Persistent racial discrimination among vascular surgery trainees threatens wellness

被引:13
作者
Pillado, Eric B. [1 ]
Li, Ruojia Debbie [1 ]
Eng, Joshua S. [1 ]
Chia, Matthew C. [1 ]
Conway, Allan [2 ]
Gomez-Sanchez, Clara [3 ]
Shaw, Palma [4 ]
Sheahan, Malachi G., III [5 ]
Bilimoria, Karl Y. [1 ]
Hu, Yue-Yung [1 ]
Coleman, Dawn M. [6 ]
机构
[1] Northwestern Univ, Surg Outcomes & Qual Improvement Ctr, Dept Surg, Chicago, IL USA
[2] Lenox Hill Hosp, Northwell Hlth, Div Vasc Surg, Dept Surg, New York, NY USA
[3] Univ Calif San Francisco, Dept Surg, Div Vasc Surg, San Francisco, CA USA
[4] Upstate Med Univ, Div Vasc Surg, Syracuse, NY USA
[5] Louisiana State Univ, Div Vasc & Endovasc Surg, Hlth Sci Ctr, New Orleans, LA USA
[6] Univ Michigan, Dept Surg, Sect Vasc Surg, FCVC 5172,1500 E Med Ctr Dr,SPC 5867, Ann Arbor, MI 48109 USA
基金
美国医疗保健研究与质量局; 美国国家卫生研究院;
关键词
Burnout; Ethnicity; Mistreatment; Race; Wellness; DIVERSITY; RESIDENCY; MISTREATMENT; PHYSICIANS; WORKFORCE; MINORITY; VIOLENCE; MODEL; RISK; CARE;
D O I
10.1016/j.jvs.2022.09.011
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: Racial/ethnic discrimination is one form of mistreatment and a known risk factor for physician burnout. In the present study, we aimed to characterize the forms and identify the sources of racial/ethnic discrimination among vascular surgery trainees. Methods: We performed a cross-sectional study of U.S. vascular surgery trainees who had voluntarily participated in an anonymous survey administered after the 2021 Vascular Surgery In-Training Examination. The primary outcome measures were self-reported mistreatment and sources of mistreatment between race and ethnicity groups. We used chi(2) tests and logistic regression for bivariate and multivariable analyses, respectively. Results: Representing all 123 vascular surgery training programs, 510 trainees (66.9% men) participated in the survey (83.6% response rate). Most of the trainees had self-identified as White (53.1%), followed by Asian (24.4%), Hispanic/Latinx (7.6%), Black (4.2%), and other/prefer not to say (10.8%). No significant differences were found in the self-reported duty hour violations among the groups. Black (56.3%) and Asian (36.3%) trainees reported higher rates of racial/ethnic discrimination compared with the White, Hispanic/Latinx, and other/prefer not to say groups ( P < .001). Patients and their families were reported as the most common source (74.7%). Other reported sources of discrimination included nurses or staff (60%), attendings (37.4%), co-residents (31.3%), and administration (16.9%). Regarding specific forms of racial discrimination, Black and Asian trainees reported the highest rates of different standards of evaluation (20% and 5.9%, respectively), being mistaken for a nonphysician (50.0% and 5.9%, respectively), slurs and/or hurtful comments (13.3% and 5.9%, respectively), social isolation (13.0% and 1.0%, respectively), and being mistaken for another trainee of the same race/ethnicity (60.0% and 33.7%, respectively). Only 62.5% of Black trainees reported their program/institution would take their mistreatment report seriously compared with the White (88.9%), Hispanic/Latinx (88.2%), Asian (83.2%), and other/prefer not to say (71.4%) trainees ( P = .01). On multivariable analysis, female gender (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.44-4.33), Asian race (OR, 6.9; 95% CI, 3.53-13.3), Black race (OR, 13.6; 95% CI, 4.25-43.4), and training in the Southeastern United States (OR, 3.8; 95% CI, 1.17-12.80) were risk factors for racial/ethnic discrimination. Conclusions: The results from the survey revealed that racial/ethnic discrimination persists in surgical training programs, with Asian and Black trainees reporting higher rates than other racial and ethnic groups. Overall, patients and family members were the most common source of racial/ethnic discrimination. However, faculty, staff, and co-trainees also contributed to racial/ethnic discrimination. Further interventions that optimize diversity, equity, and inclusion strategies and policies to address all forms of racial/ethnic discrimination with faculty, staff, and patients within the hospital are critically needed.
引用
收藏
页码:262 / 268
页数:7
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