Department of Emergency Medicine, University of California, San Francisco, San Francisco, California, USA.
Zuckerberg San Francisco General Hospital, San Francisco, California, USA.
Acad Emerg Med. 2023 Jul;30(7):765-772. doi: 10.1111/acem.14727. Epub 2023 Apr 13.
Racism has not only contributed to disparities in health care outcomes, but also has negatively impacted the recruitment, retention, and promotion of historically excluded groups in academic medicine. The 2022 Society for Academic Emergency Medicine (SAEM) consensus conference, "Diversity, Equity, and Inclusion: Developing a Research Agenda for Addressing Racism in Emergency Medicine," convened a diverse group of researchers, educators, administrative leaders, and health care providers to help address the impact of racism in three domains in academic emergency medicine: clinical research, education and training, and academic leadership. The main goals of the consensus process were to identify current knowledge gaps and create a research agenda within each domain using an iterative consensus-building methodology.
The planning committee identified three fundamental domains to develop a research agenda and created workgroups who completed a literature search to identify gaps in knowledge. After a consensus building process, potential questions were presented at the in-person consensus conference. Ninety SAEM members representing faculty and trainees participated in breakout groups in each domain to generate consensus recommendations for priority research.
For clinical research, three research gaps with six questions (n) were identified: remedies for bias and systematic racism (3), biases and heuristics in clinical care (2), and racism in study design (1). For education and training, three research gaps with seven questions were identified: curriculum and assessment (2), recruitment (1), and learning environment (4). For academic leadership, three research gaps with five questions were identified: understanding the current diversity, equity, and inclusion (DEI) landscape and culture (1), analyzing programs that improve DEI and identifying factors that lead to improved diversity (3), and quantifying the value of professional stewardship activities (1).
This article reports the results of the consensus conference with the goal of influencing emergency care research, education, and policy and facilitating collaborations, grant funding, and publications in these domains.
种族主义不仅导致医疗保健结果存在差异，还对学术医学中历史上被排斥群体的招聘、留用和晋升产生了负面影响。2022 年，学术急诊医学学会（SAEM）共识会议“多样性、公平性和包容性：制定解决急诊医学中种族主义问题的研究议程”召集了一组多元化的研究人员、教育工作者、行政领导和医疗保健提供者，以帮助解决学术急诊医学三个领域中种族主义的影响：临床研究、教育和培训以及学术领导。共识过程的主要目标是确定当前的知识差距，并使用迭代共识建立方法在每个领域制定研究议程。
规划委员会确定了三个基本领域来制定研究议程，并创建了工作组，这些工作组完成了文献搜索，以确定知识差距。在共识建立过程之后，在现场共识会议上提出了潜在问题。代表教师和学员的 90 名 SAEM 成员参加了每个领域的分组讨论，以就优先研究提出共识建议。
在临床研究方面，确定了三个研究差距和六个问题（n）：纠正偏见和系统性种族主义的方法（3）、临床护理中的偏见和启发式（2）以及研究设计中的种族主义（1）。在教育和培训方面，确定了三个研究差距和七个问题：课程和评估（2）、招聘（1）和学习环境（4）。在学术领导方面，确定了三个研究差距和五个问题：了解当前多样性、公平性和包容性（DEI）的状况和文化（1）、分析有助于改善 DEI 的计划并确定导致多样性改善的因素（3）以及量化专业管理活动的价值（1）。
本文报告了共识会议的结果，旨在影响急诊护理研究、教育和政策，并促进这些领域的合作、资助和出版物。
