Mapping the Void: Understanding Diversity, Equity, and Inclusion Training in Medicine

Area of Science:

• Healthcare professional development
• Medical education
• Workplace bias and discrimination

Background:

• Diversity, Equity, and Inclusion (DEI) training is standard for healthcare workers.
• Limited research exists on how clinician needs for DEI education change over a career.
• The impact of context on responding to bias and the adaptability of current DEI programs are not well understood.

Purpose of the Study:

• To examine how identity-based bias exposure changes with rank and context among healthcare workers.
• To evaluate healthcare workers' perceptions of existing diversity, equity, and inclusion (DEI) education.
• To identify how DEI training can be improved to meet clinicians' needs.

Main Methods:

• An electronic survey with 54 questions was administered to healthcare workers.
• Data collection occurred during Morbidity and Mortality conferences starting December 2020.
• Descriptive statistics analyzed bias exposure by rank, training effectiveness, and response strategy utility.

Main Results:

• Nearly half of 648 respondents reported monthly bias exposure; this decreased with rank for people of color, especially women of color.
• Discomfort in addressing subtle bias from patients or superiors persisted regardless of seniority.
• Over half of respondents found online DEI modules to have little utility, citing a lack of focus on structural issues and practical response strategies.

Conclusions:

• Clinicians' experiences with and ability to respond to bias are significantly shaped by identity and hospital context, irrespective of seniority.
• Current DEI training often fails to address the nuanced realities faced by healthcare workers.
• The utility of DEI education is diminished due to its inability to incorporate individual contexts and provide actionable response strategies.