Identification and Assessment of Strategies to Address Gender Inequity in the Specialty of Critical Care Medicine: A Scoping Review, Modified Consensus Process, and Stakeholder Meeting. (18th January 2022)

• Record Type: Journal Article
• Authors: Parsons Leigh, Jeanna; de Grood, Chloe; Brundin-Mather, Rebecca; Dodds, Alexandra; FitzGerald, Emily A.; Kemp, Laryssa; Mizen, Sara J.; Whalen-Browne, Liam; Stelfox, Henry T.; Fiest, Kirsten M.
• Other Names: Parsons Leigh Jeanna author non-byline.; Ahmed Sofia author non-byline.; Aslakson Rebecca author non-byline.; Barrett Kali author non-byline.; Barter Jill Ola author non-byline.; Baruah Rosaleen author non-byline.; Battista Marie-Claude author non-byline.; Bosma Karen J. author non-byline.; Burns Karen E. A. author non-byline.; Brochard Laurent Jean author non-byline.; Chung Han-Oh author non-byline.; Cook Deborah author non-byline.; Côté Andréanne author non-byline.; Dionne Joanna C. author non-byline.; Drover John author non-byline.; Douflé Ghislaine author non-byline.; Downar James author non-byline.; Duggan Shelley author non-byline.; Fowler Robert author non-byline.; Garland Allan author non-byline.; Gilfoyle Elaine author non-byline.; Hawker Gillian author non-byline.; Herridge Margaret author non-byline.; Honarmand Kimia author non-byline.; Karachi Tim author non-byline.; Kawchuk Joann author non-byline.; Khadaroo Rachel G. author non-byline.; Lara Abigail author non-byline.; Mehta Sangeeta author non-byline.; Mele Tina author non-byline.; Menon Kusum author non-byline.; Murthy Srinivas author non-byline.; Neilipovitz David author non-byline.; Olafson Kendiss author non-byline.; O'Leary Tony author non-byline.; Paunovic Bojan author non-byline.; Ramsey Clare author non-byline.; Fox-Robichaud Alison author non-byline.; Rubulotta Francesca author non-byline.; Sauro Khara author non-byline.; Scales Damon author non-byline.; Straus Sharon author non-byline.; Tsang Jennifer author non-byline.; Wunsch Hannah author non-byline.; Zavalkoff Samara author non-byline.; Zimmerman Janice author non-byline.; Fiest Kirsten author non-byline.; contributor.; Stelfox Henry Thomas author non-byline.;
• Is Part Of: Critical care explorations. Volume 4:Number 1(2022)
• Page Start: e0612
• Publication Date: 2022-01-18
• Subjects: consensus process -- critical care medicine -- gender equity -- medical specialties -- scoping review
• DOI: 10.1097/CCE.0000000000000612
• Languages: English
• ISSNs: 2639-8028

Abstract

Abstract : Supplemental Digital Content is available in the text. Abstract : OBJECTIVES: We sought to identify and prioritize improvement strategies that Critical Care Medicine (CCM) programs could use to inform and advance gender equity among physicians in CCM. DESIGN: This study involved three sequential phases: 1) scoping review that identified strategies to improve gender equity in all medical specialties; 2) modified consensus process with 48 CCM stakeholders to rate and rank identified strategies; and 3) in-person stakeholder meeting to refine strategies and discuss facilitators and barriers to their implementation. SETTING: CCM. SUBJECTS: CCM stakeholders (physicians, researchers, and decision-makers; mutually inclusive). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We identified 190 unique strategies from 416 articles. Strategies were grouped thematically into 20 categories across four overarching pillars of equity: access, participation, reimbursement, and culture. Participants prioritized 22 improvement strategies for implementation in CCM. The top-rated strategy from each pillar included: 1) nominate gender diverse candidates for faculty positions and prestigious opportunities (equitable access); 2) mandate training in unconscious bias and equitable treatment for committee (e.g., hiring, promotion) members (equitable participation); 3) ensure equitable starting salaries regardless of sex or gender (equitable reimbursement); and, 4) conduct 360° evaluations of leaders (including their direct work circle of supervisors, peers, and subordinates) through a diversity lens (equitable culture). Interprofessional collaboration, leadership, and local champions were identified as key enablers for implementation. CONCLUSIONS: We identified stakeholder-prioritized strategies that can be used to inform and enhance gender equity among physicians in CCM under four overarching equity pillars: access, participation, reimbursement, and culture. Implementation approaches should include education, policy creation, and measurement, and reporting.