Research and Scholarship

U of U Health Initiatives and Programs

Part of working as institutional leaders in equity, diversity, and inclusion (EDI) is supporting one another in this transformative work. Bart Watts, DDS (first author), is the associate dean of EDI at the School of Dentistry; José Rodríguez, MD (second author), is the associate vice president of EDI in the health system. Together, we had the opportunity to attend a longitudinal training at the Association of American Medical Colleges called the Healthcare Executive Diversity and Inclusion Certificate (HEDIC) program. This essay captures our reflections on our shared experience at HEDIC.

Read Coming Out

Lead Author

Bart Watts, DDS - Office of Equity, Diversity and Inclusion | Ethics and Professionalism Section, School of Dentistry, University of Utah School, Salt Lake City, UT

Co-Author

José E. Rodríguez, MD, FAAFP - University of Utah Health Equity, Diversity and Inclusion, Salt Lake City, UT

Watts B, Rodríguez JE. Coming Out. [published September 14, 2023]. Fam Med. https://doi.org/10.22454/FamMed.2023.192760.

Being a Scientist: In the name of perseverance

Between honoring her immigrant family and making her children proud, a first-generation PhD student fights for her place in academia.

Read Being a Scientist

Author

Tanya Espino-Sanchez - University of Utah, Salt Lake City, UT

Tanya Espino-Sanchez (2023) Being a Scientist: In the name of perseverance eLife 12:e92403. https://doi.org/10.7554/eLife.92403

Future Doctors From Underrepresented in Medicine Communities at the University of Utah

Future Doctors (FD), a high school pathway program, was developed to address the lack of compositional diversity in the health professions at our health sciences campus. We obtained, analyzed, and compared data on FD student demographic and educational achievement at undergraduate and graduate programs at the University of Utah and graduate programs at other institutions to non-FD students. We followed students from high school to graduate school. We analyzed data from 1,897 FD participants (2014–2019). FD participants were 71% women, with 50.3% identifying as students of color. Ninety-eight students matriculated in graduate school, with 75 (76%) remaining at University of Utah and 45 (46%) attending health sciences graduate programs. FD student cohorts are more diverse than those in the University of Utah undergraduate and graduate programs, contributing to the diversity of those programs. More research is needed to ensure that graduate school gains are evidenced in all underrepresented groups.

Paloma F. Cariello, MD, MPH - Office of Health Equity, Diversity and Inclusion, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT

Co-Authors

Edgar Figueroa, MD, MPH - Student Health Services, Weill Cornell Medicine, New York, NY
Christopher M. Harris, MBA - University of Utah Health Equity, Diversity and Inclusion, Salt Lake City, UT
Donna R. Eldridge, MSW - Office of Health Equity, Diversity and Inclusion, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT
Melanie Hooten, BA - Global Health Division, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT
Guillermo E. Cuevas, BS - University of Utah Health Equity, Diversity and Inclusion, Salt Lake City, UT
Jessica L. Jones, MD, MSPH - Department of Family and Preventive Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT
Maia Hightower, MD, MPH, MBA - University of Utah Health Equity, Diversity and Inclusion, Salt Lake City, UT
Kendall M. Campbell, MD - Department of Family Medicine, University of Texas Medical Branch, Galveston, TX
Mike Martineau, PhD - Office of Budget and Institutional Analysis, University of Utah, Salt Lake City, UT
José E. Rodríguez, MD - University of Utah Health Equity, Diversity and Inclusion, Salt Lake City, UT
Luis A. Oquendo, PhD - Office of Budget and Institutional Analysis, University of Utah, Salt Lake City, UT

Cariello PF, Figueroa E, Harris CM, et al. Future Doctors From Underrepresented in Medicine Communities at the University of Utah. PRiMER. 2023;7:25. https://doi.org/10.22454/PRiMER.2023.296084

Using Natural Language Processing and Machine Learning to Identify Internal Medicine–Pediatrics Residency Values in Applications

Using residency applications to the University of Utah internal medicine–pediatrics program from 2015 to 2019, the authors extracted relevant snippets of text from the narrative sections of applications. Expert reviewers annotated these snippets into specific values (academic strength; intellectual curiosity; compassion; communication; work ethic; teamwork; leadership; self-awareness; diversity, equity, and inclusion; professionalism; and adaptability) previously identified as associated with resident success. The authors prospectively applied a machine learning model (MLM) to snippets from applications from 2023, and output was compared with a manual holistic review performed without knowledge of MLM results.

Benjamin Drum, MD, PhD - assistant professor, Department of Internal Medicine, and adjunct professor, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City Utah
Jianlin Shi, MD, PhD - research associate, Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah
Bennet Peterson - graduate student, Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah
Sara Lamb, MD - vice dean of education, University of Utah School of Medicine, Salt Lake City, Utah
John F. Hurdle, MD, PhD - professor, Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah
Casey Gradick, MD, MPH - assistant professor, Department of Internal Medicine, and adjunct professor, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah

Drum, Benjamin MD, PhD1; Shi, Jianlin MD, PhD2; Peterson, Bennet3; Lamb, Sara MD4; Hurdle, John F. MD, PhD5; Gradick, Casey MD, MPH6. Using Natural Language Processing and Machine Learning to Identify Internal Medicine–Pediatrics Residency Values in Applications. Academic Medicine ():10.1097/ACM.0000000000005352, July 27, 2023. | DOI: 10.1097/ACM.0000000000005352

Perceived Disability-Based Discrimination in Health Care for Children With Medical Complexity

Disability-based discrimination in health care can lead to low quality of care, limited access to care, and negative health consequences. Yet, little is known regarding the experiences of disability-based discrimination in health care for children with medical complexity and disability. An understanding of disability-based discrimination in pediatrics is needed to drive change and improve care.

Stefanie G. Ames, MD, MS - Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
Rebecca K. Delaney, PhD - Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT
Amy J. Houtrow, MD, PhD, MPH - Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA
Claudia Delgado-Corcoran, MD - Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
Justin Alvey, MD - Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
Melissa H. Watt, PhD - Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT
Nancy Murphy, MD - Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT

Stefanie G. Ames, Rebecca K. Delaney, Amy J. Houtrow, Claudia Delgado-Corcoran, Justin Alvey, Melissa H. Watt, Nancy Murphy; Perceived Disability-Based Discrimination in Health Care for Children With Medical Complexity. Pediatrics July 2023; 152 (1): e2022060975. 10.1542/peds.2022-060975

Skin Color Representation in Teaching Photographs

Skin Color Representation in Teaching Photographs: One Institution’s Approach to Addressing Visual Racism in Medical Education

Visual racism refers to both the underrepresentation and inappropriate representation of darker skin types in medical education. By not teaching medical students and resident physicians to recognize common conditions in darker skin, it perpetuates biases that contribute to healthcare disparities for racial and ethnic minoritized groups. In this paper we describe our efforts to engage in institutional anti-racism work by addressing imbalances in representation of darker skin types in visual teaching images within our institution’s curriculum.

Ha D. H. Le - Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
Shreya Sreekantaswamy - Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
Holly Lind - Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
Michael B. Birdsall - Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
Jenna Jensen - Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
Stormy C. Foster-Palmer - College of Social & Behavioral Science, University of Utah, Salt Lake City, Utah, USA
Ben J. Brintz - Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
Candace Chow - Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
Boyd Richards - Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
Sarah D. Cipriano - Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA

Ha D. H. Le, Shreya Sreekantaswamy, Holly Lind, Michael B. Birdsall, Jenna Jensen, Stormy C. Foster-Palmer, Ben J. Brintz, Candace Chow, Boyd Richards & Sarah D. Cipriano (2023) Skin Color Representation in Teaching Photographs: One Institution’s Approach to Addressing Visual Racism in Medical Education, Teaching and Learning in Medicine, DOI: 10.1080/10401334.2023.2226648

Everyone’s Work

To truly sustain diversity, equity and inclusivity, institutions must take a shared equity leadership approach, writes Amy Fulton.

