The Harm We Cause: Spotlighting the Detrimental Consequences of Malicious Envy in Academic Medicine.

Aims and objectives: To examine factors associated with promotion of the nursing profession, to the nursing community, other healthcare professionals and the general public, by nurses employed in diverse healthcare settings. Background: Little is known about the factors that contribute to nurses’ involvement in the promotion of the nursing profession. Methods: The study population comprises a convenience sample of registered nurses (n=526) with ≥3 months’ experience in nursing, who are employed in internal and surgical units, pediatric wards, psychiatric wards, or in the community across Israel. Participants completed a self-administered questionnaire addressing socio-demographic, occupational and organizational factors relating to the nursing work environment and to the extent of nurses' involvement in promotion of the nursing profession. Descriptive statistics, one-way analysis of variance, Pearson's correlation analysis, and multivariate linear regression were performed. Results: Nurses in all the surveyed healthcare settings reported relatively low levels of involvement in promotion of the profession, either to the nursing community or to other healthcare professionals and the public. Being a female-nurse was significantly negatively associated with nurses' involvement in promotion of the nursing profession. In contrast, holding a master’s degree in nursing, having a managerial role, and working in a supportive organizational nursing work environment were the principal factors associated with positive promotion of the nursing profession. Conclusion: The extent of nurses' involvement in promotion of the nursing profession mainly depends on occupational factors and a supportive organizational nursing work environment. Clinical Relevance: Healthcare managers may advance nurses’ involvement in promotion of the profession by modifying the organizational nursing work environment. Specifically, we recommend nurse leaders to dedicate efforts to make professional promotion an integral part of a nurse’s role.

The objective of this study is to examine the subjective perception of employees about the level of trust exhibited by their superiors in relation to opportunities for career progression. To investigate the correlation between employees' impressions of their supervisors' trust and their career progression, a total of 190 out of 200 participants in the survey gave valid and usable replies. The findings of this study indicate the presence of a partial mediator role, which also exhibits a positive moderating influence on the indirect effect. The observed impact of supervisors' trust on employees' career advancement has been found to be advantageous. This relationship is somewhat mediated by factors such as job autonomy, self-efficacy, and relationship energy. The moderating variable sense of organizational justice strengthens the relationship between feeling trusted by supervisors and employee career growth and positively regulates their indirect effect through relationship energy. There is no discernible moderating effect of the inconsistent sense of organizational fairness on the mediating variable of job autonomy. The evaluation of each variable in the study involves the appraisal of employee evaluation and the use of cross-sectional data. The sample size of this study is limited to colleges and universities, and the sample size needs to be slightly reduced. Future research will encompass a broader range of organizations. Managers should pay attention to the sustainable use of talents. The lack of trust in subordinates can harm their morale and performance; therefore, it is imperative to establish transparent communication and empowerment to cultivate a sense of trust. This study elucidates how supervisory trust impacts career growth, contributing to the employee career growth theory from the trust perspective. This paper relies on the active motivation model of competence and relationships to analyze the impact of perceived trust from supervisors on employees’ professional advancement.

Aims and objectivesTo examine factors associated with promotion of the nursing profession, to the nursing community, other healthcare professionals and the general public, by nurses employed in diverse healthcare settings.BackgroundLittle is known about the factors that contribute to nurses’ involvement in the promotion of the nursing profession.MethodsThis cross-sectional study comprises a convenience sample of registered nurses (n = 526) with ≥ 3 months’ experience in nursing, who are employed in internal and surgical units, pediatric wards, psychiatric wards or in the community across Israel. Participants completed a self-administered questionnaire addressing socio-demographic, occupational and organizational factors relating to the nursing work environment and to the extent of nurses’ involvement in promotion of the nursing profession. Descriptive statistics, one-way analysis of variance, Pearson’s correlation analysis, and multivariate linear regression were performed.ResultsNurses in all the surveyed healthcare settings reported relatively low levels of involvement in promotion of the profession, either to the nursing community or to other healthcare professionals and the public. Being a female-nurse was significantly negatively associated with nurses’ involvement in promotion of the nursing profession. In contrast, holding a master’s degree in nursing, having a managerial role, and working in a supportive organizational nursing work environment were the principal factors associated with positive promotion of the nursing profession.ConclusionThe extent of nurses’ involvement in promotion of the nursing profession mainly depends on occupational factors and a supportive organizational nursing work environment.Clinical relevanceHealthcare managers may advance nurses’ involvement in promotion of the profession by modifying the organizational nursing work environment. Specifically, we recommend nurse leaders to dedicate efforts to make professional promotion an integral part of a nurse’s role.

