دورية أكاديمية
أعرض في EDS

Overcoming barriers to equality, diversity, inclusivity, and sense of belonging in healthcare education: the Underrepresented Groups' Experiences in Osteopathic Training (UrGEnT) mixed methods study.

التفاصيل البيبلوغرافية
العنوان: Overcoming barriers to equality, diversity, inclusivity, and sense of belonging in healthcare education: the Underrepresented Groups' Experiences in Osteopathic Training (UrGEnT) mixed methods study.
المؤلفون: Draper-Rodi J; University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK. jerry.draper-rodi@uco.ac.uk.; National Council for Osteopathic Research, 275 Borough High Street, SE1 1JE, London, UK. jerry.draper-rodi@uco.ac.uk., Abbey H; University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK., Hammond J; School of Allied and Public Health Professions, North Holmes Road, CT1 1QU, Canterbury, Kent, UK., Thomson OP; University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK., Brownhill K; University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK., MacMillan A; University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK.; University of Portsmouth, University House, Winston Churchill Ave, PO1 2UP, Hampshire, Portsmouth, England., Fabusuyi Y; University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK., Vogel S; University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK.
المصدر: BMC medical education [BMC Med Educ] 2024 Apr 26; Vol. 24 (1), pp. 468. Date of Electronic Publication: 2024 Apr 26.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101088679 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6920 (Electronic) Linking ISSN: 14726920 NLM ISO Abbreviation: BMC Med Educ Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Cultural Diversity* , Osteopathic Medicine*/education , Minority Groups* , Focus Groups*, Humans ; Female ; Male ; United Kingdom ; Students, Medical/psychology ; Adult ; Surveys and Questionnaires ; Young Adult
مستخلص: Background: Individuals from minority groups have historically faced social injustices. Those from underrepresented groups have been less likely to access both healthcare services and higher education. Little is known about the experiences of underrepresented students during their undergraduate studies in osteopathy in the UK. The aim of this project was to explore awareness of cultural diversity and beliefs about patients from underrepresented groups in current osteopathic educational environments and evaluate students' preparedness to manage patients from diverse groups. The project also aimed to investigate the educational experiences of students from underrepresented backgrounds during their training and their opinions on changes that could support better levels of recruitment and achievement. The findings were discussed with stakeholders in interactive workshops with the aim to develop recommendations for action and change.
Methods: A transformative action research paradigm informed this mixed methods project. It included: 1/ a survey of students from all seven osteopathic educational providers in the UK using the Multidimensional Cultural Humility Scale (MCHS); 2/ a series of focus groups with students from underrepresented groups (women, students with disabilities, students from minority ethnic backgrounds, and students identifying as LGBTQIA+); and 3/ a workshop forum to discuss findings.
Results: A total of 202 participants completed the MCHS and demographic questionnaire and seven focus groups were conducted. A model was developed to describe participants' training experiences comprising two main themes: institutional contextual obstacles (with four sub-themes) and underrepresented students' conceptual understanding of Equity, Diversity and Inclusion (EDI). Recommendations for change identified in the workshops were based on three topics: institutions, staff, and students.
Conclusion: Our findings confirm conclusions from other institutions that staff education is urgently needed to create and maintain equitable, inclusive environments in osteopathic educational institutions in the UK to support all students, particularly those from underrepresented groups. Institutional EDI processes and policies also need to be clarified or modified to ensure their usefulness, accessibility, and implementation.
(© 2024. The Author(s).)
التعليقات: Erratum in: BMC Med Educ. 2024 Jun 7;24(1):642. doi: 10.1186/s12909-024-05568-y. (PMID: 38849862)
References: Szetela A. Black lives matter at five: limits and possibilities. Ethn Racial Stud. 2020;43(8):1358–83. (PMID: 10.1080/01419870.2019.1638955)
Regulska J. The #MeToo movement as a global learning moment. Int High Educ. 2018;94:5–6. (PMID: 10.6017/ihe.2018.0.10554)
Dodd V. Met police found to be institutionally racist, misogynistic and homophobic. The guardian [Internet]. 2023 Mar 21 [cited 2024 Jan 10]; https://www.theguardian.com/uk-news/2023/mar/21/metropolitan-police-institutionally-racist-misogynistic-homophobic-louise-casey-report .
Quinn B. People like you still uttered: BAME armed forces personnel on racism in services. The guardian [Internet]. 2020 Jan 7 [cited 2024 Jan 10]; https://www.theguardian.com/uk-news/2020/jan/07/people-like-you-still-uttered-bame-armed-forces-personnel-on-racism-in-services .
The report of the Commission on Race. and Ethnic Disparities [Internet]. Gov.uk. 2021 [cited 2024 Jan 10]. https://www.gov.uk/government/publications/the-report-of-the-commission-on-race-and-ethnic-disparities .