Amy Futon - Director, New Leadership Academy

Fulton, A. (2023, April 27). Sustaining diversity, equity and inclusion requires shared leadership (opinion). Inside Higher Ed. Retrieved April 27, 2023, from https://www.insidehighered.com/opinion/career-advice/diversity/2023/04/27/everyones-work

Values-Based Resident Selection in an Internal Medicine-Pediatrics Residency Program

There is no consensus regarding values important for medical resident success, and current methods for selecting residents correlate poorly with success in residency. We developed and validated a set of values demonstrated by exemplary residents in the Internal Medicine-Pediatrics program at the University of Utah and used them to inform our resident selection process. We utilized a modified Delphi method to identify and internally validate values of successful residents. We implemented these values into the interview evaluation rubric.

Benjamin Drum, MD, PhD - Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, USA
Sara Lamb, MD - Department of Internal Medicine and Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, USA
Casey Gradick MD, MPH - Department of Internal Medicine and Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, USA

Drum, B., Lamb, S. & Gradick, C. Values-Based Resident Selection in an Internal Medicine-Pediatrics Residency Program. J GEN INTERN MED 38, 1410–1416 (2023). https://doi.org/10.1007/s11606-022-07857-y

Towards a Common Lexicon for Equity, Diversity, and Inclusion Work in Academic Medicine

Differential rewarding of work and experience has been a longtime feature of academic medicine, resulting in a series of academic disparities. These disparities have been collectively called a cultural or minority “tax,” and, when considered beyond academic medicine, exist across all departments, colleges, and schools of institutions of higher learning–from health sciences to disciplines located on university campuses outside of medicine and health. A shared language can provide opportunities for those who champion this work to pool resources for larger impacts across the institution. This article aims to catalog the terms used across academic medicine disciplines to establish a common language describing the inequities experienced by Black, Latinx, American Indian/Alaska Native and Native Hawaiian/Other Pacific Islander, Women, and other underrepresented people as well as queer, disabled, and other historically marginalized or excluded groups. These ideas are specific to academic medicine in the United States, although many can be used in academic medicine in other countries. The terms were selected by a team of experts in equity, diversity, and inclusion, (EDI) who are considered national thought leaders in EDI and collectively have over 100 years of scholarship and experience in this area.

José E. Rodríguez - University of Utah Health
Edgar Figueroa - Weill Cornell Medicine
Kendall M. Campbell - Department of Family Medicine, University of Texas Medical Branch
Judy C. Washington - Overlook Hospital at Atlantic Health
Octavia Amaechi - Spartanburg Regional Medical Center
Tanya Anim - Lee Memorial Health and Florida State University
Kari-Claudia Allen - Prisma Health/University of South Carolina School of Medicine
Krys E. Foster - Sidney Kimmel Medical College at Thomas Jefferson University
Maia Hightower - University of Utah Health
Yury Parra - New York City Health and Hospitals
Maria H. Wusu - Morehouse School of Medicine
William A. Smith - Huntsman Mental Health Institute, University of Utah
Mary Ann Villarreal - University of Utah Health
Linda H. Pololi - The National Initiative on Gender, Culture and Leadership in Medicine: C-Change, Brandeis University

Rodríguez, J.E., Figueroa, E., Campbell, K.M. et al. Towards a common lexicon for equity, diversity, and inclusion work in academic medicine. BMC Med Educ 22, 703 (2022). https://doi.org/10.1186/s12909-022-03736-6

Increasing URiM Family Medicine Residents

Increasing URiM Family Medicine Residents at University of Utah Health

The Department of Family and Preventive Medicine is home for the University of Utah’s Family Medicine Residency program. Although Utah’s diversity is steadily increasing, the race/ethnic diversity of the program’s family medicine residency does not reflect the state’s general population.

Intentional resident recruitment initiatives can transform racial/ethnic diversity in a family medicine residency program in a short amount of time.

Kirsten Stoesser, MD, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT
Kara A. Frame, MD, University of Utah Family Medicine Residency, University of Utah Health Salt Lake City, UT
Osman Sanyer, MD, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT
Jennifer P. Leiser, MD, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT
Laura Elizabeth Moreno, MD, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT
Clarivette Bosch, MD, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT
Jessica L. Jones, MD, MSPH, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT
Jessica J. Morales, MD, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT
Stephanie Rolón Rodríguez, MD, MS, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT
Jenifer Wilson, BA, Office of the Associate Vice President for Health Equity, Diversity and Inclusion, University of Utah Health, Salt Lake City, UT
Line Kemeyou, MD, Office of Health Equity, Diversity and Inclusion, University of Utah School of Medicine, Salt Lake City, UT
José E. Rodríguez, MD, FAAFP, Office for Health Equity and Inclusion, University of Utah, Salt Lake City, UT

Stoesser, K., Frame, K. A., Sanyer, O., Leiser, J. P., Moreno, L. E., Bosch, C., Jones, J. L., Morales, J. J., Rodríguez, S. R., Wilson, J., Kemeyou, L., & Rodríguez, J. E. (2021). Increasing URiM Family Medicine Residents at University of Utah Health. PRiMER (Leawood, Kan.), 5, 42. https://doi.org/10.22454/PRiMER.2021.279738

Introspection to Improve Pipelines and Graduate Programs

Introspection to Improve Pipelines and Graduate Programs at University of Utah Health

Although attrition represents a methodological challenge for evaluating our program, we agree that student factors are but a small part of the challenge, and will heed the call for introspection.

José E. Rodríguez, MD, Office for Health Equity and Inclusion, University of Utah, Salt Lake City, UT
Carolyn Bliss, PhD, University of Utah, Salt Lake City, UT
Kathryn Browning Hawes, BS, Office for Health Equity and Inclusion, University of Utah, Salt Lake City, UT
Nora Wood, PhD, University of Utah, Salt Lake City, UT
Mike Martineau, PhD, Office of Business and Institutional Analytics, University of Utah, Salt Lake City, UT
Marissa L. Diener, PhD, University of Utah, Salt Lake City, UT
Ana María López, MD, MPH, MACP, The Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA

Rodríguez JE, Bliss C, Hawes KB, et al. Introspection to Improve Pipelines and Graduate Programs at University of Utah Health. Fam Med. 2021;53(8):730-730. https://doi.org/10.22454/FamMed.2021.377645.

Diversity in the Physician Assistant Program

Increasing racial and ethnic diversity at the University of Utah physician assistant program

Among the oldest in the nation, the University of Utah Physician Assistant Program (UPAP) serves the state of Utah and surrounding areas and is a division of the Department of Family and Preventive Medicine. Recognizing the need to produce health care providers from diverse racial and ethnic backgrounds, UPAP instituted structural changes to improve student compositional diversity. This paper is a presentation and evaluation of the changes made to determine their relationship with compositional diversity, ultimate practice setting, and national rankings.