Bullying is defined as offenders abusing positions of authority and intentionally targeting individuals through persistent negative behaviors to impede education or career growth. This study sought to estimate the prevalence and nature of bullying experienced by women physician leaders in academic medicine. In this survey-based study, 547 physician graduates of an executive women's leadership training program were invited to complete a survey that measured workplace bullying in 2021. Participants were asked whether and when they had been bullied, how it impacted their careers, and remedies for bullying. Descriptive statistics were used to profile mistreatment and bullying experienced by the respondents during their professional careers and the nature of bullying. Content analysis of open-ended comments was used to describe how bullying impacted women physicians and outline recommendations for bullying prevention and mitigation. The survey response rate was 64.7% (354/547). Most women (302/354 [85.3%]) had experienced mistreatment during their careers, with more than half experiencing bullying while an attending physician (198/302 [65.6%]). Many women (187/302 [61.9%]) who screened positive for mistreatment also reported that they had been bullied at work. Of these 187 respondents, 173 (92.5%) experienced bullying from men and 121 (64.7%) reporting bullying from women (effect size = 0.34, P ≤ .001), and 115 (61.5%) reported that bullies were their immediate supervisors. Qualitative findings suggested that bullying harmed individuals' career advancement, mental health, reputation, and relationships with others. Many had to change roles or leave jobs. Participants proposed that initiatives by top-level leaders, clear definitions of bullying behavior, reporting mechanisms, and upstander training for faculty and staff could mitigate bullying. Most women physician leaders have experienced bullying. These results highlight the need to address bullying in academic medicine so that women can reach their full career potential.

Purpose – The study aims to explore the correlation between work engagement and organizational commitment from an organizational standpoint, and their influence on career advancement from the perspective of graduates Aims(s) – It will examine graduates' career growth (career goal progress, professional ability development, organizational return growth, career advancement growth), organizational commitment (affective Commitment, continuance Commitment, normative Commitment) and work engagement (vigor, dedication, absorption) . Question： Is there a significant relationship between the graduates' career growth and each of the following? a. Sustenance of their work engagement b. Manifestation of their organizational commitment Hypothesis ： Work engagement and organizational commitment positively correlate with graduates' career growth. Design/methodology/approach – This research adopts a quantitative approach with a correlational research design. The Utrecht Group's frame of reference has largely shaped the concept of work engagement. The majority of the articles examined used UWES as a tool, according to Zahari and Kaliannan's systematic review (2022). The most accepted tool to measure Organizational Commitment is that of Allen and Meyer (1990). and generalization of findings across various studies. Spearman-rank correlation was used to determine the significant relationship between graduates’ career growth and sustenance of their work engagement and manifestation of their organizational commitment. Findings – There is a significant relationship between the level of career growth and work engagement among the participants. Additionally, their level of career growth also shows a significant positive correlation with their commitment to the organization. Employees with more excellent career advancement opportunities tend to be more invested in their work and demonstrate a more substantial commitment to the organization. Limitations of the study – through consistent investment in the professional development of their employees, firms not only enhance job engagement but also foster a highly proficient and driven staff. Ultimately, this positive cycle of advancing in one's profession and being dedicated to the company helps achieve overall success and ensure its long-term existence. Originality/value – This research endeavor on graduates' work engagement, organizational commitment, and career growth proves to be highly beneficial for the government. holds significant importance as it aims to generate empirical evidence about workplace attitudes among business master's and doctorate students, as opposed to relying solely on theoretical speculation. Lastly, the industry/company/employer will also benefit from this study by having committed employees who can contribute much to the attainment of the organizations’ goals and objectives.

here is little doubt that networking is pivotal to career advancement in academic medicine. Powerful networks are the fertile soil that allow seeds of talent to grow to their full potential. Relationships developed through networking can provide access to new information, important opportunities, resources, and enhanced visibility, 1,2 all of which can alter career trajectories. With increased attention to equity in academic medicine, it is essential to recognize the effects of networking on career development and advancement. How do students, residents, fellows, and faculty currently access the benefits of networking? How do we ensure equity in access, in the context of a shortage of coaches, mentors, sponsors, and role models? In this article we consider potential strategies to improve access to networking.

