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Measuring Diversity and Inclusion in Academic Medicine: The Diversity Engagement Survey
Sharina D Person1, C Greer Jordan, Jeroan J Allison
1S.D. Person is associate professor, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts. C.G. Jordan is associate vice chancellor, Diversity and Inclusion, and assistant professor, Departments of Nursing, Psychiatry, and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts. J.J. Allison is associate vice provost, Health Disparities Research, and vice chair and professor, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts. L.M. Fink Ogawa is clinical assistant professor and director, Quality and Safety Scholarship, University of Kansas Medical Center School of Nursing, Kansas City, Kansas. L. Castillo-Page is senior director, Diversity Policy and Programs and Organizational Capacity Building Portfolio, Association of American Medical Colleges, Washington, DC. S. Conrad is senior research analyst, Association of American Medical Colleges, Washington, DC. M.A. Nivet is chief diversity officer, Association of American Medical Colleges, Washington, DC. D.L. Plummer is vice chancellor, Diversity and Inclusion, and professor, Departments of Psychiatry, Quantitative Health Sciences, and Nursing, University of Massachusetts Medical School, Worcester, Massachusetts.
Purpose:
To produce a physician and scientific workforce that advances high-quality research and culturally competent care, academic medical centers (AMCs) must assess their capacity for diversity and inclusion and leverage opportunities for improvement. The Diversity Engagement Survey (DES) is presented as a diagnostic and benchmarking tool.
Method:
The 22-item DES consists of eight factors that connect engagement theory to inclusion and diversity constructs. It was piloted at 1 AMC and then administered at 13 additional U.S. AMCs in 2011-2012. Face and content validity were assessed through a review panel. Cronbach alpha was used to assess internal consistency. Confirmatory factor analysis (CFA) was used to establish construct validity. Cluster analysis was conducted to establish ability of the DES to distinguish between institutions' degrees of engagement and inclusion. Criterion validity was established using observed differences in scores for demographic groups as suggested by the literature.
Results:
The sample included 13,694 respondents across 14 AMCs. Cronbach alphas for the engagement and inclusion factors (range: 0.68-0.85), CFA fit indices, and item correlations with latent constructs indicated an acceptable model fit and that items measured the intended concepts. Cluster analysis of DES scores distinguished institutions with higher, middle, and lower degrees of engagement and inclusion by their respondents. Consistent with the literature, black, Hispanic/Latino, female, and LGBTQ (lesbian, gay, bisexual, transgender, queer) respondents reported lower degrees of engagement than their counterparts.
Conclusions:
The DES is a reliable and valid instrument for assessment, evaluation, and external benchmarking of institutional engagement and inclusion.
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