Darin Ryujin, MS, MPAS, PA-C, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah
Jared Spackman, MPAS, PA-C, Physician Assistant Program, University of Utah, Salt Lake City, UT
Trenton J. Honda, PhD, MMS, PA-C, Northeastern University Bouvé College of Health Sciences, Boston, MA
Virginia Valentin L., DrPH, PA-C, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT
Doris Dalton, MPA, Physician Assistant Program, University of Utah, Salt Lake City, UT
Mauricio Laguan, BA, Office of the Associate Vice President for Health Equity, Diversity, and Inclusion, University of Utah, Salt Lake City, UT
Wendy L. Hobson, MD, MSPH, Department of Pediatrics, University of Utah, Salt Lake City, UT
José E. Rodríguez, MD, Office for Health Equity and Inclusion, University of Utah, Salt Lake City, UT

Ryujin D, Spackman J, Honda TJ, et al. Increasing Racial and Ethnic Diversity at the University of Utah Physician Assistant Program. Fam Med. 2021;53(5):372-375. https://doi.org/10.22454/FamMed.2021.923340.

Underrepresented Trainees for Biomedical Cancer Research

Preparing historically underrepresented trainees for biomedical cancer research careers at Huntsman Cancer Institute/University of Utah Health

Given the well-documented inequities in health care outcomes by race, ethnicity, and gender, many health career pipeline programs have focused on supporting the development of a diverse and inclusive workforce. PathMaker is a regional, competitive pipeline program that nurtures high school or undergraduate trainees from historically underrepresented backgrounds towards a career in cancer research. Our faculty and staff team collaboratively developed a cohort model curriculum that increased student awareness of research career options; provided academic and professional development, cultural and social support, evolutionary success strategies, active mentorship, and leadership skill development; and fostered an environment of continuous evaluation and improvement. PathMaker is a replicable model to increase diversity and inclusion in the biomedical cancer research workforce.

Ana María López, Professor and Vice Chair of Medical Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadephia, PA, USA
José E Rodríguez, Professor of Family Medicine and Associate Vice President for Health Equity Diversity and Inclusion, University of Utah Health, Salt Lake City, UT, USA
Kathryn Browning Hawes, Office of Health Equity, Diversity and Inclusion, University of Utah Health, Salt Lake City, UT, USA
Anna Marsden, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
Don Ayer, Department of Oncological Sciences, Huntsman Cancer Institute/University of Utah Health, Salt Lake City, UT, USA
Donna Harp Ziegenfuss, Associate Librarian, Marriott Library, University of Utah, Salt Lake City, UT, USA
Kola Okuyemi, Professor and Department Chair of Family & Preventive Medicine

Ana María López, José E Rodríguez, Kathryn Browning Hawes, Anna Marsden, Don Ayer, Donna Harp Ziegenfuss & Kola Okuyemi (2021) Preparing historically underrepresented trainees for biomedical cancer research careers at Huntsman Cancer Institute/University of Utah Health, Medical Education Online, 26:1, DOI: 10.1080/10872981.2021.1929045

Pre-loss Group Therapy for Dementia Family Care Partners

Pre-loss group therapy for dementia family care partners at risk for complicated grief

Dementia family caregiving may span more than a decade and places many family care partners (CPs) at risk for poor bereavement outcomes; estimates of complicated grief in bereaved dementia family CPs range from 10% to 20%. We adapted our efficacious complicated grief group therapy intervention for bereaved dementia caregivers for soon-to-be bereaved dementia CPs at risk for complicated grief to facilitate healthy death preparedness and eventual bereavement-pre-loss group therapy (PLGT).

Katherine P Supiano, University of Utah College of Nursing Salt Lake City USA
Troy Andersen, University of Utah College of Social Work Salt Lake City USA
Marilyn Luptak, University of Utah College of Social Work Salt Lake City USA
Cynthia Beynon, University of Utah College of Nursing Salt Lake City USA
Eli Iacob, University of Utah College of Nursing Salt Lake City USA
Sarah Elizabeth Levitt, University of Utah College of Nursing Salt Lake City USA

Supiano KP, Andersen T, Luptak M, Beynon C, Iacob E, Levitt SE. Pre-loss group therapy for dementia family care partners at risk for complicated grief. Alzheimers Dement (N Y). 2021 May 13;7(1):e12167. doi: 10.1002/trc2.12167. PMID: 34027022; PMCID: PMC8116857.

Native American Summer Research Internship

Lessons from the first decade of the Native American Summer Research Internship at the University of Utah

American Indian/Alaska Native (AI/AN) populations are facing multiple health crises, including limited access to care, high rates of chronic disease, and early mortality that is far worse than other underrepresented minorities in the United States. In 2010, the University of Utah partnered with research, cultural, and professional mentors to create a 10-week summer Native American Research Internship (NARI) program for AI/AN college students across the United States who are interested in pursuing biomedical careers. NARI attracts and supports AI/AN students by offering mentored summer research internships in an innovative, culturally aware framework that adapts to observed challenges to optimize educational experiences and support biomedical career aspirations.

Maija Holsti, MD, MPH, Department of Pediatrics, University of Utah, Salt Lake City, Utah
E.B. Clark is professor, Department of Pediatrics, and associate vice president for clinical affairs, University of Utah, Salt Lake City, Utah
Simon Fisher, MD, Department of Medicine, University of Utah, Salt Lake City, Utah
Sam Hawkins, MD, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
Heather Keenan, MD, PhD, MPH, Department of Pediatrics, University of Utah, Salt Lake City, Utah
Steven Just, PharmD, Walgreens, Minneapolis, Minnesota; recent graduate, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota
Jaymus Lee,second-year graduate student in applied biosciences, Controlled Environmental Agriculture Center, University of Arizona, Tucson, Arizona
Ed Napia, PhD, Urban Indian Center of Salt Lake, Salt Lake City, Utah
J.E. Rodriguez, MD, Department of Family Medicine, University of Utah, Salt Lake City, Utah
Franci Taylor, PhDr, American Indian Resource Center, University of Utah, Salt Lake City, Utah
Richard White, MEd, American Indian/Alaska Native Clinical and Translational Research Program, Montana State University, Bozeman, Montana
Scott Willie, NARI Program, Department of Pediatrics, University of Utah, Salt Lake City, Utah
Carrie L. Byington, MD University of California, Oakland, California

Holsti, Maija MD, MPH; Clark, Edward B. MD; Fisher, Simon MD, PhD; Hawkins, Sam MD; Keenan, Heather MD, PhD, MPH; Just, Steven PharmD; Lee, Jaymus; Napia, Ed PhD; Rodriguez, Jose E. MD; Taylor, Franci PhD; White, Richard MEd; Willie, Scott; Byington, Carrie L. MD Lessons From the First Decade of the Native American Summer Research Internship at the University of Utah, Academic Medicine: April 2021 - Volume 96 - Issue 4 - p 522-528 doi: 10.1097/ACM.0000000000003759

Documenting Food Insecurity Among Medical Students

No Food for Thought: Documenting the Prevalence of Food Insecurity among Medical Students at One Western University

Students, as a vulnerable population, experience high rates of food insecurity. Medical students’ needs have not been fully assessed and often go unmet. Food security among medical students was surveyed using USDA’s 6-item Food Security Module. Respondents (N = 170) were scored as food secure, food insecure, or very low food secure. Of 170 participants, 87 (51%) experienced food insecurity in the past year, five times the national average of 2018 (11.1%). Sixty (35%) respondents reported experiencing low food security, and 27 (16%) respondents reported very low food security placing them at risk of not meeting other basic needs, limiting academic pursuits.

Alyssa Thorman, Medical Student, University of Utah School of Medicine, Salt Lake City, Utah
Harneet Dhillon, Medical Student, University of Utah School of Medicine, Salt Lake City, Utah

Harneet Dhillon, Alyssa Thorman, Jordan Franchina. (2021) Weeding Out Hunger: A Community Garden and Food Pantry Approach to Address Medical Student Food Insecurity. Journal of Hunger & Environmental Nutrition 0:0, pages 1-5.