The purpose of this thesis research was to explore the personal, career, and academic growth of peer mentors within the College of Agriculture and Life Science (CALS) learning communities at Iowa State University (ISU). This study encompassed four objectives: (1) describe demographic traits of CALS peer mentors; (2) identify how mentors' personal growth is affected by their experiences as a peer mentor; (3) detect mentor career development and growth affected by experience as a peer mentor; and (4) determine academic growth and development affected from experiences as a peer mentor. For objectives one through four, a census survey was sent to the total population of CALS peer mentors. A total of (n=76) valuable responses were collected during the fall 2019 semester. The results were further analyzed using descriptive statistics and basic understanding of target population demographics. As findings in the literature have speculated, learning communities and their organizations differ. Objective one provided target population demographics to elevate unknown knowledge of learning community population. Gaining a full understanding of the population at large was critical in order to access development throughout and gain understanding of CALS learning community goals. Objective two accessed peer mentors personal growth or developed from the peer mentor experience. Mentors (n= 61) stated that the peer mentor experience provided a positive impact to personal growth in three major areas: (1) interpersonal skills; (2) overall confidence; and (3) connection building. Objective three developed the understanding of career growth developed from the peer mentor experience. Mentors (n=60) stated that the peer mentor experience has a positive impact on their career growth and development through four different areas: (1) gained communication skills in regards to career development; (2) confidence in current and future career endeavors; (3) leadership skills; and (4) networking connections. Objective four looked at the effect that mentors received in regards to academic growth and development from being a peer mentor. This category posed the most variation in gained qualities from being a peer mentor (n=35). Mentors stated this category had a positive impact on their higher education process and (n= 31) provided insight that there was no impact on academic growth through this program. Those who stated no impact indicated prior academic achievement and knowledge so the teaching of lower level courses did not impact their academic standing. Hopefully, this study has provided the College of Agriculture and Life Sciences Learning Community programs at Iowa State University

Introduction: Excellence, professional and personal fulfillment of nurses underscores the need for all registered nurses (RNs) to keep their skills and competencies current through professional development and career advancement opportunities. Professional development is the process by which healthcare professionals keep their skills and competencies current to meet the healthcare needs of their patients. Career advancement serves as a tool that supports nursing excellence. However, emerging evidence suggests that internationally educated nurses (IENs) progress relatively slowly through the career ladder and participate less in professional development opportunities compared to their indigenous counterparts, such as nurses educated in the U.S.(UENs). It is important to understand the factors that influence professional development and career advancement of all nurses, and particularly IENs. Mentorship and self-efficacy are major determinants of career advancement, but the influence of these two variables on professional development, and career advancement of nurses is yet to be explored. This study seeks to understand how mentorship and self-efficacy have influenced nurses' participation in professional development and career advancement activities. Methods: This study used a descriptive-correlational survey design and content analysis of open-ended questions to examine differences in levels of mentoring functions and self-efficacy of IENs compared to nurses UENs. It also explores the association among mentorship, self-efficacy, professional development and career advancement of both groups of nurses. A web-designed questionnaire was used to reach potential participants through an online survey. Results: Results showed that the socio-demographic characteristics of the respondents closely matched the U.S. nursing workforce reported in other studies. Only the role model subscale score of mentorship was significantly different between the groups. Self-efficacy was similar in both groups. While there were similarities in some professional development and career advancement measures, significant disparities were noted in others. Analysis of the open-ended questions revealed that a healthy work environment is critical for nurses' engagement in professional development and career advancement opportunities. Both groups of nurses face similar professional development challenges; however, some of the factors leading to the challenges differ between UENs and IENs. Conclusion Mentorship is essential for nurses' professional development. The socio-demographic characteristics of mentors are equally important, as nurses look up to their mentors as role models. Nurse leaders are challenged to create a healthy work environment and implement a standardized career advancement structure that will promote professional growth and development in nursing. This is essential for nurses to remain vital and leading members of the interdisciplinary care team. Each nurse has the responsibility to engage in self-leadership for personal and professional fulfillment. In comparison to UENs, IENs are only somewhat successful in the U.S. nursing workforce. Considerable work is needed to bridge the gaps in professional development and career advancement between UENs and IENs. This study identifies some of the areas where the differences exist, as well as some of the factors that contribute to these differences. Further research is necessary to validate these findings and understand the mechanisms that underlie these disparities.

Increasingly, stakeholders in the health care community are recognizing nursing as key to solving the nation's health care issues. This acknowledgment provides a unique opportunity for nursing to demonstrate leadership by developing clinical nurse leaders to collaborate with the multidisciplinary care team in driving evidence-based, safe quality, cost-effective health care services. One approach for nursing success is standardizing the entry-level education for nurses and developing a uniform professional development and career advancement trajectory with appropriate incentives to encourage participation. A framework to guide and provide scientific evidence of how frontline nurses can be engaged will be paramount. The model for professional excellence and career advancement provides a framework that offers a clear path for researchers to examine variables influencing nurses' professional development and career advancement in a systematic manner. Professional Excellence and Career Advancement in Nursing underscores professional preparedness of a registered nurse as central to leadership development. It also describes the elements that influence nurses' participation in professional development and career advancement under 4 main categories emphasizing mentorship and self-efficacy as essential variables.

