Institutional Culture of Belonging and Attrition Risk Among Women Health Care Professionals

Objective: Attrition of women health care professionals is high, threatening patient care and advances in health care sciences. Women health care professionals have often reported experiencing challenges in the workplace that lower their sense of belonging and may precipitate their attrition. The current study sought to identify dimensions of workplace belonging in women health care professionals and to determine the relative strength of association of these belonging dimensions with intent to leave (ITL) their institution. Methods: Attendees of a continuing education course on women's leadership skills in health care were surveyed about their ITL and workplace belonging experiences. Dimensions of workplace belonging were identified by factor analysis. The strength of association between ITL and each workplace belonging dimension, as well as their relative strengths of association, were assessed in ordinal regression analyses. Results: Women comprised 99% of survey participants. Three dimensions of workplace belonging were identified: "institutional culture," "interactions with supervisor," and "interpersonal relationships." More frequent experiences of support in any of the three belonging dimensions associated strongly with lower ITL. When all three belonging dimensions were considered simultaneously, ITL remained strongly related with experiences of a supportive "institutional culture" (odds ratio 0.41, p < 0.0001), while it became much less strongly related with supportive experiences in the other two dimensions. Conclusions: These findings suggest a dominant role of institutional culture in attrition risk in women health care professionals. Interventions that foster an institutional culture of diversity, opportunities for career advancement, and inclusivity might be effective in improving retention of women health care professionals.