Increasing Inclusion, Diversity, Antiracism, and Equity With a Medical School Curriculum Quality Improvement Project.

ABSTRACT: The students at Mayo Clinic Alix School of Medicine (MCASOM) wrote a call to action to medical school leadership in June 2020. The students requested help in navigating socio-political barriers that affected one another and contributed to healthcare inequities and mistrust. Using the Association of American Medical Colleges (AAMC) tool to assess cultural competence training, our team evaluated the baseline 2017-2018 MCASOM curriculum. There were 254 learning objectives, of which 43 (17%) were related to inclusion, diversity, antiracism, and equity (I-DARE). Mirroring the concerns of the students, the findings identified minimal content about antiracism and inclusion. By applying DMAIC principles for quality and process improvement, we aimed to increase the number of taught learning objectives about I-DARE content for the first-year and second-year medical students by 100%, from 43 to 86 objectives, without adversely affecting student satisfaction and true attendance. To address the underlying causes, we launched a virtual, multisite I-DARE medical school course and doubled the number of I-DARE-taught learning objectives from 43 to 107 (149%), compared with the baseline. The program evaluation review revealed that the students were self-reflective and provided a spectrum of experiences regarding the I-DARE course.

Using an employee resource group to develop GRIT in female healthcare leaders: a case study.

PURPOSE: This case study aims to demonstrate how the Greater Leadership Opportunities for Women (GLOW) Mayo Clinic Employee Resource Groups (MERG) has positively impacted leadership development focusing on growth, resilience, inspiration and tenacity (GRIT) and increased advancement for female leaders at Mayo Clinic. It will also establish how the innovative utilization of employee resource groups can positively impact the development of leaders within an institution in general and specially can enhance behaviors related to GRIT. DESIGN/METHODOLOGY/APPROACH: This case study design was used to measure the impact of the GLOW MERG's interventions through qualitative and quantitative approaches that highlight both process and outcome to increase study validity through complementarity, which "seeks elaboration, enhancement, illustration, clarification of the results from one method with the results from another" (Greene, et al., 1989, p. 259) as well as completeness and context (Onghena et al., 2019; Schoonenboom and Johnson, 2017; Bryman, 2006). Learning outcomes (knowledge), skill accomplishments and attitude development were evaluated within two weeks after each session and annually through standardized surveys sent to participants via email. The surveys were designed to capture key information about the sessions, including the impact of the session content, the willingness and ability of attendees to apply the learning and identification of opportunities for improvement in session design and delivery, as well as measure satisfaction with the activities offered, the frequency and method(s) of communication, barriers to session attendance and particular topics or speakers of interest to members (Appendix 1). Response options included dichotomous scales, Likert-type scales, multi-select and free text. This provided a voluntary response sampling, as post-session surveys were sent to all session attendees and annual surveys were sent to all GLOW MERG members, which allowed individuals to choose if they would respond to the surveys (Creswell and Creswell, 2018). To foster an environment of continuous improvement, plan-do-study-act (PDSA) cycles (Langley et al., 2009) were conducted after every survey by the event planning team and the GLOW MERG Board. Interventions were tested, reviewed and discussed during monthly board meetings and event planning. Improvements were made and results were shared with key stakeholders through regular communication channels. Additionally, 30 past and present GLOW MERG leaders were surveyed to measure their perceived impact of participation in the GLOW MERG interventions using dichotomous scales, multi-select and free text responses (Appendix 2). This targeted purposive sample was selected because of their high level of engagement with the MERG to provide a retrospective evaluation of the success of the GLOW MERG, and its interventions for career advancement related to the development of GRIT attributes, knowledge and skills resulting in career advancement for those who are/have been highly engaged with the MERG. FINDINGS: The results spanning the past few years of GLOW MERG interventions has shown that the GLOW MERG has been successful in providing targeted educational events that address the GRIT knowledge, skills and attributes, needed for female health-care leaders to be successful in developing GRIT capabilities. By staying true to its mission and vision, the GLOW MERG has been able to promote, educate and empower female leaders at Mayo Clinic while actively breaking down the barriers that can prevent women from obtaining leadership positions. RESEARCH LIMITATIONS/IMPLICATIONS: There are several limitations with this case study's data collection and sampling methods. First, the post-session and annual survey sampling was based mainly on ease of access, with responses obtained from respondents who are more likely to volunteer or those with the strongest opinions. This allowed for potential bias as responses may not be representative of all GLOW MERG member opinions. Furthermore, the purposive sample of present and past GLOW MERG leaders was also subject to volunteer bias and may not have be representative of the GLOW MERG population. Additionally, the case study examined the practices of only one site and MERG group and may not be representative of all sites or employee resources groups. PRACTICAL IMPLICATIONS: The interventions implemented by the GLOW MERG to assist women with developing GRIT knowledge, skills and attributes - barriers women often face in leadership roles - were tested, reviewed and discussed during monthly board meetings and event planning. PDSA cycles were conducted, improvements were made and results were shared with key stakeholders through regular communication channels (Langley et al., 2009). Key lessons learned from these assessments include: One size does not fit all for leadership development. GLOW members have a wide variety of backgrounds, skills and experiences. Repetition is important in the development of GRIT knowledge, skills and attributes associated with GRIT. A one-time event provides attendees with an information overview and the steps to start developing a new skill but no dedicated time to practice and implement that skill. ORIGINALITY/VALUE: The innovative utilization of employee resource groups can positively impact the development of leaders within an institution in general and specially can enhance behaviors related to GRIT.