Persistent racial discrimination among vascular surgery trainees threatens wellness.

Autor:	Pillado EB; Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University, Chicago, IL., Li RD; Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University, Chicago, IL., Eng JS; Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University, Chicago, IL., Chia MC; Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University, Chicago, IL., Conway A; Division of Vascular Surgery Lenox Hill Hospital, Department of Surgery, Northwell Health, New York, NY., Gomez-Sanchez C; Division of Vascular Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA., Shaw P; Division of Vascular Surgery, Upstate Medical University, Syracuse, NY., Sheahan MG 3rd; Division of Vascular and Endovascular Surgery, Louisiana State University Health Sciences Center, New Orleans, LA., Bilimoria KY; Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University, Chicago, IL., Hu YY; Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University, Chicago, IL., Coleman DM; Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI. Electronic address: dawn.coleman@duke.edu.
Jazyk:	angličtina
Zdroj:	Journal of vascular surgery [J Vasc Surg] 2023 Jan; Vol. 77 (1), pp. 262-268. Date of Electronic Publication: 2022 Sep 20.
DOI:	10.1016/j.jvs.2022.09.011
Abstrakt:	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 χ 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. (Published by Elsevier Inc.)
Databáze:	MEDLINE
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