Faculty of Medicine (Ewers); School of Health and Human Performance (Khsashmelmous, Hamilton-Hinch), Dalhousie University, Halifax, NS
Faculty of Medicine (Ewers); School of Health and Human Performance (Khsashmelmous, Hamilton-Hinch), Dalhousie University, Halifax, NS.
CMAJ. 2022 Oct 31;194(42):E1429-E1436. doi: 10.1503/cmaj.212129.
Increasing, supporting and cultivating diversity in health programs is key to addressing health inequities. We sought to investigate barriers and facilitators that could affect enrolment and success in health professions among people of African descent in Nova Scotia, Canada.
We conducted semistructured interviews with people who self-identified as being of African descent who resided or grew up in Nova Scotia, who were working in or pursuing a career in a health profession, and who had participated in culturally specific mentorship programs. Semistructured interviews explored participant experiences that shaped their pursuit of a health profession, as a person of African descent. We thematically analyzed transcribed interviews using constructivist grounded theory.
We interviewed 23 participants. Thematic coding showed 4 major themes. The theme of "stand on my shoulders" spoke to the importance of mentorship within the Black community. "Growing through pain" spoke to resilience amidst race-related challenges. "Never the student; ever the teacher" showed the repeated need to educate on issues of race or diversity. The final theme, "change," highlighted next steps, including the need for improvement in curricula, for development of Black faculty and for initiatives that offer support.
We found that mentorship, particularly within the community, was instrumental to promoting feelings of belonging. However, participants described the need for resilience in the face of discrimination during training and in practice in health care professions. Rather than focusing on their education, many had to educate those around them. Increased representation, support programs and updated curricula are needed to promote change.
在卫生项目中增加、支持和培养多样性是解决健康不平等问题的关键。我们试图调查可能影响在加拿大新斯科舍省的非洲裔居民入读和成功完成卫生专业学业的障碍和促进因素。
我们对自认为是非洲裔、居住或在新斯科舍省长大、从事或正在攻读卫生专业职业、并参加过特定文化背景下的指导计划的人进行了半结构化访谈。半结构化访谈探讨了参与者塑造他们作为非洲裔追求卫生专业的经验。我们使用建构主义扎根理论对转录的访谈进行了主题分析。
我们采访了 23 名参与者。主题编码显示出 4 个主要主题。主题为“站在我的肩膀上”,强调了在黑人社区内指导的重要性。“在痛苦中成长”,讲述了在与种族相关的挑战中恢复的能力。“永远不是学生,永远是老师”,表明需要反复就种族或多样性问题进行教育。最后一个主题“变革”,强调了下一步的措施,包括课程改进、黑人员工的发展以及提供支持的举措的必要性。
我们发现,指导,特别是在社区内,对于促进归属感至关重要。然而,参与者描述了在培训和医疗保健专业实践中面对歧视时需要具备韧性。许多人不得不教育周围的人,而不是专注于自己的教育。需要增加代表性、支持计划和更新课程,以促进变革。