Ruzycki Shannon M, Kelly-Turner Kenna, Hildebrand Kevin A, Yanchar Natalie L
From the Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ruzycki); the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ruzycki); the Werkland School of Education, University of Calgary, Calgary, Alta. (Kelly-Turner); the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Hildebrand, Yanchar)
From the Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ruzycki); the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ruzycki); the Werkland School of Education, University of Calgary, Calgary, Alta. (Kelly-Turner); the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Hildebrand, Yanchar).
Can J Surg. 2025 Mar 19;68(2):E108-E116. doi: 10.1503/cjs.015923. Print 2025 Mar-Apr.
Strategies to address inequities, bias, and discrimination that disadvantage Canadian physicians from marginalized groups are urgently needed. We describe a multilevel needs assessment of equity, diversity, and inclusion (EDI) in 2 departments of surgery that focused on identifying evidence-based interventions.
We invited members of the departments of surgery at the University of Calgary and the University of Saskatchewan to complete the Diversity Engagement Survey (DES), a 22-item instrument designed to understand workplace engagement and inclusion among physicians, with higher scores indicating greater engagement and inclusion. Leaders completed a Leadership EDI Readiness Assessment to understand their own barriers to EDI work and an Organizational EDI Readiness Assessment to understand structures for EDI in their division. Leaders were provided resources and interventions to address the identified gaps in these assessments.
The most common organizational gaps in structures for EDI work in surgical divisions and training programs ( = 34, 37.4%) were in community outreach and measurement and reporting. Surgeons who identified as cisgender men ( = 101) felt more engaged and included than those who identified as cisgender women ( = 43; 3.81 [standard deviation (SD) 0.73] v. 3.51 [SD 0.78]; = 0.04). White cisgender men ( = 66) had the highest feelings of engagement and inclusion (mean 3.95 [SD 0.62]). Participating surgical sections and training programs were directed to evidence-informed initiatives to improve community outreach and measurement and reporting to address EDI in their settings.
Our findings support that gender and racial or ethnic identities influence the workplace experiences of surgeons in Canada. A multilevel approach to EDI work in surgical departments can direct leaders to areas for intervention.
迫切需要采取策略来解决那些使加拿大边缘化群体医生处于不利地位的不平等、偏见和歧视问题。我们描述了对两个外科部门的公平、多样性和包容性(EDI)进行的多层次需求评估,其重点是确定基于证据的干预措施。
我们邀请了卡尔加里大学和萨斯喀彻温大学外科部门的成员完成多样性参与度调查(DES),这是一份包含22个条目的问卷,旨在了解医生在工作场所的参与度和包容性,得分越高表明参与度和包容性越强。领导者完成了领导力EDI准备情况评估,以了解他们在EDI工作中自身的障碍,并完成了组织EDI准备情况评估,以了解其部门中EDI的结构。为领导者提供了资源和干预措施,以解决这些评估中发现的差距。
外科部门和培训项目中EDI工作结构最常见的组织差距(n = 34,37.4%)在于社区外展以及衡量和报告方面。认定自己为顺性别男性的外科医生(n = 101)比认定自己为顺性别女性的外科医生(n = 43;3.81[标准差(SD)0.73]对3.51[SD 0.78];P = 0.04)感觉更有参与感和更具包容性。白人顺性别男性(n = 66)的参与感和包容性最强(平均3.95[SD 0.62])。参与调查的外科科室和培训项目被引导采取基于证据的举措,以改善社区外展以及衡量和报告,从而解决其环境中的EDI问题。
我们的研究结果支持性别以及种族或族裔身份会影响加拿大外科医生的工作场所体验这一观点。外科部门EDI工作的多层次方法可以指导领导者确定干预领域。