Dens Higano Jennifer, Tilburt Jon C, Hafferty Frederic W
Physical Medicine and Rehabilitation resident at Mayo Clinic in Rochester, Minnesota, United States.
Department of Medicine and Biomedical Ethics, Division of General Internal Medicine, Mayo Clinic, Scottsdale, Arizona, United States; Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota, United States.
J Natl Med Assoc. 2023 Feb;115(1):18-25. doi: 10.1016/j.jnma.2022.12.006. Epub 2022 Dec 28.
Despite recent attention to social justice, diversity, equity, and inclusion within medical education, little is currently known about whether and to what extent that attention has translated into the language of formal documents articulating organization purpose: medical school mission statements. Mission statements are the marquee declaration of a medical school's identity and purpose, and a recommended tool for applicants to determine "fit" when applying. This study examines whether and to what extent social justice, diversity, equity, and inclusion have made it into the formal public statements of organizational purpose and identity over the last several years. Mission statements were extracted manually from the 2007, 2017, and 2021 AAMCs Medical School Admission Requirements (MSAR) database for both U.S. and Canadian M.D. granting medical schools. Then each mission statement version was coded for the presence and degree of diversity language including words like social justice, diversity, equity, and inclusion using an agreed-upon lexicon. Frequencies and within school changes over time were analyzed. Among 139 medical schools with discoverable mission statements from 2007, 91% (n=127) changed their MSs between 2007 and 2021. In 2007, 24% (n=33) of MSs contained diversity language. By 2017 nearly half of MSs; 47% (n=65) contained any reference to such language. But by 2021, despite 46 school having changed their MSs again, only a few more included diversity language in their MSs (56%; n=77). The most common terms used were "diversity," followed by the increasing presence of words like "inclusion," "equity," and "justice" by 2021. Curiously, a few schools redacted diversity language from 2007 to 2021. A Diversity Thesaurus of 22 terms was iteratively identified, with all terms searched in all MSs. Overall, mission statement change was quite common with most medical schools making changes across the 14 years covered in this study. And despite a doubling of the number of medical schools MSs mentioning diversity over a 10-year period, that increase seemed to slow in recent years even among schools who had a chance to change their MS. As of mid-2021, two in five US medical schools still have no mention of diversity related language in their most formal, said articulation of organizational purpose.
尽管近期医学教育领域对社会正义、多元化、公平性和包容性给予了关注，但目前对于这种关注是否以及在多大程度上转化为阐明组织宗旨的正式文件语言（即医学院的使命宣言），人们知之甚少。使命宣言是医学院身份和宗旨的重要声明，也是申请者在申请时确定“契合度”的推荐工具。本研究考察了在过去几年中，社会正义、多元化、公平性和包容性是否以及在多大程度上被纳入了组织宗旨和身份的正式公开声明中。从2007年、2017年和2021年美国和加拿大授予医学博士学位的医学院的美国医学院协会（AAMC）医学院入学要求（MSAR）数据库中手动提取使命宣言。然后，使用商定的词汇表，对每个使命宣言版本中是否存在以及多元化语言的程度进行编码，这些语言包括社会正义、多元化、公平性和包容性等词汇。分析了频率以及学校内部随时间的变化。在2007年有可发现使命宣言的139所医学院中，91%（n = 127）在2007年至2021年间修改了其使命宣言。2007年，24%（n = 33）的使命宣言包含多元化语言。到2017年，近一半的使命宣言；47%（n = 65）包含了此类语言的任何提及。但到2021年，尽管有46所学校再次修改了其使命宣言，只有少数学校在其使命宣言中增加了多元化语言（56%；n = 77）。使用最频繁的词汇是“多元化”，其次是到2021年“包容性”“公平性”和“正义”等词汇的出现频率不断增加。奇怪的是，有几所学校在2007年至2021年间删除了多元化语言。反复确定了一个包含22个术语的多元化词库，并在所有使命宣言中搜索了所有术语。总体而言，使命宣言的修改相当普遍，大多数医学院在本研究涵盖的14年中都进行了修改。尽管在10年期间提到多元化的医学院使命宣言数量增加了一倍，但近年来这种增长似乎放缓，即使是那些有机会修改其使命宣言的学校也是如此。截至2021年年中，五分之二的美国医学院在其最正式的组织宗旨表述中仍未提及与多元化相关的语言。