HS-LEAP Program

Exceeding expectations: students underrepresented in medicine at University of Utah Health

The University of Utah serves an increasingly diverse state and houses the only public medical school, dental school, and college of pharmacy in the state. Utah’s diversity in the health professions lags behind the diversity of its general population, and the nation. The Health Sciences Learning, Engagement, Achievement, and Progress (HS-LEAP) Program is associated with increased students underrepresented in medicine success in undergraduate programs and elevated participation in graduate programs in medicine, dentistry, pharmacy, physician assistant, nursing, and public health. Similar programs, with continuous assessment and evaluation, could be adopted in other locations to improve the representation of these groups in health professions.

Carolyn Bliss, PhD, University of Utah, Salt Lake City, UT
Nora Wood, PhD, University of Utah, Salt Lake City, UT
Mike Martineau, PhD, Office of Business and Institutional Analytics, University of Utah, Salt Lake City, UT
Kathryn Browning Hawes, BS, Office for Health Equity and Inclusion, University of Utah, Salt Lake City, UT
Ana María López, MD, MPH, MACP, The Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
José E. Rodríguez, MD, Office for Health Equity and Inclusion, University of Utah, Salt Lake City, UT

Bliss C, Wood N, Martineau M, Hawes KB, López AM, Rodríguez JE. Exceeding Expectations: Students Underrepresented in Medicine at University of Utah Health. Fam Med. 2020;52(8):570-575. https://doi.org/10.22454/FamMed.2020.137698.

Free Clinic Volunteering

Higher levels of self-efficacy and readiness for a future career of Spanish speaking physician assistant students after their volunteer work in a student-run free clinic in the United States

Volunteering at a free clinic may influence career choice among health profession students. The purpose of this study was to explore knowledge, skills, attitudes, self-efficacy, interest in future work with the underserved, and interest in primary care among physician assistant (PA) students through an analysis of demographic characteristics of PA students at a student-run free clinic in the United States.

Shannon Weaver, Division of Physician Assistant Studies, University of Utah, Salt Lake City, UT, USA
Zainub Hussaini, Department of Sociology, University of Utah, Salt Lake City, UT, USA
Virginia Lynn Valentin, Division of Physician Assistant Studies, University of Utah, Salt Lake City, UT, USA
Samin Panahi, Department of Sociology, University of Utah, Salt Lake City, UT, USA
Sarah Elizabeth Levitt, Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
Jeanie Ashby, Maliheh Free Clinic, Salt Lake City, UT, USA
Akiko Kamimura, Department of Sociology, University of Utah, Salt Lake City, UT, USA

Weaver, S., Hussaini, Z., Valentin, V. L., Panahi, S., Levitt, S. E., Ashby, J., & Kamimura, A. (2019). Higher levels of self-efficacy and readiness for a future career of Spanish speaking physician assistant students after their volunteer work in a student-run free clinic in the United States. Journal of educational evaluation for health professions, 16, 27. https://doi.org/10.3352/jeehp.2019.16.27

U of U Health Authors

Impostor Phenomenon Among Family Medicine Residency Program Directors: A CERA Study

Impostor phenomenon (IP) can be described as feelings of inadequacy that exist despite apparent success. Although IP may be related to multiple important outcomes in physicians, it has not been examined among residency program directors (PDs).

Read the CERA Study

Lead Author

Bharat Gopal, MD, MPH - Samaritan Family Medicine Residency, Corvalis, OR

Co-Authors

Katherine T. Fortenberry, PhD - Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT
Olivia Coskey, MPH - Research Development Office, Samaritan Health Services, Corvallis, OR

Gopal B, Fortenberry KT, Coskey O. Impostor Phenomenon Among Family Medicine Residency Program Directors: A CERA Study. Fam Med. 2023;55(8):550-555. https://doi.org/10.22454/FamMed.2023.439256.

Ageism as a barrier to eliciting what matters

Ageism as a barrier to eliciting what matters: A call for multigenerational action to confront the invisible “-ism”

The local drug store might seem to be an unlikely place to harbor discriminatory messaging about older people. However, the greeting card section is rife with generalizations about older adults that depict aging as a process that inevitably leads to functional and cognitive decline, despite the fact that only 2.5% of older people over age 65 lived in nursing facilities as of 2020. When one considers that 93.4% of US adults aged 50 to 80 experience “everyday” ageism, and that ageism is rampant throughout all sectors of society including entertainment, the media, and politics, it is unsurprising that ageism is present in health care as well.

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Author

Timothy W. Farrell MD, AGSF - associate professor, Associate Chair for Equity, Diversity and Inclusion, Division of Physician Assistant Studies, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah

Farrell, T.W. (2023), Ageism as a barrier to eliciting what matters: A call for multigenerational action to confront the invisible “-ism”. J Am Geriatr Soc. https://doi.org/10.1111/jgs.18551

Implicit Association Test Alone Is Not Sufficient to Increase Underrepresented Minority Representation in Physician Assistant Programs

Physician assistant (PA) program matriculants are consistently less diverse than the US population. This study evaluates whether administration of an Implicit Association Test (IAT) to PA program admission committees is associated with changes in the likelihood of (1) receiving an admission interview, (2) receiving an offer of admission, and (3) matriculation of individuals underrepresented in medicine (URiM).

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Authors

Darin Ryujin, MS, MPAS - associate professor, Associate Chair for Equity, Diversity and Inclusion, Division of Physician Assistant Studies, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah
Doris Dalton, MPA - director of admissions, Division of Physician Assistant Studies, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah
Menerva Yole-Lobe, MPAS - assistant professor, Division of Physician Assistant Studies, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah
Michelle DiBiase, DHSc - professor, chair and program director, Department of Physician Assistant Studies, AT Still University, Mesa, Arizona
Paula Phelps, MHE, MPAS - professor, associate program director, Department of Physician Assistant Studies, Idaho State University, Pocatello, Idaho
Ann Madden, MHS - associate clinical professor, director of clinical education Drexel University Physician Assistant Program, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania
Jon Clark, MBA - assistant director, Operations, Department of Medical Sciences, Northeastern University, Boston, Massachusetts.
Carey L Barry, MHS - department chair, associate clinical professor, Department of Medical Sciences, Northeastern University, Boston, Massachusetts
José E. Rodriguez, MD - associate vice president, Office for Health Equity, Diversity and Inclusion, University of Utah Health. Salt Lake City, Utah
Trenton Honda, PhD, MMS - clinical professor, associate dean, School of Clinical and Rehabilitation Sciences, Department of Medical Sciences, Northeastern University, Boston, Massachusetts

Ryujin D, Dalton D, Yole-Lobe M, DiBiase M, Phelps P, Madden A, Clark J, Barry CL, Rodriguez JE, Honda T. Implicit Association Test Alone Is Not Sufficient to Increase Underrepresented Minority Representation in Physician Assistant Programs. J Physician Assist Educ. 2023 Jul 19. doi: 10.1097/JPA.0000000000000523. Epub ahead of print. PMID: 37467215.

Predictors of applicant pool racial and ethnic diversity among physician assistant education programs

Predictors of applicant pool racial and ethnic diversity among physician assistant education programs: a national cross-sectional cohort study

Numerous studies have demonstrated that the increasing racial and ethnic diversity of the US population benefits from access to healthcare providers from similarly diverse backgrounds. Physician assistant (PA) education programs have striven to increase the diversity of the profession, which is predominantly non-Hispanic white, by focusing on admitting students from historically excluded populations. However, strategies such as holistic admissions are predicated on the existence of racially and ethnically diverse applicant pools. While studies have examined correlates of matriculation into a medical education program, this study looks earlier in the pipeline and investigates whether applicant – not matriculant – pool diversity varies among PA programs with different characteristics.

