创伤外科前线的公平性：一场#人人享有东部创伤外科学会（EAST4ALL）圆桌会议
Equity on the frontlines of trauma surgery: An #EAST4ALL roundtable.
作者信息
Tung Lily, Long Andrea M, Bonne Stephanie, Tseng Esther S, Bruns Brandon, Joseph Bellal, Williams Brian H, Stein Deborah, Freischlag Julie A, Goulet Nicole, Khandelwal Cathleen, Kiselak Elizabeth, Hoofnagle Mark, Gelbard Rondi, Rattan Rishi, Joseph D'Andrea, Bernard Andrew, Zakrison Tanya L
机构信息
From the Division of Trauma (L.T.), Vancouver General Hospital, Vancouver, British Columbia, Canada; Acute Care Surgery(A.M.D.), University of California San Francisco Fresno, Fresno, California; Division of Trauma and Surgical Critical Care (S.B.), Rutgers New Jersey Medical School, Newark, New Jersey; Division of Trauma, Critical Care, Burns, and Emergency General Surgery, Department of Surgery (E.S.T.), MetroHealth Medical Center, Cleveland, Ohio; R Adams Cowley Shock Trauma Center (B.B.), University of Maryland, Baltimore, Maryland; Trauma, Critical Care, Burn and Emergency Surgery (B.J.), University of Arizona College of Medicine, Tucson, Arizona; Section for Trauma and Acute Care Surgery (B.H.W., T.L.Z.), The University of Chicago Medicine, Chicago, Illinois; Department of Surgery (D.S.), University of California San Francisco, San Francisco, California; CEO Wake Forest Baptist Health, Dean Wake Forest School of Medicine (J.E.F.), Winston-Salem, North Carolina; Division of Trauma, Critical Care and Emergency of Surgery (N.G.), NYU Langone, New York University School of Medicine, New York, New York; Department of Surgery (C.K.), Cleveland Clinic, Cleveland, Ohio; Department of Trauma, Surgical Critical Care and Injury Prevention (E.K.), Hackensack University Medical Center, Hackensack University Medical Center, Hackensack, New Jersey; Division of Acute and Critical Care Surgery (M.H.), Washington University in St. Louis, St. Louis, Missouri; Division of Trauma (R.G.), University of Alabama at Birmingham, Birmingham, Alabama; Division of Trauma Surgery and Critical Care (R.R.), DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida; Division of Trauma and Acute Care Surgery, Department of Surgery (DA.J.), NYU Winthrop Hospital & NYU Long Island School of Medicine, Mineola, New York; Acute Care Surgery (A.B.), University of Kentucky College of Medicine, Lexington, Kentucky.
出版信息
J Trauma Acute Care Surg. 2021 Jan 1;90(1):129-136. doi: 10.1097/TA.0000000000002965.
BACKGROUND
Inequity exists in surgical training and the workplace. The Eastern Association for the Surgery of Trauma (EAST) Equity, Quality, and Inclusion in Trauma Surgery Ad Hoc Task Force (EAST4ALL) sought to raise awareness and provide resources to combat these inequities.
METHODS
A study was conducted of EAST members to ascertain areas of inequity and lack of inclusion. Specific problems and barriers were identified that hindered inclusion. Toolkits were developed as resources for individuals and institutions to address and overcome these barriers.
RESULTS
Four key areas were identified: (1) harassment and discrimination, (2) gender pay gap or parity, (3) implicit bias and microaggressions, and (4) call-out culture. A diverse panel of seven surgeons with experience in overcoming these barriers either on a personal level or as a chief or chair of surgery was formed. Four scenarios based on these key areas were proposed to the panelists, who then modeled responses as allies.
CONCLUSION
Despite perceived progress in addressing discrimination and inequity, residents and faculty continue to encounter barriers at the workplace at levels today similar to those decades ago. Action is needed to address inequities and lack of inclusion in acute care surgery. The EAST is working on fostering a culture that minimizes bias and recognizes and addresses systemic inequities, and has provided toolkits to support these goals. Together, we can create a better future for all of us.
背景
外科培训及工作场所存在不公平现象。东部创伤外科学会（EAST）创伤外科公平、质量与包容特别工作组（EAST4ALL）致力于提高人们的认识，并提供资源以消除这些不公平现象。
方法
对EAST成员进行了一项研究，以确定不公平和缺乏包容的领域。识别出了阻碍包容的具体问题和障碍。开发了工具包，作为个人和机构应对及克服这些障碍的资源。
结果
确定了四个关键领域：（1）骚扰和歧视；（2）性别薪酬差距或平等；（3）隐性偏见和微侵犯；（4）点名文化。组建了一个由七名外科医生组成的多元化小组，他们在个人层面或作为外科主任或主席在克服这些障碍方面具有经验。根据这些关键领域提出了四个场景，并向小组成员展示，然后他们作为同盟者模拟应对措施。
结论
尽管在解决歧视和不公平问题方面取得了明显进展，但住院医师和教员在工作场所仍继续遇到与几十年前类似程度的障碍。需要采取行动来解决急性护理外科中的不公平和缺乏包容的问题。EAST正在努力营造一种文化，尽量减少偏见，认识并解决系统性不公平问题，并提供了工具包来支持这些目标。我们共同努力，可以为我们所有人创造一个更美好的未来。
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