Office of Diversity, Equity, and Inclusion: Engagement and Leadership Opportunities for Trainees.

Introduction: To achieve a healthier future for all, improving diversity through efforts such as diversifying faculty and leadership in academic medicine is imperative. Therefore, medical trainees (medical students, residents, fellows) from groups underrepresented in medicine (UiM) are encouraged to pursue academic careers and have opportunities to gain faculty leadership skills during their training. Trainees also need exposure to the leadership positions within various offices of an academic institution such as the Office of Diversity, Equity, and Inclusion (DEI). The goal of this module is to expose UiM trainees to the Office of DEI and leadership competencies that can be obtained via service and leadership opportunities with it. Methods: The Kern model was used in the development, implementation, and evaluation of this 75-minute workshop. The workshop consisted of a PowerPoint presentation, reflection exercises, and case discussion to raise trainees' awareness of the Office of DEI and opportunities to become engaged with and develop faculty leadership competencies through the office. Results: Sixty-six diverse learners across three sites completed pre- and postworkshop surveys. Ninety-five percent of participants agreed or strongly agreed that the learning objectives of the workshop had been met. Discussion: Overall, this interactive workshop facilitated learners' awareness of the responsibilities of the Office of DEI and opportunities for learners to develop faculty leadership competencies through engagement. Although primarily evaluated among medical students, the module can be of use to learners and faculty of other health professions programs with an Office of DEI.

The Future LGBT Health Professional: Perspectives on Career and Personal Mentorship.

PURPOSE: Mentorship is a critical factor contributing to career success. There is limited research on the quality of mentoring relationships for LGBT health professionals. This study explores facilitators of, obstacles to, and strategies for successful mentorship for LGBT health professional trainees. METHODS: We applied a convenience sampling strategy to collect quantitative and qualitative data among LGBT health professional trainees. The authors identified trends in data using bivariate analyses and Consensual Qualitative Research methods. RESULTS: Seventy-five LGBT trainees completed surveys and a subset of 23 survey respondents also participated in three focus groups. Among survey participants, 100% identified along the queer spectrum; 10.7% identified along the trans spectrum; 36.0% identified as a racial or ethnic minority; and 61.3% were in MD/DO-granting programs. Eighty-eight percent of trainees reported working with at least one mentor and 48.5% of trainees had at least one mentor of the same sexual orientation. Seventy-two percent of trainees endorsed the importance of having an LGBT-identified mentor for personal development. Qualitative data showed that trainees valued such a mentor for positive role modeling and shared understanding of experiences. Fifty-nine percent of trainees felt it was important to have an LGBT-identified mentor for career development. LGBT peer networking and LGBT-related professional advice were cited as unique benefits in the qualitative findings. CONCLUSION: LGBT health professional trainees have unique personal and career development needs that may benefit from LGBT mentorship. Academic health centers that facilitate LGBT mentorship could enhance LGBT health trainees' academic productivity and personal development.

Balancing Two Cultures: American Indian/Alaska Native Medical Students' Perceptions of Academic Medicine Careers.

American Indians and Alaska Natives (AI/AN) remain underrepresented in the academic medicine workforce and little is known about cultivating AI/AN medical students' interest in academic medicine careers. Five structured focus groups were conducted including 20 medical students and 18 physicians. The discussion guide explored factors influencing AI/AN trainees' academic medicine career interest and recommended approaches to increase their pursuit of academia. Consensual qualitative research was employed to analyze transcripts. Our research revealed six facilitating factors, nine dissuading factors, and five recommendations towards cultivating AI/AN pursuit of academia. Facilitators included the opportunity to teach, serving as a role model/mentor, enhancing the AI/AN medical education pipeline, opportunities to influence institution, collegiality, and financial stability. Dissuading factors included limited information on academic career paths, politics, lack of credit for teaching and community service, isolation, self-doubt, lower salary, lack of positions in rural areas, lack of focus on clinical care for AI/AN communities, and research obligations. Recommendations included heighten career awareness, recognize the challenges in balancing AI/AN and academic cultures, collaborate with IHS on faculty recruitment strategies, identify concordant role models/mentors, and identify loan forgiveness programs. Similar to other diverse medical students', raising awareness of academic career opportunities especially regarding teaching and community scholarship, access to concordant role models/mentors, and supportive institutional climates can also foster AI/AN medical students' pursuit of academia. Unique strategies for AI/AN trainees include learning how to balance AI/AN and academic cultures, collaborating with IHS on faculty recruitment strategies, and increasing faculty opportunities in rural areas.

Community-based participatory research in Little Haiti: challenges and lessons learned.

BACKGROUND: Community-based participatory research (CBPR) is an effective methodology for developing relevant interventions with socially marginalized communities. However, implementing CBPR methods is challenging for several reasons. This paper presents challenges encountered in the context of an ongoing CBPR initiative in Little Haiti in Miami, Florida, and describes the solutions used to address them. OBJECTIVES: We sought to describe the challenges faced and lessons learned while conducting CBPR in Little Haiti. METHODS: Community-academic partnerships were created to guide the creation of culturally relevant cancer interventions and research. LESSONS LEARNED: Historical distrust of research, cultural constructions of health and illness, and literacy issues are key considerations when developing partnerships with Haitian and other marginalized, immigrant communities. CONCLUSIONS: Partnerships are fostered over time through demonstrated mutual commitment to improving health and building community capacity. Communities must play an active role throughout the research process to ensure that studies are culturally relevant, and ensuing intervention, sustainable.

Overview of the STAndards for BipoLar Excellence (STABLE) project.

The goal of the STAndards for BipoLar Excellence (STABLE) project was to advance quality of care for bipolar disorder by promoting improved recognition and increased use of evidence-based practices. This article presents a brief overview of the project's objectives, the make-up of the STABLE National Coordinating Council, and the development and field testing of a series of evidence-based clinical performance measures. Findings from field testing of these measures are summarized and highlight the continuing gap between current care and evidence-based recommendations in many key clinical areas in psychiatric and primary care.

Development of evidence-based performance measures for bipolar disorder: overview of methodology.

The STAndards for BipoLar Excellence (STABLE) Project was organized in 2005 to improve quality of care for bipolar disorder by developing and testing a set of evidence-based clinical process performance measures related to identifying, assessing, managing, and coordinating care for bipolar disorder. This article first briefly reviews the literature on the science of performance measurement and the use of performance measures as a tool for quality improvement. It then presents a detailed overview of the methodology used to develop the STABLE performance measures. Steps included choosing a clinical area to be measured, selecting key aspects of care for measurement, designing specifications for the measures, developing a data collection strategy, testing the scientific strength (validity, reliability, feasibility) of the measures, and obtaining, analyzing, and reporting conformance findings for the measures. Five of the STABLE measures have been endorsed by the National Quality Forum as part of their Standardizing Ambulatory Care Performance Measures project: screening for bipolar mania/hypomania in patients diagnosed with depression, assessment for risk of suicide, assessment for substance use, screening for hyperglycemia when atypical antipsychotic agents are prescribed, and monitoring change in level of functioning in response to treatment. Additional STABLE measures will be submitted to appropriate national organizations in the future. It is hoped that these measures will be used in quality assessment activities and that the results will inform efforts to improve care for individuals with bipolar disorder.