骨科增加多样性的障碍：住院医师培训项目视角
Barriers to Increasing Diversity in Orthopaedics: The Residency Program Perspective.
作者信息
McDonald Tyler C, Drake Luke C, Replogle William H, Graves Matthew L, Brooks Jaysson T
机构信息
Department of Orthopaedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson, Mississippi.
School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi.
出版信息
JB JS Open Access. 2020 May 11;5(2). doi: 10.2106/JBJS.OA.20.00007. eCollection 2020 Apr-Jun.
BACKGROUND
There are little data to explain why the surgical subspecialty of orthopaedic surgery struggles with improving the racial/ethnic composition of its workforce. The current work sought to determine what orthopaedic residency program directors and coordinators believe are the barriers to improving diversity at their own programs.
METHODS
Between November 17, 2018, and April 1, 2019, a 17-question survey was electronically distributed to the program directors and coordinators of 155 allopathic orthopaedic surgery residency programs. Seventy-five of 155 programs (48.4%) responded to the survey. A p-value of < 0.05 was used to determine statistical significance.
RESULTS
The most commonly stated barriers to increasing diversity within the orthopaedic surgery programs were the following: "We do not have enough minority faculty, which may deter the applicants" (69.3%), "We consistently rank minority applicants high but can never seem to match them" (56%), and "Not enough minorities are applying to our program" (54.7%). Programs with higher percentages of underrepresented minority (URM) faculty had higher percentages of URM residents (p = 0.001). Programs participating in the Nth Dimensions and/or Perry Initiative programs had a higher percentage of URM faculty as compared to the residency programs that did not participate in these programs (p = 0.004). URM residents represented 17.5% of all residents who resigned and/or were dismissed in the 10 years preceding the survey while also only representing 6% of all orthopaedic residents during the same time period.
CONCLUSIONS
From the orthopaedic residency program perspective, the greatest perceived barrier to increasing the racial/ethnic diversity of residents in their program is their lack of URM faculty. Surveyed programs with more URM faculty had more URM residents, and programs participating in Nth Dimensions and/or Perry Initiative programs had a higher percentage of URM faculty.
背景
几乎没有数据能够解释为何骨外科这一外科亚专业在改善其从业人员的种族/民族构成方面存在困难。当前研究旨在确定骨科住院医师培训项目主任和协调员认为在他们自己的项目中改善多样性存在哪些障碍。
方法
在2018年11月17日至2019年4月1日期间，通过电子方式向155个opathic骨外科住院医师培训项目的主任和协调员发放了一份包含17个问题的调查问卷。155个项目中有75个（48.4%）回复了该调查。使用p值<0.05来确定统计学显著性。
结果
在骨科手术项目中，最常提到的增加多样性的障碍如下：“我们没有足够的少数族裔教员，这可能会阻碍申请人”（69.3%），“我们一直将少数族裔申请人排在高位，但似乎总是无法与他们匹配”（56%），以及“申请我们项目的少数族裔不足”（54.7%）。少数族裔代表性不足（URM）教员比例较高的项目，其URM住院医师的比例也较高（p = 0.001）。与未参与这些项目的住院医师培训项目相比，参与第N维度和/或佩里倡议项目的项目中URM教员的比例更高（p = 0.004）。在调查前的10年里，URM住院医师占所有辞职和/或被解雇住院医师的17.5%，而在同一时期，他们仅占所有骨科住院医师的6%。
结论
从骨科住院医师培训项目的角度来看，他们认为在增加项目中住院医师的种族/民族多样性方面最大的障碍是缺乏URM教员。接受调查的项目中，URM教员越多，URM住院医师就越多，并且参与第N维度和/或佩里倡议项目的项目中URM教员的比例更高。
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