Trenton J. Honda - School of Clinical and Rehabilitation Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
Daytheon Sturges - Department of Family Medicine, MEDEX Northwest, University of Washington School of Medicine, Seattle, WA, USA
Daphne C. Mills - Physician Assistant Education Association, Washington DC, USA
Cynthia X. Yuen - National Education Association, Washington DC, USA
Ryan W. Chitwood - Synovus, Columbus, GA, USA
José E. Rodríguez, MD - Office of Health Equity, Diversity, and Inclusion, University of Utah Health, Salt Lake City, UT, USA; Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA

Honda, T.J., Sturges, D., Mills, D.C. et al. Predictors of applicant pool racial and ethnic diversity among physician assistant education programs: a national cross-sectional cohort study. BMC Med Educ 23, 514 (2023). https://doi.org/10.1186/s12909-023-04500-0

Strengthening Family Medicine’s Role in Diversity, Inclusion, and Health Equity

We were pleased to read the article entitled “Diversity, Inclusion, and Health Equity in Academic Family Medicine,” by Jacobs et al, which describes the diversity, inclusion, and health equity (DIHE) infrastructure of academic family medicine departments. Considering the racial inequities in health care, it is encouraging to see that family medicine is playing a prominent role in addressing DIHE in academia.

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Authors

Johnathan E. Henderson, MD - Atrium Health Floyd Family Medicine Residency, Rome, GA
Octavia Amaechi, MD - Spartanburg Regional Family Medicine Residency, Spartanburg, SC
José E. Rodríguez, MD - University of Utah Health, Salt Lake City, UT

Henderson JE, Amaechi O, Rodriguez JE. Strengthening Family Medicine’s Role in Diversity, Inclusion, and Health Equity. Fam Med. 2023;55(3):213-213. doi: 10.22454/FamMed.2023.375894

A Peculiar Trend: Family Medicine Residents of Color Are Less Burned Out

We were pleased to read the article by Davis et al examining the association between burnout and professional milestone attainment for family medicine resident physicians. We were very surprised by the finding that, in their study of over 2500 family medicine residents, Black, Latinx, and Asian family medicine residents experience burnout at lower rates than their White peers. It defies logic that residents who identify as Black, Indigenous, or a Person of Color (BIPOC) experience lower levels of burnout when they are differentially and systematically burdened by experiences of discrimination, microaggressions, and inequitable access to mentorship and structured opportunity and lack of belonging compared to their non-BIPOC colleagues. In the discussion, the authors did not have room to explore why burnout trends show the opposite of what we would expect to see. We offer the following insights as to why these findings might be valid, and we would welcome discussion from the authors on this finding.

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Authors

Nicole M. Jackson, MD - Department of Family Medicine, Boston University School of Medicine, Boston, MA | Department of Family Medicine, University of New England College of Osteopathic Medicine, Biddeford, ME | Eastern Connecticut Health Network’s Family Medicine Residency Program, Manchester, CT
Maria Harsha Wusu, MD, MSEd - Department of Family Medicine, Morehouse School of Medicine, Atlanta, GA
Judy C. Washington, MD, FAAFP - Overlook Family Medicine Residency Program, Summit, NJ | Atlantic Medical Group, Morristown, NJ
José E. Rodríguez, MD - Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT

Jackson NM, Wusu MH, Washington JC, Rodriguez JE. A Peculiar Trend: Family Medicine Residents of Color Are Less Burned Out. Fam Med. 2023;55(2):132-133. https://doi.org/10.22454/FamMed.2022.440940.

Start With Individuals, but Ensure That Antiracism Becomes an Institutional Value

We were excited to read the article, “Teaching About Racism in Medical Education: A Mixed-method Analysis of a Train-the-Trainer Faculty Development Workshop,” by Dr Edgoose et al. We applaud the authors for curating a day-long faculty development workshop that provided vocabulary, resources, and tools to address racism. We encourage the authors to continue leading this workshop so that more of us can learn from their expertise and wisdom, ground ourselves with a shared language, engage in crucial conversations, and participate in best-practice activities that deepen our awareness around this work.

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Authors

Angela T. Echiverri, MD, MPH - Contra Costa Family Medicine Residency, San Francisco, CA
Yury Parra, MD, AAHIVS - Contra Costa Family Medicine Residency, San Francisco, CA
José E. Rodríguez, MD - University of Utah Health, Salt Lake City, UT

Echiverri AT, Parra Y, Rodríguez J. Start With Individuals, but Ensure That Antiracism Becomes an Institutional Value. Fam Med. 2023;55(1):67-68. https://doi.org/10.22454/FamMed.55.689129.

A Follow-Up to “The Family Tree Spreads its Limbs: National Academy of Medicine Family Physician New Members 2021”

Shortly after the publication of the editorial celebrating the induction of several family medicine colleagues into the National Academy of Medicine (NAM), I was quickly emailed by the indelible Dr John Frey, “What about Dr Alexandra Adams?” Clearly, in my excitement to share accolades of colleagues in family medicine, I missed 2 very important people. This served as a reminder that family physicians work in a variety of settings outside of family medicine departments. In addition to learning about Dr Adams, I was also alerted to Dr Olayiwola, another family physician, on the list of inductees. I offer my sincerest apology for the hurt I have caused these 2 phenomenal leaders.

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Authors

José E. Rodríguez, MD, FAAFP - University of Utah Health, Salt Lake City, Utah
Edgar Figueroa, MD, MPH, FAAFP - Weill Cornell Medicine, New York, New York

Rodríguez JE, Figueroa E. A Follow-Up to "The Family Tree Spreads its Limbs: National Academy of Medicine Family Physician New Members 2021". Ann Fam Med. 2022 Nov-Dec;20(6):503-504. doi: 10.1370/afm.2893. PMID: 36443086; PMCID: PMC9705042.

Addressing and Dismantling the Legacy of Race and Racism in Academic Medicine: A Socioecological Framework

Over the past several years, in both clinical and academic medicine, there seems to be a growing consensus that racial/ethnic health inequities result from social, economic and political determinants of health rather than from nonexistent biological markers of race. Simply put, racism is the root cause of inequity, not race. Yet, methods of teaching and practicing medicine have not kept pace with this truth, and many learners and practitioners continue to extrapolate a biological underpinning for race. To achieve systemic change that moves us toward racially/ethnically equitable health outcomes, it is imperative that medical academia implement policies that explicitly hold us accountable to maintain a clear understanding of race as a socio-political construct so that we can conduct research, disseminate scholarly work, teach, and practice clinically with more clarity about race and racism. This short commentary proposes the use of a socioecological framework to help individuals, leadership teams, and institutions consider the implementation of various strategies for interpersonal, community-level, and broad institutional policy changes. This proposed model includes examples of how to address race and racism in academic medicine across different spheres, but also draws attention to the complex interplay across these levels. The model is not intended to be prescriptive, but rather encourages adaptation according to existing institutional differences. This model can be used as a tool to refresh how academic medicine addresses race and, more importantly, normalizes conversations about racism and equity across all framework levels.