This study evaluated the status of Project FREE scholars regarding their professional advancement, employing a quantitative approach with a descriptive comparative design. The participants included graduates from Batch 1 (273) and Batch 2 (175) of the Project FREE Paglaum Scholarship Program, with a total of 448 participants identified through Fixed Effect Omnibus and One Way analysis, and selected via stratified random sampling with proportional allocation. A researcher-developed survey questionnaire was administered to collect data. The findings revealed a high overall satisfaction level with the support provided by the Provincial Government of Negros Occidental and the Department of Education. Additionally, significant differences in support were identified based on various demographic and professional factors. The study underscored the positive impact of the professional development program on teachers’ positions and salary grades, indicating that the Project FREE Paglaum Scholarship Program has effectively contributed to their professional advancement. This premise is evidenced by the significant increase in teachers' salary grades following program participation, which demonstrates the program's effectiveness in enhancing qualifications and compensation, ultimately facilitating career progression. Overall, the program yielded substantial positive outcomes in empowering teachers' professional development and career advancement. Future research is recommended to investigate the effects of the Project FREE Paglaum Scholarship Program on the learning competencies of students taught by these scholars, as this could provide deeper insights into the program's broader impact on education quality. Keywords: Project FREE (Flagships to Reach Educational Excellence) Paglaum Scholarship Program, satisfaction, support, Department of Education, provincial government, teacher professional development

To explore nurses' experiences and perceptions of career growth and its influencing factors, as career growth is more closely associated with individual attitudes and behaviours in the new career era. A qualitative descriptive design was used. Thirty-one nurses from 10 secondary and 8 tertiary hospitals in Sichuan Province of China were purposively selected to participate in this study. The data were collected using individual semi-structured face-to-face interviews. Two researchers independently reviewed the transcripts and emergent coding. The data were analysed using qualitative content analysis. The nurses' perceptions of career growth fully described the nurses' experience and occurred in five dimensions: career promotion, career goal progress, professional ability and quality improvement, professional identity development and increase in personal prestige. The factors influencing career growth were identified at the organizational, individual and social levels. Career growth in nursing was complex, changed over time and showed several specific characteristics compared with other careers. The nurse-specific symbol of career growth was professional identity development, which reflected career progression characteristics. Career growth is a multi-dimensional concept with varying influencing factors. The meaning of career growth for nurses is distinct from that for employees in other careers. Nursing managers should guide nurses to comprehensively assess their career growth from multiple perspectives, and professional identity development deserves more attention. Both organizations and individuals should take responsibility for career management to pursue career growth.

