Refining a DEI Assessment Tool for Use in Optimizing Professional STEM Societies for Gender Equity.

Historic science, technology, engineering and mathematics (STEM) disciplinary cultures were founded in a system that was predominately male, white, heterosexual, and able-bodied (i.e., "majority"). Some societal norms have changed, and so has demand for inclusive STEM engagement. However, legacy mental models, or deeply held beliefs and assumptions, linger and are embedded in the STEM system and disciplinary cultures. STEM reform is needed to maximize talent and create inclusive professions, but cannot be achieved without recognizing and addressing norms and practices that disproportionately serve majority vs. minoritized groups. As leading voices in disciplinary work and application, disciplinary and professional societies (Societies) are instrumental in shaping and sustaining STEM norms. We, leaders of the Amplifying the Alliance to Catalyze Change for Equity in STEM Success (ACCESS+) project, recognize the need to provide Society diversity, equity, and inclusion (DEI) change leaders with tools necessary to foster systemic change. In this Perspectives article, we present the Equity Environmental Scanning Tool (EEST) as an aid to help Society DEI change leaders elucidate legacy mental models, discern areas of strength, identify foci for advancement, and benchmark organizational change efforts. We share our rationale and work done to identify, and, ultimately, adapt a Society DEI self-assessment tool from the United Kingdom. We share background information on the UK tool, content and structural changes made to create the EEST, and an overview of the resulting EEST. Ultimately, we seek to increase awareness of a Society-specific DEI self-assessment tool designed to help Society DEI change leaders advance inclusive reform.

Scientific Societies Integrating Gender and Ethnoracial Diversity Efforts: A First Meeting Report from Amplifying the Alliance to Catalyze Change for Equity in STEM Success (ACCESS+).

Professional STEM societies have been identified as an important lever to address STEM diversity, equity, and inclusion. In this Perspectives article, we chronicle the highlights of the first Amplifying the Alliance to Catalyze Change for Equity in STEM Success (ACCESS+) convening held in September 2021. Here, we introduce the three-part ACCESS+ approach using a model that entails (i) completion of a DEI self-assessment known as the equity environmental scanning tool, (ii) guided action plan development and iteration, and (iii) sustained participation in a community of practice.

The Inclusive Professional Framework for Societies: Changing Mental Models to Promote Diverse, Equitable, and Inclusive STEM Systems Change.

Science, technology, engineering, and mathematics (STEM) professional societies (ProSs) are uniquely positioned to foster national-level diversity, equity, and inclusion (DEI) reform. ProSs serve broad memberships, define disciplinary norms and culture, and inform accrediting bodies and thus provide critical levers for systems change. STEM ProSs could be instrumental in achieving the DEI system reform necessary to optimize engagement of all STEM talent, leveraging disciplinary excellence resulting from diverse teams. Inclusive STEM system reform requires that underlying "mental models" be examined. The Inclusive Professional Framework for Societies (IPF: Societies) is an interrelated set of strategies that can help ProSs change leaders (i.e., "boundary spanners") and organizations identify and address mental models hindering DEI reform. The IPF: Societies uses four "I's"-Identity awareness and Intercultural mindfulness (i.e., equity mindset) upon which inclusive relationships and Influential DEI actions are scaffolded. We discuss how the IPF: Societies complements existing DEI tools (e.g., Women in Engineering ProActive Network's Framework for Promoting Gender Equity within Organization; Amplifying the Alliance to Catalyze Change for Equity in STEM Success' Equity Environmental Scan Tool). We explain how the IPF: Societies can be applied to existing ProS policy and practice associated with common ProS functions (e.g., leadership, membership, conferences, awards, and professional development). The next steps are to pilot the IPF: Societies with a cohort of STEM ProSs. Ultimately, the IPF: Societies has potential to promote more efficient, effective, and lasting DEI organizational transformation and contribute to inclusive STEM disciplinary excellence.

Pain coping skills training and lifestyle behavioral weight management in patients with knee osteoarthritis: a randomized controlled study.