Jennifer Y. C. Edgoose - Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI
Diana N. Carvajal - Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD
Kristin M. P. Reavis - Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD
Lashika Yogendran - Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI
Angela T. Echiverri - Department of Family & Community Medicine, University of California, San Francisco, San Francisco, CA
José E. Rodriguez - Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT

The Journal of the American Board of Family Medicine Nov 2022, jabfm.2022.220050R2; DOI: 10.3122/jabfm.2022.220050R2

Racial Concordance, Rather Than Cultural Competency Training, Can Change Outcomes

Dr. Guillaume’s piece on Cultural Competence truly does move the conversation on health equity. When cultural competence was first introduced, it rapidly was seen as a solution to growing health disparities among racial and ethnic groups in the United States. However, to date, cultural competency training has not been associated with patient outcomes. Dr. Guillaume teaches us that racial concordance (when the patient and providers share a race/ethnicity) is associated with greater acceptance of preventive measures, greater patient satisfaction and improved show rates. Her letter is a strong argument for increasing racial and ethnic diversity in all health professions.

Gina Guillaume, MD - North by Northeast Community Health Center, Portland, OR
Juan Robles, MD - Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, NY
José E. Rodríguez, MD - Departments of Family Medicine and Health Equity, Diversity and Inclusion, University of Utah Health, Salt Lake City

Guillaume G, Robles J, Rodríguez JE. Racial Concordance, Rather Than Cultural Competency Training, Can Change Outcomes. Fam Med. 2022;54(9):745-746. https://doi.org/10.22454/FamMed.2022.633693.

Submit It Again! Learning From Rejected Manuscripts

Rejection of manuscripts by academic journals can be devastating for early-career family medicine faculty members. Taking experience from teaching early-career underrepresented in medicine faculty members writing and scholarship skills, we identify and explain five lessons to be learned from rejected manuscripts. The five lessons are: (1) rejections teach journal scope, (2) rejections teach process, (3) rejection should lead to resubmission, (4) rejections reflect writing effort, and (5) rejections happen to papers, not authors. Early-career family medicine faculty can use these lessons for reassurance and to adapt behaviors to remain in the scholarship arena.

Kendall M. Campbell, MD - Department of Family Medicine, University of Texas Medical Branch, Galveston, TX
Judy C. Washington, MD - Overlook Family Medicine Residency, Atlantic Medical Group at Atlantic Health, Morristown, NJ
Donna Baluchi, MLIS - Eccles Health Sciences Library, University of Utah Health, Salt Lake City, UT
José E. Rodríguez, MD - Department of Family and Preventive Medicine & University of Utah Health Equity Diversity and Inclusion, Salt Lake City

Campbell KM, Washington JC, Baluchi D, Rodríguez JE. Submit It Again! Learning From Rejected Manuscripts. PRiMER. 2022;6:42. https://doi.org/10.22454/PRiMER.2022.715584

What Do Underrepresented in Medicine Junior Family Medicine Faculty Value From a Faculty Development Experience?

While there is increased attention to underrepresented in medicine (URiM) faculty and students, little is known about what they value in faculty development experiences. We performed a URiM-focused, 3-day family medicine faculty development program and then collected program evaluation forms. The program evaluations had open-ended questions and a reflection on the activity. We used inductive open coding using NVivo software. We analyzed open-ended responses and reflections, and identified themes. Although this faculty development experience was designed to teach writing skills to URiM junior faculty, their collective responses indicate that they found value beyond the skills taught and appreciated the approach taken in this activity.

Krys E. Foster, MD, MPH - Department of Family and Community Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA<
Juan Robles, MD - Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, NY
Tanya Anim, MD - Department of Family Medicine, Lee Memorial Health and Florida State University, Ft. Meyers, FL
Octavia Amaechi, MD - Department of Family Medicine, Spartanburg Regional Medical Center, Spartanburg, SC
Kari-Claudia Allen, MD - Prisma Health-University of South Carolina Family Medicine Residency Program, Columbia, SC
Yury Parra, MD - Department of Family Medicine, New York City Health and Hospitals, New York, NY
Maria Harsha Wusu, MD, MSEd - Department of Family Medicine, Morehouse School of Medicine, Atlanta, GA
Donna Harp Ziegenfuss, EdD, MS - Marriott Library University of Utah, Salt Lake City, UT
Kendall M. Campbell, MD - Brody School of Medicine, East Carolina University, Greenville, NC
José E. Rodríguez, MD - Departments of Family Medicine and Health Equity, Diversity and Inclusion, University of Utah Health, Salt Lake City
Judy C. Washington, MD - Overlook Family Medicine Residency and Atlantic Medical Group at Atlantic Health, Morristown, NJ

Foster KE, Robles J, Anim T, et al. What Do Underrepresented in Medicine Junior Family Medicine Faculty Value From a Faculty Development Experience? Fam Med. 2022;54(9):729-733. https://doi.org/10.22454/FamMed.2022.895447.

Residency Diversity Data Needed to Understand Reporting of Racism/Discrimination

Authored by Kaden Jordan, a fourth-year medical student at the Spencer Fox Eccles School of Medicine at the University of Utah, who is applying to family medicine residencies, reminding researchers that when doing surveys about equity, diversity and inclusion, the demographics of the respondent’s matter, and can affect the reliability of the data.

Kaden Jordan - University of Utah School of Medicine, Salt Lake City
José E. Rodríguez, MD - Departments of Family Medicine and Health Equity, Diversity and Inclusion, University of Utah Health, Salt Lake City

Jordan K, Rodríguez JE. Residency Diversity Data Needed to Understand Reporting of Racism/Discrimination. Fam Med. 2022;54(9):748-749. https://doi.org/10.22454/FamMed.2022.789311.

Oral health is an integral component of age-friendly care

Although dental literature may not have directly informed the 4Ms framework at its inception, it is becoming increasingly evident that oral health is a critical component of geriatric care. We believe healthcare professionals and policymakers should explicitly include oral health as an essential component of the Age-Friendly Health Systems movement.

Alberto Enrique Varela DDS, Section of Geriatric and Adult Special Care Dentistry, University of Utah School of Dentistry, Salt Lake City, Utah, USA
Jose E. Rodriguez MD, Office of the Associate Vice-President for Health Equity, Diversity, and Inclusion, University of Utah Health, Salt Lake City, Utah, USA
Timothy W. Farrell MD, AGSF, Division of Geriatrics, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah, USA

Varela, A.E., Rodriguez, J.E. and Farrell, T.W. (2022), Oral health is an integral component of age-friendly care. J Am Geriatr Soc. https://doi.org/10.1111/jgs.17834

We can do better

Looking across the healthcare professions, some professional oaths pay homage to the importance of diversity, equity, and inclusion (DEI), and others do not. Notably, the Hippocratic Oath, both the original and a widely accepted modern version, is silent on the issue. The Oath of the Pharmacist, on the other hand, was recently updated to describe not only the actions that will be taken to advance DEI (promote inclusion, embrace diversity, advocate for justice), but the ends this oath will achieve—advancing health equity.

Daytheon Sturges, PhD, MPAS, PA-C, Family Medicine, University of Washington, Seattle, WA
Jeanne Cawse-Lucas, MD, Department of Family Medicine, University of Washington, Seattle, WA
Darin Ryujin MS, MPAS, PA-C, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT
José E. Rodríguez MD, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT
Temple S. Howell-Stampley MD, MBA, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
Bau P. Tran PharmD, MMS, PA-C, University of Texas Southwestern Medical Center, Texas Tech University College of Pharmacy, Dallas, TX
Trenton J. Honda PhD, MMS, PA-C, School of Clinical and Rehabilitation Sciences, Northeastern University, Boston, MA

Sturges, Daytheon PhD, MPAS, PA-C; Cawse-Lucas, Jeanne MD; Ryujin, Darin MS, MPAS, PA-C; Rodriguez, José E. MD; Howell-Stampley, Temple S. MD, MBA; Tran, Bau P. PharmD, MMS, PA-C; Honda, Trenton J. PhD, MMS, PA-C We can do better, JAAPA: April 2022 - Volume 35 - Issue 4 - p 14-15 doi: 10.1097/01.JAA.0000827124.00118.42

Bias and the Psychological Safety in Healthcare Teams

The levels of biases, stereotypes, and prejudices are present at the same level within our healthcare teams as they are in society in general. The effect of biases on teams, team development, and team functioning is less known, but what to do with bias is known and important for all healthcare clinicians to understand. Exploring bias and psychological safety is vital for optimal team development. Teams need trust, sense of belonging, and a culture of open communication to provide the best care possible for their patients; yet often teams do not address their own biases or stereotypes nor do they feel prepared to open these conversations. In this article, we present a case study, provide definitions of bias and psychological safety, as well as offer strategies to combat biases, provide steps all of the healthcare team can employ to promote belongingness in the interprofessional team, and offer strategies of supporting team members experiencing biases.

