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Measuring Race Equality in the Obstetrics and Gynaecology Workforce and Training: A Delphi Core Outcome Set Study
Nicola Adanna Okeahialam1,2, Jameela Sheikh3,4, John Allotey5
1St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
Insights
A new core outcome set (COS) was developed to standardize race equality measurement in obstetrics and gynaecology (O&G) training and workforce. This initiative aims to improve equity and inclusivity within the O&G sector.
Area of Science:
- Medical Education
- Healthcare Workforce Diversity
- Obstetrics and Gynaecology
Background:
- Race equality is a critical issue within the healthcare workforce, particularly in obstetrics and gynaecology (O&G).
- Lack of standardized metrics hinders effective measurement and reporting of race equality in the O&G workforce and training.
Purpose of the Study:
- To develop a core outcome set (COS) for standardized measurement and reporting of race equality.
- To enhance race equality within the UK's obstetrics and gynaecology workforce and training programs.
Main Methods:
- A multi-stakeholder Delphi survey was conducted with 45 participants, including clinicians, trainees, and service representatives.
- Outcomes were identified from literature, condensed, and prioritized using a nine-point Likert scale over two rounds.
- Consensus was defined as a median score of ≥8 and an interquartile range of ≤2.
Main Results:
- Initially 92 outcomes were identified, reduced to 41, and then 18 core outcomes were selected through consensus.
- Key themes included workforce representation, pay equity, postgraduate training, disciplinary actions, career progression, and experiences of harassment and bullying.
- A final consultation meeting with 15 participants refined the core outcome set.
Conclusions:
- This study presents the first core outcome set (COS) specifically designed to assess race equality in the O&G workforce.
- Standardized reporting will facilitate benchmarking, guide targeted interventions, and foster a more equitable and inclusive O&G profession.
- The developed COS is crucial for advancing race equality and improving professional experiences in obstetrics and gynaecology.
Objective:
To develop a core outcome set (COS) to standardise measurement and reporting of race equality within the obstetrics and gynaecology workforce and training.
Design:
Multi-stakeholder Delphi survey.
Setting:
Obstetrics and gynaecology care in secondary and tertiary hospitals in the UK.
Population:
Clinicians, trainees, service managers, researchers, midwives, and service design representatives from healthcare organisations, professional bodies, and charities relevant to maternity services and medical education.
Methods:
Relevant outcomes from the literature were identified and grouped thematically. We undertook a two-round Delphi survey, prioritising outcomes by scoring on a nine-point Likert scale (1 = limited importance, 9 = critical). Consensus was predefined as a median score ≥ 8 and IQR ≤ 2. The final core outcome set was finalised by consensus and consultation.
Main Outcome Measures:
A minimum set of core outcomes for assessing race equality within obstetrics and gynaecology workforce and training.
Results:
The survey was completed by 45 stakeholders. Ninety-two outcomes were identified, condensed to 41 and grouped across 11 themes. Thirteen were chosen in the first round, five in the second, 10 additional were proposed, and after consensus, 18 were selected to be included as core outcomes. Fifteen participants attended the final consultation meeting. Outcome themes included workforce representation, pay, postgraduate training, disciplinary processes, career progression, and harassment and bullying.
Conclusions:
This is the first COS developed to measure race equality in the obstetrics and gynaecology workforce. Standardised reporting of these outcomes will enable benchmarking across organisations, inform targeted interventions, and support the development of a more equitable and inclusive workforce.
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