Adams R. Minority ethnic Britons’ educational success not reflected in pay. 2022.
Higher Education Statistics Agency. Higher Education Graduate Outcomes Statistics: UK, 2017/18 - Graduate activities and characteristics [Internet]. 2020 [cited 2024 Jan 10]. https://www.hesa.ac.uk/news/18-06-2020/sb257-higher-education-graduate-outcomes-statistics/activities .
Rimmer A. One in four trainee doctors report discriminatory behaviours from colleagues, GMC finds. BMJ. 2023;1601.
British Medical Association. Factors preventing progress of ethnic minority doctors into senior positions [Internet]. 2022 [cited 2024 Jan 10]. https://www.bma.org.uk/media/5748/bma-why-are-we-still-here-commissioned-report-june-15-2022.pdf .
Norris M, Hammond JA, Williams A, Grant R, Naylor S, Rozario C. Individual student characteristics and attainment in pre registration physiotherapy: a retrospective multi site cohort study. Physiotherapy. 2018;104(4):446–52. (PMID: 10.1016/j.physio.2017.10.006)
Neves J, Hillman N. Student academic experience survey. H. E. P. I. a. H. E. Academy, editor.; 2020.
Bachmann CL, Gooch B. LGBT in Britain - universities Report. London: Stonewall; 2018.
Universities, and Colleges Admissions Service. Entry rates into higher education. Ethnicity, factsfigures [Internet]. 2023 [cited 2024 Jan 10]. https://www.ethnicity-facts-figures.service.gov.uk/education-skills-and-training/higher-education/entry-rates-into-higher-education/latest#by-ethnicity .
Johnson JL, Bottorff JL, Browne AJ, Grewal S, Hilton BA, Clarke H. Othering and being othered in the context of health care services. Health Commun. 2004;16(2):255–71. (PMID: 10.1207/S15327027HC1602_7)
Nixon SA. The coin model of privilege and critical allyship: implications for health. BMC Public Health. 2019;19(1):1637. (PMID: 10.1186/s12889-019-7884-9)
ESFA. Education and Skills agreements 2020 to 2021 [Internet]. Gov.uk. 2020 [cited 2024 Jan 10]. https://www.gov.uk/guidance/esfa-education-and-skills-agreements-2020-to-2021 .
Office for Students. Equality, diversity and student characteristics data - Office for Students. 2022 Jun 7 [cited 2024 Jan 10]; https://www.officeforstudents.org.uk/publications/equality-diversity-and-student-characteristics-data/?_cldee=Hgjd4C0mN-Ei1iAE9EzevenIhwSZ7Dxxo3wjIT8PIAo1SUA3S-H3H-VFCowOM6WI&recipientid=lead-46be407d3275ec1189430022481aa1a1-74564b23bb16438c9a14de1abd81377a&esid=cd365273-6de5-ec11-bb3c-002248004e75.
UCAS. What is the experience of disabled students in education? [Internet]. 2022 [cited 2024 Jan 10]. https://www.ucas.com/file/610106/download?token=1kwt_gKE .
Hammond J, Marshall-Lucette S, Davies N, Ross F, Harris R. Spotlight on equality of employment opportunities: a qualitative study of job seeking experiences of graduating nurses and physiotherapists from black and minority ethnic backgrounds. Int J Nurs Stud. 2017;74:172–80. (PMID: 10.1016/j.ijnurstu.2017.07.019)
Hammond JA, Williams A, Walker S, Norris M. Working hard to belong: a qualitative study exploring students from black, Asian and minority ethnic backgrounds experiences of pre-registration physiotherapy education. BMC Med Educ [Internet]. 2019;19(1). https://doi.org/10.1186/s12909-019-1821-6 .
General Medical Council. GMC targets elimination of disproportionate complaints and training inequalities [Internet]. 2021 [cited 2021 Autumn 5]. https://www.gmc-uk.org/news/news-archive/gmc-targets-elimination-of-disproportionate-complaints-and-training-inequalities .
Ross MH, Setchell J. People who identify as LGBTIQ + can experience assumptions, discomfort, some discrimination, and a lack of knowledge while attending physiotherapy: a survey. J Physiother. 2019;65(2):99–105. (PMID: 10.1016/j.jphys.2019.02.002)
Ross MH, Setchell J. Physiotherapists vary in their knowledge of and approach to working with patients who are LGBTQIA+: a qualitative study. J Physiother. 2023;69(2):114–22. (PMID: 10.1016/j.jphys.2023.02.012)
Council of Deans. Anti-racism in AHP Education: Building an Inclusive Environment [Internet]. 2023 [cited 2024 Jan 10]. https://www.councilofdeans.org.uk/wp-content/uploads/2023/03/Anti.racism.in_.ahp_.education.report.pdf .
