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行动呼吁:急诊医学住院医师选拔中的公平、多样性和包容性

Call to action: equity, diversity, and inclusion in emergency medicine resident physician selection.

作者信息

Primavesi Robert, Patocka Catherine, Burcheri Adam, Coutin Alexandre, Morizio Alexandre, Ali Amir, Pandya Anjali, Gagné Austin, Johnston Bobby, Thoma Brent, LeBlanc Constance, Fovet Frédéric, Gallinger John, Mohadeb Juan, Ragheb Mirna, Dong Sandy, Smith Sheila, Oyedokun Taofiq, Newmarch Tate, Knight Vanessa, McColl Tamara

机构信息

Montreal General Hospital, McGill University, Montreal, QC, Canada.

University of Calgary, Calgary, AB, Canada.

出版信息

CJEM. 2023 Jul;25(7):550-557. doi: 10.1007/s43678-023-00528-9. Epub 2023 Jun 27.

Abstract

OBJECTIVES

This call to action seeks to improve emergency care in Canada for equity-deserving communities, enabled by equitable representation among emergency physicians nationally. Specifically, this work describes current resident selection processes and makes recommendations to enhance the equity, diversity, and inclusion (EDI) of resident physician selection in Canadian emergency medicine (EM) residency programs.

METHODS

A diverse panel of EM residency program directors, attending and resident physicians, medical students, and community representatives met monthly from September 2021 to May 2022 via videoconference to coordinate a scoping literature review, two surveys, and structured interviews. This work informed the development of recommendations for incorporating EDI into Canadian EM resident physician selection. At the 2022 Canadian Association of Emergency Physicians (CAEP) Academic Symposium, these recommendations were presented to symposium attendees composed of national EM community leaders, members, and learners. Attendees were divided into small working groups to discuss the recommendations and address three conversation-facilitating questions.

RESULTS

Symposium feedback informed a final set of eight recommendations to promote EDI practices during the resident selection process that address recruitment, retention, mitigating inequities and biases, and education. Each recommendation is accompanied by specific, actionable sub-items to guide programs toward a more equitable selection process. The small working groups also described perceived barriers to the implementation of these recommendations and outlined strategies for success that are incorporated into the recommendations.

CONCLUSION

We call on Canadian EM training programs to implement these eight recommendations to strengthen EDI practices in EM resident physician selection and, in doing so, help to improve the care that patients from equity-deserving groups receive in Canada's emergency departments (EDs).

摘要

目标

此次行动呼吁在加拿大改善对符合公平需求社区的急诊护理,这需要全国急诊医生中有公平的代表性来推动。具体而言,这项工作描述了当前的住院医师选拔流程,并提出建议以增强加拿大急诊医学(EM)住院医师项目中住院医师选拔的公平性、多样性和包容性(EDI)。

方法

一个由EM住院医师项目主任、主治医生和住院医师、医学生以及社区代表组成的多元化小组,于2021年9月至2022年5月期间每月通过视频会议会面,以协调一项范围界定文献综述、两项调查和结构化访谈。这项工作为将EDI纳入加拿大EM住院医师选拔的建议制定提供了依据。在2022年加拿大急诊医师协会(CAEP)学术研讨会上,这些建议被提交给由全国EM社区领袖、成员和学习者组成的研讨会与会者。与会者被分成小型工作组来讨论这些建议,并回答三个促进对话的问题。

结果

研讨会的反馈形成了最终的八项建议,以在住院医师选拔过程中促进EDI实践,这些建议涉及招聘、留用、减轻不公平和偏见以及教育等方面。每项建议都附有具体的、可操作的子项目,以指导各项目实现更公平的选拔过程。小型工作组还描述了实施这些建议所察觉到的障碍,并概述了纳入建议中的成功策略。

结论

我们呼吁加拿大的EM培训项目实施这八项建议,以加强EM住院医师选拔中的EDI实践,从而有助于改善加拿大急诊科中符合公平需求群体的患者所接受的护理。

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