This month, The Center for the Future of the Health Professions will be posting another monthly op-ed column for 2021. Our columns represent strong, informed, and focused opinions on issues that affect the future of the health professions. As mentioned in the past, the center was developed to provide state, local, and national policymakers and health system stakeholders with accurate, reliable, and comprehensive data and research about the healthcare workforce, so they can effectively plan for a sustainable future and make the best use of available resources.
This month features a discussion of The Why and the Need: The Benefit of Diverse Faculty, written by Tessa M. Tibben, DHSc, MPAS, PA-C, assistant professor in the Department of Physician Assistant Studies at A.T. Still University’s Arizona School of Health Sciences (ATSU-ASHS). We encourage readers to share their thoughts after reading this important piece.
Increasing racial and ethnic concordance among healthcare providers also increases the opportunity for patient choice.1 It provides better educational experiences for health professions students to continue to learn skills related to cultural competence in health care.1 According to the 2004 Institutes of Medicine report In the Nation’s Compelling Interest: Ensuring Diversity in the Health Care Workforce, minority representation in healthcare fields was below their respective representation in the general population of communities in the United States.1 Further literature, such as the 2004 Sullivan Commission on Diversity in Healthcare Workforce, also highlights the need to increase minority representation in healthcare fields to reduce healthcare disparities and improve outcomes.7,8,9
As a result of past research findings, an increasing number of academic institutions have endeavored to increase their student populations of underrepresented individuals in medicine (UIM) and have committed to improving the diversity of their curriculum and cultural competence training to meet societal health needs.1 In addition to increasing UIM student representation, commitment to increasing institutional diversity and inclusion also requires hiring diverse faculty and staff.3
The benefit of diverse faculty
Diversity is essential for excellence and requires institutional transformation at all levels to catalyze cultural change. The benefit of increasing diversity among students, faculty, and leadership is creating a broader scope of perspectives, lived experiences, and discussion. Embracing diverse groups’ unique perspectives will organically shift paradigms and increase all individuals’ cultural competence, promoting an environment that yields diversity, inclusivity, and culturally competent health professions graduates.7 To increase institutional excellence in diversity, one step is to recruit and hire diverse faculty intentionally; however, UIM faculty tends to be disproportionately low in academic medical institutions.3
Present barriers reported in the literature
Research from the past few decades highlights commonly reported adversities and experiences of UIM in faculty roles. Some of these factors may also be experienced by non-UIM faculty colleagues, such as lack of guidance with managing teaching load, research, and lack of support from upper administration.5 Beyond these commonly felt experiences, UIM faculty with frequency report lack of mentorship, experienced microaggressions, and faculty colleagues and students’ bias.4,5,6,10,11 They also cite feelings of not feeling their voice, work, or research carries value, inequitable workloads, and challenges with receiving promotion and tenure as barriers to retention.4,5,6,10,11
Lack of mentorship, coupled with feelings of isolation and decreased support, is frequently experienced by UIM faculty.2,3,5,6,11 One contributable cause to consider may be a discordance between an institution’s mission statements and the actions of recruitment and hiring of diverse faculty.5,6,10 Often, UIM faculty report the need to create their social support network outside of their department or institution secondary to lack of internal support and mentorship.5,6,10
Microaggressions, bias, and feelings of not being valued are barriers cited by UIM faculty.3,5,6,10 Minority faculty report resistance to being heard or having their perspectives valued if these thoughts do not align with the majority culture, which commonly results in their initiatives not being advanced. When promoted to positions of leadership, UIM faculty report experiencing increased resistance to their voices and perspectives.5
Another measure by which UIM faculty report feeling a lack of value is their work on diversity, equity, and inclusion initiatives.3,5,6 Diverse faculty are often asked to sit on diversity committees, which adds extra duties to their workload. 3,5,6 Though these efforts are often in direct support of an institution’s mission, they often are time-consuming, taking away from other scholarship opportunities.3,5,6,10 Moreover, the service work of diversity, equity, and inclusion is at times not held in the same regard to other forms of scholarship, contributing to promotion and tenure barriers.3,5,6,10 Other reported barriers to promotion and tenure are increased bias and negative faculty reviews, decreased grant awards, and institutions’ trends to promote more majority than minority faculty.3,4,5,10
Opportunities for improvement
One means to increase UIM faculty is to develop pipeline efforts, mentoring diverse students who aspire to become academicians in the future. The literature supports the theory of UIM students feeling more compelled to return to their academic institutions in a faculty role if their student experiences were positive.3,7,11 Institutions can host cultural humility training workshops for faculty and staff to promote conversations around diversity, equity, and inclusion, promoting needed change and opportunity for persons to identify microaggressions and bias in the workplace.5,11
Collaborative work at all levels of an institution, such as those led by Clinton Normore, MBA, ATSU’s vice president of diversity & inclusion, and his office, creates fertile soils for the fruit of equality and inclusivity yielding a more welcoming environment to all. One of the actions led by Normore was the University’s first comprehensive cultural proficiency climate study. This study informed and spurred the universities’ Advisory Council on Diversity (ACOD) to create campus-wide initiatives. University-wide efforts, led by Normore, have garnered ATSU being the only graduate health professions university to receive the Higher Education Excellence in Diversity (HEED) Award recognition consistently from 2017–20. The HEED award demonstrates ATSUs commitment to affirming and valuing human difference, which is at the core of diversity, equity, and inclusion efforts.
Other opportunities to diminish UIM faculty barriers are developing formal mentoring programs and creatively collaborating with community organizations in the health professions field to create a pool of mentors.2,5 For institutions that embrace, place value on, and promote diversity in their mission statements, consideration to broaden and expand the definition of scholarship to include work done in this realm supports faculty who spend great lengths of time and effort championing this cause, better positioning them for promotion.2,5
As previously stated, diversity is essential for excellence. Diversity amid faculty (and leadership) increases diversity in curriculum and pedagogy, lends to the development of diverse community partnerships for an academic institution, allows for a breadth of voices and perspectives in making informed decisions, creates an inclusive environment welcoming to all, and fosters successful recruitment and retention of diverse faculty, staff, and students.8 Ultimately, this will position academic medical institutions to answer better the community call for diverse, culturally competent health care professionals.