Overweight and obese patients with osteoarthritis (OA) experience more OA pain and disability than patients who are not overweight. This study examined the long-term efficacy of a combined pain coping skills training (PCST) and lifestyle behavioral weight management (BWM) intervention in overweight and obese OA patients. Patients (n=232) were randomized to a 6-month program of: 1) PCST+BWM; 2) PCST-only; 3) BWM-only; or 4) standard care control. Assessments of pain, physical disability (Arthritis Impact Measurement Scales [AIMS] physical disability, stiffness, activity, and gait), psychological disability (AIMS psychological disability, pain catastrophizing, arthritis self-efficacy, weight self-efficacy), and body weight were collected at 4 time points (pretreatment, posttreatment, and 6 months and 12 months after the completion of treatment). Patients randomized to PCST+BWM demonstrated significantly better treatment outcomes (average of all 3 posttreatment values) in terms of pain, physical disability, stiffness, activity, weight self-efficacy, and weight when compared to the other 3 conditions (Ps<0.05). PCST+BWM also did significantly better than at least one of the other conditions (ie, PCST-only, BWM-only, or standard care) in terms of psychological disability, pain catastrophizing, and arthritis self-efficacy. Interventions teaching overweight and obese OA patients pain coping skills and weight management simultaneously may provide the more comprehensive long-term benefits.

Teaching the anatomy of oncology: evaluating the impact of a dedicated oncoanatomy course.

PURPOSE: Anatomic considerations are often critical in multidisciplinary cancer care. We developed an anatomy-focused educational program for radiation oncology residents integrating cadaver dissection into the didactic review of diagnostic, surgical, radiologic, and treatment planning, and herein assess its efficacy. METHODS AND MATERIALS: Monthly, anatomic-site based educational modules were designed and implemented during the 2008-2009 academic year at Duke University Medical Center. Ten radiation oncology residents participated in these modules consisting of a 1-hour didactic introduction followed by a 1-hour session in the gross anatomy lab with cadavers prepared by trained anatomists. Pretests and posttests were given for six modules, and post-module feedback surveys were distributed. Additional review questions testing knowledge from prior sessions were integrated into the later testing to evaluate knowledge retention. Paired analyses of pretests and postests were performed by Wilcoxon signed-rank test. RESULTS: Ninety tests were collected and scored with 35 evaluable pretest and posttest pairs for six site-specific sessions. Posttests had significantly higher scores (median percentage correct 66% vs. 85%, p<0.001). Of 47 evaluable paired pretest and review questions given 1-3 months after the intervention, correct responses rates were significantly higher for the later (59% vs. 86%, p=0.008). Resident course satisfaction was high, with a median rating of 9 of 10 (IQR 8-9); with 1 being "less effective than most educational interventions" and 10 being "more effective than most educational interventions." CONCLUSIONS: An integrated oncoanatomy course is associated with improved scores on post-intervention tests, sustained knowledge retention, and high resident satisfaction.

The relationship of self-reported pain and functional impairment to gait mechanics in overweight and obese persons with knee osteoarthritis.

OBJECTIVE: To examine the degree to which 2 commonly used measures of pain and disability, the Arthritis Impact Measurement Scales (AIMS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), relate to objective gait measurements. DESIGN: A descriptive study of the influence of self-reported pain and perceived functional impairment on gait mechanics in osteoarthritic adults. SETTING: A university clinical research laboratory. PARTICIPANTS: Overweight/obese adults with radiographic knee osteoarthritis (OA) as well as pain and disability associated with the disease (N=179). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The AIMS and WOMAC were administered to determine self-report measures of pain and disability. Speed, stride length, support time, knee angle, and peak vertical force (PVF) were determined from 3-dimensional kinematic and kinetic data collected on subjects walking at self-selected normal and fast speeds. Anthropometric data and radiographic levels of OA were also collected. RESULTS: Pearson correlation analysis showed that the AIMS physical disability score was inversely correlated with speed, stride length, and knee range of motion at both speeds and PVF at the fast speed. The WOMAC function score was inversely correlated with speed and stride length at both speeds and with PVF at fast speed. The WOMAC pain score was inversely correlated with speed and PVF at the fast speed. Regression analysis revealed that the AIMS physical disability score and body mass index accounted for the greatest variation in speed at the normal speed. Overall, AIMS physical disability and WOMAC function explained a larger proportion of variance in gait mechanics than radiographic measures of OA disease severity. CONCLUSIONS: Taken together, the results suggest that the AIMS physical disability and WOMAC function scores are associated with some important measures of gait impairment.

An interactive method for teaching anatomy of the human eye for medical students in ophthalmology clinical rotations.

