Breuner Cora, Moore Emily, Walsh Elaine, Hilman Stephanie, Mitzel Julia, Thomas Anita, Walker-Harding Leslie
Adolescent Medicine, Seattle Children's Hospital, Seattle, USA.
Pediatric Cardiology, Seattle Children's Hospital, Seattle, USA.
Cureus. 2024 Aug 2;16(8):e66028. doi: 10.7759/cureus.66028. eCollection 2024 Aug.
Addressing the issues of workplace advancement, resilience, and retention within medicine is crucial for creating a culture of equity, respect, and inclusivity especially towards women and nonbinary (WNB) providers including advanced practice providers (APPs), most notably those from marginalized groups. This also directly impacts healthcare quality, patient outcomes, and overall patient and employee satisfaction. The purpose of this study was to amplify the voices on challenges faced by WNB providers within a pediatric academic healthcare organization, to rank workplace interventions addressing advancement, resilience, and retention highlighting urgency towards addressing these issues, and, lastly, to provide suggestions on how to improve inclusivity.
Participants were self-identified WNB providers employed by a pediatric healthcare organization and its affiliated medical university. An eligibility screener was completed by 150 qualified respondents, and 40 WNBs actually participated in study interviews. Interviews were conducted using a semi-structured interview guide to rank interventions targeted at improving equity, with time allotted for interviewees to discuss their personal lives and how individual circumstances impacted their professional experiences.
WNB providers called for efficient workflows and reducing uncompensated job demands. Support for family responsibilities, flexible financial/compensation models, and improved job resources all were endorsed similarly. Participants ranked direct supervisor and leader support substantially lower than other interventions. Conclusions: Career mentorship and academic support for WNB individuals are recognized interventions for advancement and retention but were not ranked as top priorities. Respondents focused on personal supports as they relate to family, job resources, and flexible compensation models. Future studies should focus on implementing realistic expectations and structures that support whole lives including professional ambitions, time with family, personal pursuits, and self-care.
解决医学领域的职业发展、适应力和留用问题，对于营造公平、尊重和包容的文化至关重要，尤其是对女性和非二元性别（WNB）医疗服务提供者，包括高级实践提供者（APP），特别是那些来自边缘化群体的人员。这也直接影响医疗质量、患者预后以及患者和员工的总体满意度。本研究的目的是放大WNB医疗服务提供者在儿科学术医疗组织中所面临挑战的声音，对解决职业发展、适应力和留用问题的工作场所干预措施进行排序，突出解决这些问题的紧迫性，最后就如何提高包容性提供建议。
参与者为一家儿科医疗组织及其附属医科大学聘用的自我认定为WNB的医疗服务提供者。150名合格受访者完成了资格筛选，40名WNB实际参与了研究访谈。访谈采用半结构化访谈指南进行，以对旨在改善公平性的干预措施进行排序，同时留出时间让受访者讨论他们的个人生活以及个人情况如何影响他们的职业经历。
WNB医疗服务提供者呼吁提高工作流程效率并减少无补偿的工作要求。对家庭责任的支持、灵活的财务/薪酬模式以及改善工作资源等方面同样得到认可。参与者将直属上级和领导的支持排在远低于其他干预措施的位置。结论：对WNB个人的职业指导和学术支持是公认的促进职业发展和留用的干预措施，但未被列为首要任务。受访者关注与家庭、工作资源和灵活薪酬模式相关的个人支持。未来的研究应侧重于实施符合实际的期望和结构，以支持包括职业抱负、与家人相处时间、个人追求和自我保健在内的整个生活。