Inequities in health are increasingly recognized across the country and globe.1,2 These inequities in morbidity and mortality stratify on demographic attributes, including race, ethnicity, gender identity, sexual orientation, ability, language status, and other factors individually and intersectionally.3–7 Anesthesiologists witness these health inequities across a broad range of practice areas and health care services.8–11 The root causes of healthcare inequities are multifactorial and operate at systemic and individual levels. At the systemic or structural level, biases built into policies, procedures, and practices influence the equity of healthcare delivery. These structural biases are often rooted in historical and sociopolitical discrimination, via varied mechanisms including differential access to healthcare;12,13 discriminatory policies and practices;9,14,15 and biased clinical reference standards.16–20 Implicit bias, in contrast, occurs at the individual level while also collectively influencing outcomes. Implicit bias may be linked to differential response to patient concerns, including time to evaluation,21,22 degree of diagnostic workup,21–24 clinical communication,25 access to referral,26 and/or access to treatment options,27 all ultimately influencing care outcomes. A diverse workforce is a necessary component in mitigating bias and inequity. The distribution of race, gender, and other demographics in the current healthcare workforce does not correspond to the overall patient population distribution.28–30 In academic anesthesiology, only 3% of the anesthesiologist workforce comprises Black or African-American physicians (versus 13% of the general population), and only 6% are from all races underrepresented in medicine (versus 34% of the general population).31–33 Women constitute 35% of academic anesthesiology faculty (compared to 50% of the general population).34 From 2009 to 2019, the number of ACGME-accredited pain fellowship programs increased by 14%; however, data reveals persistent gender and race disparities in the demographics of pain fellows.35,36 The root causes for workforce inequities mirror the causes of health inequities: structural and individual bias and microaggressions in the secondary and medical education pathways,37 as well as remnants of more explicit discriminatory policies and practices, such as sociopolitical segregation, educational segregation, and the residual impact of reports and legislation, e.g. the Flexner Report, which led to widespread closure of historically Black medical schools and strained the pathways for individuals of color to enter physician careers, with lasting impact.38–41 Not only is there prima facie value in a diverse, inclusive, and equitable workforce, there are also many reasons why workforce diversity positively influences healthcare outcomes, and conversely why lack of diversity contributes to healthcare outcomes disparities.33 Countless evidence-supported correlations have been identified regarding the benefits of workforce diversity on physician development and patient experience and outcomes. For physicians, some of these benefits include increased productivity and innovation,42 improved cognitive and affective development,43,44 and expanded breadth and depth of educational and research agendas.33,45 For patients, these benefits include improved clinician-patient communication,46–48 improved patient satisfaction and knowledge,49–53 increased academic focus on addressing disparities,33,45,54 improved access,50–52,55 and better quality of care and outcomes.46–48,55–61 The leak Even the apparent recent increases in healthcare workforce diversity obscure the magnitude of the current workforce disparity problem. While there have been modest increases in diversity in the healthcare workforce in aggregate, the proportion of individuals from backgrounds underrepresented in medicine ("URiM") consistently decreases at each level of advancement in medicine.31,62–66 In 2021, 1% of matriculants to United States medical schools identified as Native American or Alaskan Native, 11% identified as Black or African American, and 13% identified as Hispanic, Latine, or of Spanish origin.67 Women represented 55% of matriculants.67 In contrast, among 2021 anesthesiology residents, 0.1% identified as Native American or Alaskan Native, 5% identified as Black or African American, and 5% identified as Hispanic, Latine, or of Spanish origin. Only 33% identified as female and only one student identified as gender non-binary.68 A change in the proportions of race and gender representation from one level to the next reflects inequity, highlighting the "leak," so to speak. This gap further stratifies at the faculty level, where most URiM physicians in academic medicine, including anesthesiology, are at the instructor or assistant professor rank, and are underrepresented at higher ranks, including associate professor, professor, chair, associate dean, or dean.31,66,69–71 As stated previously, the driving factors for workforce and advancement inequities are historical injustices as well as ongoing systemic barriers to the success of URiM individuals, which may be modifiable or mitigated. These challenges include implicit biases in the advancement process,31,72–74 micro- and macroaggressions,37,75–77 deficiency of optimal mentors,31,78,79 disparate access and information regarding opportunities for advancement,74,79 disparate expectations (e.g., the "minority tax," the "glass ceiling," and the "glass cliff"),45,74,80–82 and other insidious factors. Herein, we will describe strategies for improving diversity and equitable representation in the anesthesiologist workforce, specifically by improving pathways and environments to enter and advance in anesthesiology. Although each individual whose identity includes one or more URiM demographic categories (e.g., race, gender identity, sexual orientation, et al) faces unique challenges, we will collectively explore common challenges and themes for any URiM individuals or groups. We will also describe examples from our experience implementing a strategic plan for this mission. Strategies range from readily accessible options for individuals committed to this cause, up to complex, resource-intensive program-building initiatives. Programmatic interventions Departmental, divisional, and training program leaders have numerous opportunities and imperatives to promote diversity, equity, and inclusion (DEI) in our field, particularly through focused recruitment and retention (fulfillment and advancement). Recruitment in this context means both the recruitment of anesthesia-bound URiM individuals to a particular institution and the recruitment of URiM individuals to pursue a career in duplicate the specialty of anesthesiology. "Retention" in this context goes beyond simply retaining individuals to stay in this field or at the institution; ensuring their development, fulfillment, advancement, and thriving is also crucial. Furthermore, this yields self-sustaining benefits, as a diverse, equitable, inclusive environment is one of the strongest tools for recruiting and retaining URiM individuals in an institution, department, or program. Advancement of any or all of the recommendations outlined throughout this work contributes to recruitment and retention, enhancing the more explicit guidelines mentioned below.29,83,84 Recruitment Equitable recruitment entails an equitable approach to all aspects of workforce recruitment – for all roles. In this section, we will discuss recommendations for the recruitment framework for any role, though many examples are most salient for the physician workforce. In graduate medical education, the recruitment process begins long before the application cycle, and we will discuss those seminal elements subsequently in the Pathways section. These recommendations include prioritizing outreach to URiM candidates, addressing systemic and implicit bias challenges at all stages of the recruitment process, diversifying the recruitment leadership, and fostering a data responsive environment. URiM-focused recruitment outreach Demonstrate valuing of URiM candidates through directed outreach – at Historically Black Colleges and Universities, through URiM-focused national societies and their conferences (e.g., Student National Medical Association, National Hispanic Medical Association, American Medical Women's Association, Medical Student Pride Alliance, Association of Native American Medical Students, National First Generation to Medicine Association (FGLIMed)), and via formal or informal networks and affinity groups. For faculty, consider engaging in cohort or cluster recruitment – recruitment of faculty in cohorts can promote a collective morale, with benefits in productivity, retention, and thriving.85 URiM-curated recruitment experiences Provide curated opportunities for URiM candidates to gain experience, exposure, and