House of Commons. House of Commons Women and Equalities Committee Black maternal health Third Report of. Session 2022–23 Report, together with formal minutes relating to the report Ordered by the House of Commons [Internet]. 2023 [cited 2024 Jan 10]. https://committees.parliament.uk/publications/38989/documents/191706/default/ .
Gonzales G, Przedworski J. Comparison of health and health risk factors between lesbian, gay, and bisexual adults and heterosexual adults in the United States: Results from the National Health…. JAMA Intern Med [Internet]. 2016; https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2530417?casa_token=CRF1uNk3F_8AAAAA:pJQ_7UypXiwhMMO0KeqLEGf5Jb6fZC_EBg0QrmXRF507vY5Pl7srcTta6fWsDqHmuOQCZYIGoQ&casa_token=OWWuxn8UEDwAAAAA:4YRNKNxWmG-6LZfnl_MEATduHjHiawDrLprat8Y59Nopll1K-Yw1HV-zL5K15z5lZBn1X9FPUg.
Cross TL. Towards a culturally competent system of care: a monograph on effective services for minority. Washington, DC: Georgetown University; 1989.
Hook JN, Davis DE, Owen J, Worthington EL, Utsey SO. Cultural humility: measuring openness to culturally diverse clients. J Couns Psychol. 2013;60(3):353–66. (PMID: 10.1037/a0032595)
NHS England. Chief Allied Health Professions Officer extends her remit to two additional professions [Internet]. 2017 [cited 2024 Jan 10]. https://www.england.nhs.uk/2017/04/chief-allied-health-professions-officer-extends-her-remit-to-two-additional-professions/ .
General Osteopathic Council. Standards of Practice [Internet]. 2023 [cited 2024 Jan 10]. https://www.osteopathy.org.uk/standards/ .
MacMillan A, Hohenschurz-Schmidt D, Migliarini DV, Draper-Rodi DJ. Discrimination, bullying or harassment in undergraduate education in the osteopathic, chiropractic and physiotherapy professions: a systematic review with critical interpretive synthesis. Int J Educ Res Open. 2022;3(100105):100105. (PMID: 10.1016/j.ijedro.2021.100105)
O’Cathain A, Murphy E, Nicholl J. The quality of mixed methods studies in health services research. J Health Serv Res Policy. 2008;13(2):92–8. (PMID: 10.1258/jhsrp.2007.007074)
Creswell JW, Clark VP. Designing and conducting mixed methods research. SAGE; 2018.
Mertens DM. Transformative paradigm. J Mix Methods Res. 2007;1(3):212–25. (PMID: 10.1177/1558689807302811)
Creswell JW. Research Design: qualitative, quantitative, and mixed methods approaches. SAGE; 2014.
Ball S, Harshfield S, Carpenter A, Bertscher A, Marjanovic S. Patient and public involvement and engagement in research. Santa Monica: RAND Corporation; 2019.
Gonzalez E, Sperandio KR, Mullen PR, Tuazon VE. Development and initial testing of the multidimensional cultural humility scale. Meas Eval Couns Dev. 2021;54(1):56–70. (PMID: 10.1080/07481756.2020.1745648)
Finch H. Focus groups. Qualitative research practice: A guide for social science students and researchers. Ritchie J, London LJ, editors. J Ritchie and L J. 2003;170–98.
Holloway I, Wheeler S. Qualitative research in nursing and healthcare. Wiley; 2010.
Kite J, Phongsavan P. Insights for conducting real-time focus groups online using a web conferencing service. F1000Res. 2017;6:122. (PMID: 10.12688/f1000research.10427.2)
Mertens DM. Transformative mixed methods research. Qual Inq. 2010;16(6):469–74. (PMID: 10.1177/1077800410364612)
Kaiser K. Protecting respondent confidentiality in qualitative research. Qual Health Res. 2009;19(11):1632–41. (PMID: 10.1177/1049732309350879)
R Core Team. A Language and Environment for Statistical Computing [Internet]. R Foundation for Statistical Computing, Vienna, Austri; 2023 [cited 2024 Oct 1]. https://www.R-project.org/ .
Rosseel Y. lavaan: AnRPackage for Structural Equation Modeling. J Stat Softw [Internet]. 2012;48(2). https://doi.org/10.18637/jss.v048.i02 .
Van Buuren S. Groothuis-Oudshoorn, mice: Multivariate imputation by chained equations in r. J Stat Softw. 2011;45:1–67. (PMID: 10.18637/jss.v045.i03)
Welch BL. The generalization of ‘student’s’ problem when several different population varlances are involved. Biometrika. 1947;34(1–2):28–35.