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Authors

Brenda Luther, PhD, RN - Associate Professor, University of Utah, College of Nursing, Salt Lake City
Valerie Flattes, PhD, APRN, ANP-BC - Associate Dean for Equity, Diversity, and Inclusion, University of Utah, College of Nursing, Salt Lake City

Luther, Brenda; Flattes, Valerie. Bias and the Psychological Safety in Healthcare Teams. Orthopaedic Nursing 41(2):p 118-122, March/April 2022. | DOI: 10.1097/NOR.0000000000000831

Address White Fragility in Order to Engage in Racial Caucusing

Guh et al demonstrated how a 90-minute experiential workshop on racial affinity caucusing (RAC) enabled participants to feel comfortable implementing RAC at their own institutions...In places where faculty are unfamiliar with the power of RAC, gaining familiarity with the realities of White fragility may be a prerequisite for an RAC workshop, and can be further explored in that space.

Tiffany Ho, MD, MPH, University of Utah Department of Family and Preventive Medicine, Salt Lake City, UT
José Rodríguez, MD, FAAFP, Office of Health Equity, Diversity, and Inclusion, University of Utah Health, Salt Lake City, UT

Ho T, Rodríguez J. Address White Fragility In Order to Engage in Racial Caucusing. Fam Med. 2022;54(4):318-318. https://doi.org/10.22454/FamMed.2022.162964.

Implementing High-Quality Primary Care Through a Health Equity Lens

The National Academies of Sciences, Engineering, and Medicine (NASEM) released a report on Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care, that provided a framework for defining high-quality primary care and proposed 5 recommendations for implementing that definition. Using the report’s framework, we identified health equity challenges and opportunities with examples from primary care systems in the United States and Canada. The time to transition those conversations to actionable items to improve the health of patients, families, and communities is now.

Azza Eissa, MD, PhD, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
Robyn Rowe, PhD, ICES Central, Strategic Partnerships & Digital Services, Indigenous Data Team, Kingston, Ontario, Canada
Andrew Pinto, MD, MSc, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
George N. Okoli, MD, MSc, George and Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
Kendall M. Campbell, MD, Department of Family Medicine, University of Texas Medical Branch, Galveston, Texas
Judy C. Washington, MD, Atlantic Medical Group, Overlook Family Medicine Residency Program, Summit, New Jersey
José E. Rodríguez, MD, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, Utah

Eissa A, Rowe R, Pinto A, Okoli G, Campbell K, Washington J, Rodríguez J. Implementing High-Quality Primary Care Through a Health Equity Lens. Ann Fam Med 2022;20:Online. https://doi.org/10.1370/afm.2785.

The Family Tree Spreads its Limbs

The Family Tree Spreads its Limbs: National Academy of Medicine Family Physician New Members 2021

It is my pleasure to introduce you to and celebrate the accomplishments of Dr Erik Brodt and Dr Kendall Campbell, family physicians who have both been recently elected to the National Academy of Medicine. While this is a great honor for them, it is also an honor for our specialty, and we should recognize that both of these outstanding physicians identify as underrepresented in medicine! To help you get to know these amazing colleagues, I will share some interesting facts about their lives, as well as their internationally recognized work.

José E. Rodríguez, MD, FAAFP, University of Utah Health, Salt Lake City, UT, USA

Rodríguez J. E. (2022). The Family Tree Spreads its Limbs: National Academy of Medicine Family Physician New Members 2021. Annals of family medicine, 20(1), 2–3. https://doi.org/10.1370/afm.2787

Dismantling Anti-Black Racism in Medicine

The murders of George Floyd and countless other members of the Black community by police prompted family medicine journals and professional societies to publish antiracism statements that provide actions, plans, and accountability structures to eliminate systemic anti-Black racism in medicine...Anti-Black racism is perpetuated by the limited compositional diversity of health systems, and racism happens in the absence of overtly racist people.

José E. Rodríguez, MD, FAAFP, University of Utah Health, Salt Lake City, Utah
Kendall M. Campbell, MD FAAFP, University of Texas Medical Branch, Galveston, Texas
Judy C. Washington, MD, FAAFP, Overlook Family Medicine Residency Program, Summit, New Jersey

JE Rodríguez, KM Campbell, JC Washington. Am Fam Physician. 2021 Dec ;104(6):555-556.

An Approach to Faculty Development for Underrepresented Minorities in Medicine

The diversity of the US physician workforce lags significantly behind the population, and the disparities in academic medicine are even greater, with underrepresented in medicine (URM) physicians accounting for only 6.8% of all US medical school faculty. We describe a “for URM by URM” pilot approach to faculty development for junior URM Family Medicine physicians that targets unique challenges faced by URM faculty.

Juan Robles, MD, Division of Physician Assistant Studies, University of Utah, Salt Lake City, UT, USA
Tanya Anim, MD, Family Medicine Residency Program at Lee Health, Florida State University College of Medicine, Tallahassee, Florida
Maria Harsha Wusu, MD, MSEd, Department of Family Medicine, Morehouse School of Medicine, Atlanta, Georgia
Krys E. Foster, MD, MPH, Department of Family and Community Medicine, Thomas Jefferson University at the Sidney Kimmel Medical College, Philadelphia, Pennsylvania
Yury Parra, MD, Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York
Octavia Amaechi, MD, Spartanburg Regional Family Medicine Residency, Medical University of South Carolina, Charleston, South Carolina
Kari-Claudia Allen, MD, MPH, Palmetto Health-USC Family Medicine Residency Program, University of South Carolina School of Medicine, Columbia, South Carolina
Jose E. Rodríguez, MD, University of Utah School of Medicine, Salt Lake City
Kendall M. Campbell, MD, Department of Family Medicine, East Carolina University, Greenville, North Carolina
Dmitry Tumin, PhD, Brody School of Medicine at East Carolina University, Greenville, North Carolina
Judy Washington, MD, Overlook Family Medicine Residency Program, Atlantic Health System, Summit, New Jersey

Robles, J., Anim, T., Wusu, M. H., Foster, K. E., Parra, Y., Amaechi, O., Allen, K. C., Rodríguez, J. E., Campbell, K. M., Tumin, D., & Washington, J. (2021). An Approach to Faculty Development for Underrepresented Minorities in Medicine. Southern medical journal, 114(9), 579–582. https://doi.org/10.14423/SMJ.0000000000001290

Addressing the Use of Teams in Primary Care

Teams have been important in primary care for almost 15 years, and the recent National Academies of Sciences, Engineering, and Medicine (NASEM) report, Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care, calls for the formation of diverse interprofessional teams that are well prepared and well supported to meet the primary care needs of their communities in the future. In addition, the report specifically recommends that teams be paid to care for people, that teams are trained where people live and work, and that teams are served by new information technology. In this issue of Annals of Family Medicine, we feature articles addressing these recommendations.