insights on the program, department, or institution. Dedicating rotation spots or scholarships for visiting electives in anesthesiology may be particularly valuable for individuals at medical schools not offering anesthesiology rotations for medical students and also for individuals with financial constraints. Faculty or resident ambassadors – who represent the program or institution and offer another insight into the institutional DEI culture – may be crucial in connecting URiM candidates with potential opportunities. URiM recruitment and "Second Look" events provide candid settings to learn about the environment, strengths, and challenges at the program or institution. However, these events should be designed with equitable access in mind and not create further disparity due to financial or other burdens. Publicizing DEI policies and mission statements explicitly may be helpful for prospective and current trainees, faculty, and staff because it implies institutional commitment and promotes culture and psychological safety. In order to hold weight, these stated policies must be matched by actual practice. Equitable and holistic candidate selection practices Approach candidate selection for interviews and candidate scoring and ranking equitably and holistically. In clerkships, disparities in clerkship grades and Medical Student Performance Evaluation summary words were found to favor white students over URiM or non-URiM minority students.86 One study found that most fourth-year medical student participants recalled being asked at least one potentially discriminatory interview question about their marital status, children, pregnancy plans, place of birth or national origin, religion, or ethnicity.87 Another study of resident selection found that Asian applicants had their personality less often discussed.88 Strategies to mitigate bias in the interview process might be including life-performance questions (e.g., leadership, community service, overcoming adversity, realistic self-appraisal, ability to recognize and navigate one's own bias, and ability to set goals and self-responsibility) and consistently asking the same questions to all participants.89 Addressing biased evaluation approaches and implementing alternative criteria may improve fairness and equity in assessment of candidate qualifications, and increase trainee diversity.90 Anti-bias training and awareness Everyone involved in the candidate recruitment and selection process must understand the value of the perspectives that URiM candidates bring to patient care and health equity, and the risks of those candidates being undervalued due to bias in the selection process. Not only have URiM candidates likely experienced systemic bias upstream that may influence their candidacy, they are also at risk of experiencing implicit bias during the application process. URiM candidates are at a higher risk of being subjected to interviewer bias, conscious or unconscious.83,91 Even the demographics conveyed (or presumed) in their written application can influence how their candidacy is perceived during interviewee selection and the eventual evaluation and ranking process. For example, a Harvard Business School research trial demonstrated that applications that had been "whitened" (i.e. revised by the researchers to exclude race-revealing data) were more than twice as likely to receive interview invitations than the same applications which preserved the data indicating that the applicant was Black or African-American.92 Implement specialized anti-bias training for those involved in the recruitment, interviewing, evaluation, and selection processes, in addition to the general anti-bias and cultural humility education that should exist at any institution.93 These training sessions should ideally be interactive, practical, expert-led, and tailored for the specific context or practice; simple click-through, self-study modules are not enough.94 Recruitment team diversity Diversify recruitment teams, and be mindful of the "minority tax,"80 i.e. the disproportionate utilization of URiM faculty without compensation to "represent" the institution in recruitment, mentorship, administrative, and other DEI-related positions in order to promote the appearance of a diverse institution. A diverse recruitment team can recruit a diverse workforce and is an accepted best practice for prioritizing diversity.95–97 However, URiM faculty career advancement can be hindered by expectations that they serve as diversity representatives in disproportion to non-URiM faculty. This disproportionate administrative burden on URiM, individuals though often well intentioned by leadership, comes at the cost of opportunities that lead to true career development and advancement activities.23 Time spent serving the DEI mission of the department, through recruitment or other avenues, should be appropriately recognized and built into a time-based or financial compensation structure.80,98,99 Data responsive environment Promoting a data-responsive environment requires that leadership identify, collect, evaluate, and respond to quantitative and qualitative data regarding the recruitment and selection processes, as well as the overall DEI environment at the program, department, or institution. For example, the influence of bias may be suggested by comparing the proportions of URiM to non-URiM individuals at each stage of the process: applicants, interview invitees, interviewees, new hires, promotions, and appointments to leadership roles. Metrics specific to graduate medical education recruitment may include the proportions of URiM to non-URiM individuals ranked to match, matched, advancing yearly, passing examinations, completing training, and ultimately achieving board certification if practicing. If there is a decrease in the proportion of URiM individuals from one stage to the next, systemic factors are likely contributory and should be explored in depth. This may include a more in-depth evaluation of, for example, how specific interviewers are rating individuals from different backgrounds, whether subtly biased language may be marked on URiM evaluations, and what events or metrics are cited in individual cases of promotion or advancement denial or delay.92,100,101 Collect qualitative data by engaging with individuals regarding the outcomes: find out why individuals chose to join the institution, but make equal effort to find out why others chose not to accept an interview invitation, chose not to rank to match, or chose not to accept a professional or academic position. Retention/thriving climate In addition to the recruitment-specific approaches, some needs must be addressed at a departmental or institutional level to promote the necessary characteristics of a thriving environment. As mentioned previously, "retention" goes beyond simply retaining individuals to stay in this field or at a particular institution, and requires ensuring their development, fulfillment, advancement, and thriving. Recommendations for promoting a diverse, equitable, and inclusive environment include explicit and compensated DEI leadership roles, committees, and departmental missions; high-quality anti-bias training; robust mentorship and sponsorship; directed, deliberate support; and fostering a data-responsive environment and safe culture. DEI leadership roles and committees Create leadership positions and DEI councils. Some institutions, such as the Mount Sinai School of Medicine, have reported success after a dedicated council was created to oversee early pipelines, outreach, and recruitment of URiM physicians, with representatives institution-wide.102 While a study in 2022 found that many anesthesiology departments had diversity and inclusion initiatives, only a few reported clearly defined leadership roles, which may hinder departmental success in promoting diversity.103 DEI leadership roles and activities should be compensated in a time-based or financial structure in order to recognize the value they provide to the institution, and ensure available time for the success of the efforts. DEI mission Define a departmental DEI mission that clearly prioritizes diversity, equity, and inclusion in patient care, research, education, innovation, and any other divisions of the department. While it is crucial to prioritize DEI in professional development as detailed here, there must be a parallel commitment to demonstrating this as a priority in these other domains for a comprehensively safe and positive environment. For example, perceiving an increased minority tax,99 witnessing microaggressions against patients of certain demographics,104 or noticing that health equity research is less valued in a department105 may undermine the morale of URiM faculty. Anti-bias training and health equity education Anti-bias training for all faculty and administrative leadership roles is imperative for creating an inclusive