Kato Hirotaka, Del Castillo De Calvo Maria I, Muhammad Waliah, Castellanos Celia E, Aung Zabu Myint, Amr Mahmoud, Niu Chunling, Kaye Clifford A, Sweigart Joseph R
Division of Hospital Medicine, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, USA.
Division of Hospital Medicine, Georgetown Community Hospital, Georgetown, USA.
Cureus. 2025 Aug 11;17(8):e89816. doi: 10.7759/cureus.89816. eCollection 2025 Aug.
Introduction We aimed to identify priority areas among strategies to foster an inclusive and engaging work environment and to examine how these strategies relate to one another through a needs assessment in a large hospital medicine group. Methods We conducted a secondary analysis of an anonymous survey administered in February 2023 at the University of Kentucky, a university hospital in the southern United States. A total of 85 respondents at the Division of Hospital Medicine ranked nine key strategies by urgency, including recruitment, retention, educational opportunities, belonging, psychological safety, inclusive workplace, inclusive policies, equity in care, and opportunities for collaboration. We used unfolding multidimensional scaling (UMDS) to visualize the relationships among respondents and strategies. Results Of the 85 complete responses, the respondents were primarily physicians (60 (70%)), White (51 (60%)), and women (43 (51%)). Retention (3.6±2.6) and belongingness (4.1±2.6) had the lowest (i.e., highest priority) mean ranks. The UMDS plot suggested one dimension spanning from diversity to inclusivity and the other from organizational to interpersonal continuum. Belonging and psychological safety clustered in the interpersonal-inclusivity domain, while recruitment, retention, and collaboration clustered in the interpersonal-diversity domain. Inclusive workplace, inclusive policies, and equity in care were aligned within the organizational-inclusivity domain. Education was an outlier, suggesting varied interpretations of its importance. Conclusion Belonging emerged as a high-priority strategy closely linked with psychological safety, suggesting its role in workforce inclusivity and engagement. Fostering belonging may support retention and promote a more inclusive culture in academic hospital medicine. Clarifying the definition and measurement of belonging can enhance its integration into institutional strategies.
引言 我们旨在确定促进包容且引人入胜的工作环境的策略中的优先领域，并通过对一家大型医院医学集团的需求评估来研究这些策略之间的相互关系。方法 我们对2023年2月在美国南部一所大学医院肯塔基大学进行的一项匿名调查进行了二次分析。医院医学科的85名受访者按照紧迫性对九项关键策略进行了排序，包括招聘、留用、教育机会、归属感、心理安全感、包容性工作场所、包容性政策、医疗公平以及合作机会。我们使用展开多维尺度分析（UMDS）来直观呈现受访者与策略之间的关系。结果 在85份完整回复中，受访者主要是医生（60人（70%））、白人（51人（60%））以及女性（43人（51%））。留用（3.6±2.6）和归属感（4.1±2.6）的平均排名最低（即优先级最高）。UMDS图显示一个维度从多样性延伸至包容性，另一个维度从组织层面延伸至人际层面连续体。归属感和心理安全感聚集在人际 - 包容性领域，而招聘、留用和合作聚集在人际 - 多样性领域。包容性工作场所、包容性政策和医疗公平在组织 - 包容性领域内保持一致。教育是一个异常值，表明对其重要性存在不同解读。结论 归属感成为与心理安全感紧密相关的高优先级策略，表明其在劳动力包容性和参与度方面的作用。培养归属感可能有助于留用人员，并在学术医院医学中促进更具包容性的文化。明确归属感的定义和衡量标准可以增强其融入机构策略的程度。