Braun V, Clarke V. Reflecting on reflexive thematic analysis. Qual Res Sport Exerc Health. 2019;11(4):589–97. (PMID: 10.1080/2159676X.2019.1628806)
Yvonne Feilzer M. Doing mixed methods research pragmatically: implications for the rediscovery of pragmatism as a research paradigm. J Mix Methods Res. 2010;4(1):6–16. (PMID: 10.1177/1558689809349691)
Tollemache N, Shrewsbury D, Llewellyn C. Que(e) rying undergraduate medical curricula: a cross-sectional online survey of lesbian, gay, bisexual, transgender, and queer content inclusion in UK undergraduate medical education. BMC Med Educ [Internet]. 2021;21(1). https://doi.org/10.1186/s12909-021-02532-y .
Shepherd SM. Cultural awareness workshops: limitations and practical consequences. BMC Med Educ. 2019;19(1):14. (PMID: 10.1186/s12909-018-1450-5)
Tervalon M, Murray-García J. Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor Underserved. 1998;9(2):117–25. (PMID: 10.1353/hpu.2010.0233)
Foronda C, Baptiste D-L, Reinholdt MM, Ousman K. Cultural humility. J Transcult Nurs. 2016;27(3):210–7. (PMID: 10.1177/1043659615592677)
Solchanyk D, Ekeh O, Saffran L, Burnett-Zeigler IE, Doobay-Persaud A. Integrating cultural humility into the medical education curriculum: strategies for educators. Teach Learn Med. 2021;33(5):554–60. (PMID: 10.1080/10401334.2021.1877711)
Bakaa N, Southerst D, Côté P, Macedo L, Carlesso LC, MacDermid J et al. Assessing cultural competency among Canadian chiropractors: a cross-sectional survey of Canadian Chiropractic Association members. Chiropr Man Therap [Internet]. 2023;31(1). https://doi.org/10.1186/s12998-023-00474-4 .
Flateland SM, Pryce-Miller M, Skisland AV-S, Tønsberg AF, Söderhamn U. Exploring the experiences of being an ethnic minority student within undergraduate nurse education: a qualitative study. BMC Nurs [Internet]. 2019;18(1). https://doi.org/10.1186/s12912-019-0389-0 .
Jowsey T. Three zones of cultural competency: surface competency, bias twilight, and the confronting midnight zone. BMC Med Educ [Internet]. 2019;19(1). https://doi.org/10.1186/s12909-019-1746-0 .
Shapiro J, Lie D, Gutierrez D, Zhuang G. That never would have occurred to me: a qualitative study of medical students’ views of a cultural competence curriculum. BMC Med Educ [Internet]. 2006;6(1). https://doi.org/10.1186/1472-6920-6-31 .
Equality. and Human Rights Commission. Tackling racial harassment: Universities challenged. 2019.
Gottlieb M. The case for a cultural humility framework in social work practice. J Ethn Cult Divers Soc Work. 2021;30(6):463–81. (PMID: 10.1080/15313204.2020.1753615)
LeBlanc C, Sonnenberg LK, King S, Busari J. Medical education leadership: from diversity to inclusivity. GMS J Med Educ. 2020;37(2):Doc18.
Norris M, Hammond J, Williams A, Walker S. Students with specific learning disabilities experiences of pre-registration physiotherapy education: a qualitative study. BMC Med Educ [Internet]. 2020;20(1). https://doi.org/10.1186/s12909-019-1913-3 .
GuildHE. EDI & ANTI-RACISM BRIEFING #15. Tackling Harassment and the importance of EDI. 2021.
General Osteopathic Council. Graduate Outcomes and Standards for Education and Training [Internet]. London. 2022. https://www.osteopathy.org.uk/news-and-resources/document-library/publications/graduate-outcomes-and-standards-for-education-and-training/ .
Quality Assurance Agency for Higher Education. Subject Benchmark Statement Osteopathy. Gloucester: QAA; 2024.
Universities, and Colleges Admissions Service. Entry rates into higher education [Internet]. Entry rates into higher education. Ethnicity, factsfigures. 2020 [cited 2021 Aug 2]. https://www.ethnicity-facts-figures.service.gov.uk/education-skills-and-training/higher-education/entry-rates-into-higher-education/latest#by-ethnicity .
MacMillan A, Corser A, Clark Z. Inclusivity and accessibility in undergraduate osteopathic education for students with disability: a scoping review. Int J Osteopath Med. 2021;40:38–45.
فهرسة مساهمة: Keywords: Disability; Equity diversity and inclusion; Ethnic minorities; LGBTQIA+; Oppressed; Osteopathic undergraduate education; Social Justice; Transformative action research; Underrepresented; Women
تواريخ الأحداث: Date Created: 20240426 Date Completed: 20240427 Latest Revision: 20240607
رمز التحديث: 20240608
مُعرف محوري في PubMed: PMC11055260
DOI: 10.1186/s12909-024-05404-3
PMID: 38671395
قاعدة البيانات: MEDLINE
الوصف
تدمد:1472-6920
DOI:10.1186/s12909-024-05404-3