Much research has shown the benefits of additional anatomical learning and dissection beyond the first year of medical school human gross anatomy, all the way through postgraduate medical training. We have developed an interactive method for teaching eye and orbit anatomy to medical students in their ophthalmology rotation at Duke University School of Medicine. We provide review lectures on the detailed anatomy of the adult human eye and orbit as well as the developmental anatomy of the eye. These lectures are followed by a demonstration of the anatomy of the orbit using conventional frontal and superior exposures on a prosected human cadaver. The anatomy is projected onto a large LCD screen using a mounted overhead camera. Following a brief lecture on clinically relevant anatomy, each student then dissects a fresh porcine (pig) eye under low magnification using a dissecting microscope. These dissections serve to identify structures extrinsic to the eyeball, including extraocular muscle attachments, small vessels, optic nerve stalk, and fascial sheath of the eyeball (Tenon's fascia). Dissection then shifts to the internal anatomy of the eyeball. The size and anatomy of the porcine eye is comparable with that of the human and the dissection provides students with a valuable hands-on learning opportunity that is otherwise not available in embalmed human cadavers. Students and clinical faculty feedback reveal high levels of satisfaction with the presentation of anatomy and its scheduling early during the ophthalmology clerkship.

Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability.

This study examined the degree to which pain catastrophizing and pain-related fear explain pain, psychological disability, physical disability, and walking speed in patients with osteoarthritis (OA) of the knee. Participants in this study were 106 individuals diagnosed as having OA of at least one knee, who reported knee pain persisting for six months or longer. Results suggest that pain catastrophizing explained a significant proportion (all Ps < or = 0.05) of variance in measures of pain (partial r(2) [pr(2)] = 0.10), psychological disability (pr(2) = 0.20), physical disability (pr(2) = 0.11), and gait velocity at normal (pr(2) = 0.04), fast (pr(2) = 0.04), and intermediate speeds (pr(2) = 0.04). Pain-related fear explained a significant proportion of the variance in measures of psychological disability (pr(2) = 0.07) and walking at a fast speed (pr(2) = 0.05). Pain cognitions, particularly pain catastrophizing, appear to be important variables in understanding pain, disability, and walking at normal, fast, and intermediate speeds in knee OA patients. Clinicians interested in understanding variations in pain and disability in this population may benefit by expanding the focus of their inquiries beyond traditional medical and demographic variables to include an assessment of pain catastrophizing and pain-related fear.

Sex differences in biomechanics associated with knee osteoarthritis.

Osteoarthritis of the knee is seen more frequently in females than males. However, few studies have examined the interplay of gender, gait mechanics, pain, and disability in persons with osteoarthritis. This study examines the influence of anthropometrics, radiographic disease severity, pain, and disability on gender differences in gait mechanics in patients with knee osteoarthritis. Gait mechanics for 26 men and 30 women were collected using 3-D kinematics and kinetics. Women had a significantly lower knee adduction moment than men and a significantly higher stride frequency. Within female subjects, variations in gait mechanics were primarily explained by weight, BMI, pain, and disability. In males, variations in gait mechanics were primarily explained by age and disability.

Racial differences in gait mechanics associated with knee osteoarthritis.

BACKGROUND AND AIMS: This study examines racial differences in gait mechanics in persons with knee osteoarthritis and the influence of anthropometrics, educational level, radiographic disease severity (rOA), and self-report measures of pain and disability on racial differences in gait. METHODS: One hundred seventy five (64 black and 111 white) adults with radiographic knee OA were tested. 3-D kinematic and kinetic data were collected while subjects walked at two self-selected speeds (normal and fast). Anthropometric data, radiographic level of OA, and self-report measures of pain and disability were also collected. Gait patterns were compared across groups and within groups. RESULTS: Black and white subjects did not differ significantly in radiographic OA. However, blacks walked significantly more slowly when asked to walk fast. At the normal speed, blacks had a smaller knee range of motion and loading rate than whites. Blacks also took longer to reach their peak maximum ground reaction force than whites. Within black subjects variations in gait mechanics were primarily explained by BMI, rOA, selfreported psychological disability, and pain self-efficacy. In white subjects, variations in gait mechanics were primarily explained by weight, age, velocity, psychological disability, and self-efficacy. CONCLUSIONS: Blacks in this study had a pattern of gait mechanics generally associated with high levels of osteoarthritis, though they did not differ significantly in rOA from whites. The variability in gait patterns exhibited by blacks was most strongly related to variance in walking speed, anthropometrics, and perceived physical ability. Taken together, these results suggest that race is an important factor that must be considered in the treatment and study of osteoarthritis.