equity, Inclusion Committee (DEI Committee) established summer guide arena, selected membership. Through process iterative revision, created:Diversity, core values research, education, advocacy, We broaden across cultural, demographic, cognitive, style domains. Our environment attain greatest potential, eliminate inequities, provide all. Operationalizing changing culture require: education raising consciousness surgeons, allied practitioners inclusion; formalizing racism organization; 3) career development needed children, 4) affirmatively supporting needs school, residency, fellowship;[46]Butler Britt L.D. Green ML Longaker Initiative: effective method number under-represented minorities surgery.J 2010; 211: 561-566https://doi.org/10.1016/j.jamcollsurg.2010.06.019Abstract (27) Scholar,[47]Dai J.C. Agochukwu-Mmonu Hittelman A.B Strategies attracting urology.Curr Urol Rep. 20 Sep 2): 61https://doi.org/10.1007/s11934-019-0921-5Crossref (17) 5) championing growth mentors leaders organization. remainder paper outlines strategy inclusivity understand composition alignment population, distribute gather information such race / orientation, religious preferences. results agenda leverage bonuses. Implicit interactions, decisions, outcomes. biases lead negative evaluation person characteristics weight status, or disability. exist similar (typically low moderate) they public.[48]Hall W.J. M.V. Lee K.M. al.Implicit processionals outcomes: review.Am Public 105: e60-e76Crossref (640) Several studies significant associations metrics bias.[49]FitzGerald Hurst professionals: review.BMC Med Ethics. 1): 19Crossref (498) Scholar,[50]Maina I.W. Belton T.D. Ginzberg Singh al.A decade studying using association test.Soc 199: 219-229Crossref (193) link decision-making clear.[51]Dehon Weiss Jones Faulconer Systematic decision making.Acad Emerg 24: 895-904Crossref (109) Many employ Tests (IATs), which exercises available website Project Implicit, research cognition.[52]Project Implicit. https://www.projectimplicit.net/ Versions tests examine topics body weight, sexuality, skin tone, religion, age. [53]Greenwald A.G. McGhee Schwartz J.L Measuring cognition: test.J Pers Psychol. 1998; 74: 1464-1480Crossref (6649) Though there debate literature about IATs’ ability meaningfully predict discrimination disparate practices,54Oswald F.L. Mitchell Blanton Jaccard al.Predicting discrimination: meta-analysis IAT criterion studies.J 171-192Crossref (345) 55Greenwald Banaji Nosek B.A Statistically small test societally effects.J 108: 553-561Crossref (265) 56Oswald al.Using effect sizes unknown societal significance.J 562-571Crossref (78) 57Carlsson Agerstrom closer look literature.Scand 57: 278-287Crossref (38) generally regarded useful tools discussions.[58]Sukhera Wodzinski Rehman Gonzalez C.M professions education: meta-narrative review.Perspect Educ. 8: 267-275Crossref As initial step towards lowering organization, take IATs require future so when boarding. encourage chairs well incorporate work. opportunities aim stimulate self-reflection discussion. submitting topical articles “Articles Interest” email; writing themed quarterly submission Journal Surgery; developing toolkit public; contributing content Library (http://www.pedsurglibrary.com); sponsoring plenary break-out sessions believe ongoing decrease influences bias, paired broad-based changes directly structural systemic forms ultimately contribute representative patients.[59]Kang S.K. Kaplan Working myths Solutions.Lancet. 393: 579-586Abstract (63) disproportionate Covid-19 pandemic had populations[60]Webb Hooper Nápoles A.M. Pérez-Stable COVID-19 disparities.JAMA. https://www.doi.org/1001/jama.2020.8598Crossref (752) high-profile killings several Americans police spring given cause again consider light events, issued commitment equity justice.[61]Waldhausen Newman Statement justice.Am Assoc. June 2020])https://eapsa.org/apsa-info/about-us/news/statement-on-equity-and-social-justice/Google injustices disproportionately people color living below poverty line. called issues. inclusive culture, ensure programmatic addresses marginalized patients, continuously raise around challenging issues like generational poverty, racism. path becoming surgeon demanding rigor duration. success matching into averages 50%, despite pursuing 11–13 years post-graduate training, having median 15 publications, completing subspecialty spending average $8000 interviews.[62]Savoie K.B. Kulaylat A.N. Huntington J.T. match numbers: defining successful application.J 55: 1053-1057Abstract Scholar,[63]Chandler N.M. Litz C.N. Chang Danielson P.D Efficacy videoconference interviews match.J 76: 420-426Crossref (31) effort especially students disadvantaged Socioeconomic factors parental attainment prevent promising even beginning journey.[64]Youmans Q.R. Essien U.R. Capers Q 4th. - what USMLE pass/fail scoring means medicine.N 382: 2393-2395Crossref Lack courses materials standardized exams further exacerbate leaks pipeline. result, exam scores frequently His

برای دانلود باید عضویت طلایی داشته باشید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

American Pediatric Surgical Association Ethics Statement

Although the intrinsic philosophy at the core of medical care has remained unchanged over the centuries, modern medicine is heavily dependent on pharmacological and technological advances. Effective medications, from analgesics and anesthetics to antibiotics and chemotherapeutic agents, are continuously being developed and improved. The sophistication and reliability of ubiquitous medical equip...

متن کامل

Diversity and inclusion training in pediatric departments.

BACKGROUND AND OBJECTIVE The diversifying US population of children necessitates assessing the diversity of the pediatric academic workforce and its level of cultural competency training. Such data are essential for workforce and educational policies. METHODS An 8-question survey was sent to 131 US pediatric chairs to assess plans for diversity, targeted groups, departmental diversity, divers...

متن کامل

Firearm injuries and children: a policy statement of the American Pediatric Surgical Association.

Received June 29, 2013; Accepted July 9, 2013. From the Children’s Hospital of Philadelphia, University o School of Medicine, Philadelphia, PA (Nance), Lucile Pack Hospital, Stanford University School of Medicine, Pa (Krummel), and Children’s Hospital of Wisconsin, Medi Wisconsin, Milwaukee, WI (Oldham). Correspondence address: Michael L Nance, MD, FAC Hospital of Philadelphia, University of Pe...

متن کامل

Antibiotics and appendicitis in the pediatric population: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review.

OBJECTIVE The aim of the study was to review evidence-based data regarding the use of antibiotics for the treatment of appendicitis in children. DATA SOURCE Data were obtained from PubMed, MEDLINE, and citation review. STUDY SELECTION We conducted a literature search using "appendicitis" combined with "antibiotics" with children as the target patient population. Studies were selected based ...

متن کامل

the search for the self in becketts theatre: waiting for godot and endgame

this thesis is based upon the works of samuel beckett. one of the greatest writers of contemporary literature. here, i have tried to focus on one of the main themes in becketts works: the search for the real "me" or the real self, which is not only a problem to be solved for beckett man but also for each of us. i have tried to show becketts techniques in approaching this unattainable goal, base...

15 صفحه اول

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

ژورنال

عنوان ژورنال: Journal of Pediatric Surgery

سال: 2021

ISSN: ['0022-3468', '1531-5037']

DOI: https://doi.org/10.1016/j.jpedsurg.2020.11.011