culture. As stated previously, this training must go beyond the ubiquitous and rote modules that accommodate learner multi-tasking.94 Intensive anti-bias training should be interactive and practically tailored to the audience. Anti-bias culture emanates from the examples set by leadership. Institutions benefit when key leaders are willing to interrogate their own biases and acknowledge the pervasive nature of bias and inequities even among progressive, well-intentioned individuals and institutions.106 In addition, developing a robust health equity education program may play a valuable role in increasing workforce diversity and promoting an inclusive culture – by serving as a recruitment tool, by elevating candidates from underrepresented backgrounds, and by broadcasting an institutional commitment to health equity.94,107,108 In our institution, several initiatives have been started, including sponsored electives in anesthesiology and health equity for visiting students, a health equity in anesthesiology and critical care curriculum for medical students, a longitudinal case-based health equity curriculum for anesthesiology residents, and a health equity seminar series for critical care fellows. Mentorship and sponsorship Mentorship and sponsorship are paramount. Early and direct access to invested mentors can elevate individuals in their careers and help achieve a more representative number of URiM anesthesiologists, particularly in leadership positions.109–113 Pairing junior URiM team members with qualified mentors and can to a to in their careers, through informal or direct to and other career development opportunities. is a at many of available URiM mentors for URiM and there will likely to be a workforce equity is While many individuals may a this may not be a realistic at most In many it may better serve to be with qualified even without demographic URiM faculty in promotion or Women and other URiM underrepresented in leadership and academic in academic anesthesiology, in professor, chair, and may influence the promotion and process who have experienced bias throughout their careers may be over for or be less likely to be for leadership positions or due to not to the same demographic or as those in positions of the value of URiM team members and ensure that the work of all is recognized appropriately the and institution. for and needs URiM by time and financial for these and a culture of can promote innovation, and increase Create and for and health care, financial and One is and programs for URiM fellows. A of 1% of for these initiatives had URiM and faculty promotion and increased programs and recruitment can inequities and for and URiM environment As for the recruitment process, program and departmental may provide opportunities to and mitigate bias and inequity. data may include demographics with evaluations, time to and other more of academic and/or clinical must be when these in order to at any or as opportunities for in program or departmental than further and by gender are and must to be data should be with invested the of on the potential for and of and potential In healthcare where is individuals may to about from team physicians or administrative because out can their professional tools the with of can be with to from individuals on domains of in and from URiM individuals at the institution to learn about barriers and challenges that may be the institutional culture. A study by the School of Medicine found that URiM faculty were less likely to that faculty recruitment was that and that they be at their current institution in resident events and of can the of any URiM trainee should be a and explored for opportunities to and prioritizing a data-responsive environment, leadership can to URiM team members that their is their are and leadership is willing to make necessary to improve the institutional environment and promote While the of URiM representation in academic anesthesiology in some with some metrics have to change (e.g., the distribution of and faculty appointments and been that diversity will at least to professional equity to the population achieve these individuals at level in the or institution must recognize the of the candidate and academic institutions, URiM can benefit from and at stages of their faculty recruitment, retention, and career advancement longitudinal at the work and levels. these strategies for increasing access to research, and URiM faculty can experience increased and through barriers and programs In a environment, DEI leaders may to new programs dedicated to improving pathways for URiM individuals to pursue careers in anesthesiology. to as are specialized initiatives designed to and students from underrepresented backgrounds to pursue and healthcare and and other unique In programs engaging students in and programs have positive outcomes for URiM students in several key including academic and into health medical these the at each stage of advancement, as detailed URiM representation at more junior at more levels. In order to promote and ensure diversity at all of a approach to programs may be at each advancing educational Although these programs have demonstrated impact at other educational and have the potential to elevate URiM success at the institutional level and at a national or At our institution, we the Pathways in in with the of and is a program to recruit and URiM medical students to pursue academic component of the program is designed to evidence-supported factors in URiM academic success and career Although there are many for a program, we this experience as a potential for other to or The program is of of and other on at for time and to on to medical student (e.g., and to correspond with key of the medical student The longitudinal nature students to with the program throughout their own advancement in medical training and to find to their The to of application and structural barriers and implicit and These sessions URiM students to the breadth of available to pursue in URiM individuals are underrepresented in more This may be due to including differential exposure, differential access to mentorship on application and implicit and structural bias in the application While the is less modifiable via a program, the program the other factors in the sessions of each the program all of the strategies for candidacy, and participants with potential mentors in these are interactive and sessions to in developing and their academic medical program includes sessions for each of medical such as time in medical for and and rotation for The are throughout the to for each medical student stage (e.g., in the and interview in the The overall includes as well as areas identified by in research on barriers to academic further the program are in advance of the program to any particular of is to program for their in for by numerous a may be specifically on this A of on rotation includes for mentorship, time a on the interview research, an match, and for fellowship or next In addition to the informal by the specialty and the of each program is dedicated to direct opportunities through the which or potential mentors and or selection invitations for valued with invitations for of the is while being mindful of the "minority program leaders for to be recognized and compensated on a time-based academic by the department. of the success of this program is the institutional and direct administrative from the of and the of Medical and the School of program with and and and implicit bias healthcare workforce and can impact health outcomes and success and workforce equity in anesthesiology must be a priority for healthcare program and individual and must be directed DEI that ensure more equitable access for URiM individuals to pursue anesthesiology training, in their careers, and into leadership in and these on race, gender, and other can be but these are critical for bias and While many of the interventions may be opportunities are available at level to the and make a positive impact on workforce We our recommendations can serve as a for anesthesiology leaders to DEI at their programs and and to URiM representation and success in the field of anesthesiology. an individual level, this means and to a more inclusive work environment. For anesthesiology training programs and advancing healthcare workforce equity requires comprehensively DEI data and addressing such as bias in recruitment and advancement, workforce education, and dedicated for and programs are a approach to elevate healthcare workforce equity in a an impact at the level may robust and and of the educational have an increased to promote about race, ethnicity, gender, orientation, ability status, and other factors. also have a professional and to systemic inequities and of bias in anesthesiology and medicine we recognize the of fostering diversity and equity in we to a for our our patients, and of that they have of