José E. Rodríguez, MD, FAAFP, Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
Therese Zink, MD, MPH, FAAFP, Department of Family Medicine & School of Public Health, Brown University, Providence, RI, USA

JE Rodríguez, T Zink, Addressing the Use of Teams in Primary Care. Ann Fam Med 2021;19:386-387. https://doi.org/10.1370/afm.2741.

Abolish the minority woman tax!

In this issue of the Journal of Women's Health, Rodrigues Armijo et al. are to be commended on their excellent article on citizenship tasks for women physicians in academic medicine and the extra burden they shoulder for the sole privilege of being academic physicians. They have elucidated how citizenship tasks are unfairly distributed and coined a new addition to the literature—a “citizenship tax.” It is appalling, but it is the very tip of the iceberg.

José E. Rodríguez, Office of Health Equity, Diversity and Inclusion, University of Utah Health, Salt Lake City, Utah, USA
Maria Harsha Wusu, Family Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA
Tanya Anim, Family Medicine Residency Program at Lee Health, College of Medicine, Florida State University, Ft. Myers, Florida, USA
Kari-Claudia Allen, Palmetto Health-USC Family Medicine Residency Program, University of South Carolina School of Medicine, Columbia, South Carolina, USA
Judy C. Washington, Family Medicine, Overlook Medical Center, Summit, New Jersey, USA

JE Rodríguez, MH Wusu, T Anim, KC Allen, JC Washington, Abolish the Minority Woman Tax!.Journal of Women's Health.Jul 2021.914-915.http://doi.org/10.1089/jwh.2020.8884

Dear White People

We are living in unprecedented times. While the world is grappling with COVID-19, we find the horrors of racism looming equally large as we, yet again, confront lurid deaths in the center of the news cycle of Black and brown people from police bias and brutality. Those of us who have been championing antiracism and justice work and bearing the burden of the “minority tax” have been overwhelmed by sudden asks from our well-intentioned White colleagues of how to best respond. In the tone of the Netflix series, “Dear White People,” we further emphasize that we are not alone in trying to reach out to you, our White colleagues and leaders. Please hear our story and heed our call to action.

Krys E. Foster, Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
Christina N. Johnson, Overlook Family Medicine Residency Program, Summit, New Jersey
Diana N. Carvajal, Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, Maryland
Cleveland Piggott, Department of Family Medicine, University of Colorado, Aurora, Colorado
Kristin Reavis, Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, Maryland
Jennifer Y. C. Edgoose, Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Tricia C. Elliott, JPS Health Network, Fort Worth, Texas
Marji Gold, Department of Family and Social Medicine, Albert Einstein College of Medicine Bronx, New York
José E. Rodríguez, University of Utah Health, Salt Lake City, Utah
Judy C. Washington, Overlook Family Medicine Residency Program, Summit, New Jersey

KE Foster, CN Johnson, DN Carvajal, C Piggott, K Reavis, JYC Edgoose, TC Elliott, M Gold, JE Rodríguez, JC Washington ...Dear White People. The Annals of Family Medicine January 2021, 19 (1) 66-69; DOI: https://doi.org/10.1370/afm.2634

Maximizing Black applicant matriculation in US PA programs

Maximizing Black applicant matriculation in US PA programs: associations between the number of submitted applications and likelihood of matriculation

Physician Assistants (PA) are important members of the medical team, and increasing diversity in healthcare professionals has been consistently associated with improved health outcomes for underrepresented minority patients. In this study of a national cohort of PA program applicants, we investigated whether the number of programs a student applied to (Application Number, AN) was significantly associated with increased likelihood of matriculation into a PA program.

Trenton Honda, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
Trenton D. Henry, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
Ellen D. Mandel, Physician Assistant Program, St. Elizabeth University, Morristown, NJ, USA
Alicia Quella, Department of Physician Assistant Studies, Augsburg University, Minneapolis, MN, USA
José E. Rodríguez, Office of the Associate Vice President for Health Equity, Diversity, and Inclusion, University of Utah Health, UT, Salt Lake City, USA
Shahpar Najmabadi, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
Virginia L. Valentin, Division of Physician Assistant Studies Department of Family and Preventive Medicine, University of Utah, UT, Salt Lake City, USA

Honda, T., Henry, T.D., Mandel, E.D. et al. Maximizing Black applicant matriculation in U.S. PA programs: associations between the number of submitted applications and likelihood of matriculation. BMC Med Educ 21, 127 (2021). https://doi.org/10.1186/s12909-021-02563-5

Sharing the Power of White Privilege to Catalyze Positive Change in Academic Medicine

White privilege can be often overlooked and poorly understood in academic medicine, by those who wield it, and by those who suffer from its deleterious effects. As our nation reckons with the murders of unarmed Black people by police, recognizing that many white people have been allies and agents of change forBlack and other minority people, discussing how the power of white privilege can be shared is needed. The authors discuss the power of white privilege and how that power can be shared to promote change in academic medicine.

José E. Rodríguez, Office of the Associate Vice President for Health Equity, Diversity and Inclusion, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT, USA
Dmitry Tumin, Division of Academic Affairs, Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC, USA
Kendall M. Campbell, Research Group for Underrepresented Minorities in Academic Medicine, Brody School of Medicine, Division of Academic Affairs, East Carolina University, 600 Moye Blvd AD-47, Greenville, NC, 27834, USA

Rodríguez, J.E., Tumin, D. & Campbell, K.M. Sharing the Power of White Privilege to Catalyze Positive Change in Academic Medicine. J. Racial and Ethnic Health Disparities 8, 539–542 (2021). https://doi.org/10.1007/s40615-020-00947-9

Reverse Mentoring between Minority Students and Faculty

Faculty from groups underrepresented in medicine, including Blacks, Latinx, American Indians, Alaska natives, and Pacific Islanders, experience a multitude of obstacles to entering and advancing in the field. At predominantly white institutions, u derrepresented facuty are often isolatedd from majority faculty and mainstream fulcture, feeling uncomfortable and out of place...

Kendall M. Campbell, MD, Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina
Michaela M. Braxton, MSW, Lenoir Country Health Department, Kinston, North Carolina
Dmitry Tumin, PhD, Department of Family Medicine and Department of Pediatrics, Brody School of Medicine, East Carollina University, Greenville, North Carolina
José E. Rodríguez, MD, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah

Campbell, K. M., Braxton, M. M., Tumin, D., & Rodríguez, J. E. (2020). Reverse Mentoring between Minority Students and Faculty. Journal of Best Practices in Health Professions Diversity, 13(2), 184–188. https://www.jstor.org/stable/27056500

Minority Physicians Are Not Protected by Their White Coats

We applaud the authors’ work in their brief report “Implicit Bias Training in a Residency Program: Aiming for Enduring Effects,” and their work to address bias on a systemic level. A priority of the study was to provide insight into how biases perpetuate institutional inequities, exacerbate structural racism, and the significant damage this causes. We wish to add that minority resident physicians are not protected by their white coats. They are also subjected to bias and discrimination from staff, patients, attendings, and colleagues. This has a direct, negative impact on patient care.

Octavia Amaechi, MD, Spartanburg Regional Family Medicine Residency Program, Spartanburg, SC
José E. Rodríguez, MD, Office for Health Equity and Inclusion, University of Utah, Salt Lake City, UT

Amaechi O, Rodríguez JE. Minority Physicians Are Not Protected by Their White Coats. Fam Med. 2020;52(8):603-603. https://doi.org/10.22454/FamMed.2020.737963.