Creating Inclusive Environments
Success and attrition among deaf health students and professionals: Describing an underrepresented minority segment of the healthcare workforce.
Goals: We aim to describe the DHH healthcare workforce via survey, and to understand factors contributing to the attrition of DHH people attempting to enter the healthcare education system and workforce.
Description: Deaf and hard of hearing (DHH) people constitute an underserved health minority population in the United States. While some evidence from the DHH and other minority populations suggests that DHH patients benefit clinically from working with language-concordant primary care clinicians (i.e., from communication concordance), and that DHH physicians and medical students are interested in working in primary care and with DHH populations, DHH people are under-represented in the healthcare workforce. Because data on hearing and other disability factors are not routinely collected, we aim to describe the DHH healthcare workforce via survey, and to understand factors contributing to the attrition of DHH people attempting to enter the healthcare education system and workforce.
Project Team: Christopher Moreland, M.D., M.P.H.; Lisa Meeks, Ph.D.
Understanding the Experiences of Racial Microaggressions among Minority Medical, Nursing, and Physician Assistant Students.
Goals: We aim to better understand the effects of racial microaggressions in medical, nursing, and physician assistant schools.
Description: This project studies how and when Black, Hispanic, and Native American students in medical, nursing, and physician assistant schools experience racial microaggressions, how microagressions impact academic performance, and effective strategies for creating an inclusive and supportive learning environment. The study will utilize a mix-method approach to elucidate findings relevant to academic faculty, deans, and administrators working to improve the racial climate of their institutions.
Project Team: Kupiri Ackerman-Barger, Ph.D., R.N.
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Meet the Researcher
Dr. Ackerman-Barger is assistant adjunct professor at the UC Davis Betty Irene Moore School of Nursing. She provides a nursing and FNP/PA perspective and helps guide the Center to include inter-professional colleagues and develop a research agenda focused on diversity in nursing. Her academic interest relate to health equity and social justice. She has a particular interest in the preparation of nurse leaders and nurse educators with the capability and desire to promote diversity in nursing school as a mechanism for increasing nursing workforce diversity.
Dr. Piri Ackerman-Barger on Microaggressions
Promoting Wellness and Satisfaction in Medical Residents by Understanding Microaggressions
Goals: We aim to determine the prevalence of microaggressions experienced by underrepresented physicians in residency. We will also explore how experiencing microaggressions influences satisfaction with residency training for underrepresented residents. Finally, we will identify the relationship between microaggressions and symptoms of depression in underrepresented physicians in residency.
Description: Racial microaggressions are subtle statements and behaviors that unconsciously communicate denigrating messages to people of color. Residents who are mistreated experience higher levels of stress, are at higher risk for depression, and have higher suicide rates than the general population. Residents subjected to abuse and harassment have more job dissatisfaction and think more about leaving the profession of medicine. This negatively impacts the pipeline of physicians. In this study, we will collect survey data from residents across the country to look at their experiences with microaggressions to understand the prevalence, how it influences resident satisfaction, the relationship with depression and the impact of multiple identities on microaggressions.
Project Team: Kupiri Ackerman-Barger, Ph.D., R.N.
The Pathway Project-Medical Students with Disability: Performance and Trajectory into the Physician Workforce
Goals: This project will
- Examine the performance and trajectory of disabled medical students.
- Describe the proportion of disabled learners who elect to enter primary care specialties.
- Identify whether accommodation improves performance and trajectory of medical students with disability.
- Identify predictors of to graduation and match for learners with disability.
Description: Nearly one fifth of the US population has a disability and many of these Americans experience disparities in the health care they receive. In part, these healthcare disparities result from a lack of understanding about disability by healthcare providers. The current education of physicians in is grounded in a biomedical model that emphasizes pathology, impairment, or dysfunction rather than a social model of disability that focuses on removing barriers for individuals with disabilities and improving functionality. It is believed that the inclusion of learners with disabilities in medical education will positively impact patient care, by increasing cultural understanding of disability, reducing bias through proximal relationships, and challenging stereotypes and improving confidence in the ability of physicians with disabilities through mechanisms of intercontact theory. An increased awareness and positive construct of disability may contribute to the reduction of health care disparities faced by patients with disabilities, improving overall health and wellbeing of this population. This study will determine if graduation rates and overall performance in medical school differed between students with and without disabilities overall and within categories of disability. This study will also assess whether MCAT scores and use of accommodations predict success of students with disabilities.
Developing an Evidence-Based Toolkit to Improve Diversity, Equity, and Inclusion in Graduate Medical Education
Goals: Through this research, we will:
- Identify and develop a taxonomy of the diversity policies and practices currently by training programs in IM residency to promote diversity, equity, and inclusion using novel machine learning techniques and qualitative analysis, and
- Determine the relation between the policies and practices and the gender and racial/ethnic diversity of the associated IM training programs.
Description: The Accreditation Council of Graduate Medical Education (ACGME) released its first diversity accreditation standard in the 2019 academic year. Now, all residency training programs must have practices and policies to ensure a diverse training environment. Nevertheless, evidence-based policies and practices to achieve a diverse learning environment remain poorly understood. To address this critical knowledge gap, we will: 1) identify and develop a taxonomy of the diversity and inclusion policies and practices currently used by Internal Medicine (IM) residency training programs using novel machining learning techniques and qualitative analysis and 2) examine the association between these diversity practices and policies and the historical gender and racial/ethnic compositional diversity of the respective IM training programs. Policies and practices associated with greater gender and racial/ethnic diversity in IM residency programs will comprise a toolkit of evidence-based strategies to promote diversity, equity, and inclusion in GME that is currently lacking.
Project Team: Boatright M.D., M.B.A., M.H.S.