Women's leadership development is becoming a top focus for organizations seeking to increase diversity, creativity, and sustainable success. Despite increasing female labor participation, women remain underrepresented in senior leadership positions due to a variety of issues, such as cultural norms, organizational biases, work-life conflicts, and limited access to sponsorship and mentorship. This study examines the possibilities and challenges of developing women leaders using a mixed-methods approach that includes surveys of 200 women professionals and interviews with HR directors. Data analysis using descriptive statistics, correlation, regression, and percentage analysis revealed that gender stereotypes, ambiguous promotion procedures, and a lack of gender-focused leadership programs continue to impede women's advancement. However, organized leadership development has a favorable effect on professional advancement and leadership readiness. On the other hand, work-life regulations, inclusive workplace cultures, mentorship programs, and organized leadership development programs all have a favorable impact on career growth and leadership readiness. The research provides companies with useful recommendations for improving women's leadership pipelines, removing barriers, and creating an equitable and effective leadership environment. Keywords: Work-Life Balance, Inclusive Organizational Culture, Women's Leadership Development, Gender Diversity, Organizational Bias, Mentorship and Sponsorship, and Leadership Training Programs

Time to Step Up and Do Our Part to Address Sex Inequalities in Cardiothoracic Anesthesiology

COVID-19 pandemic, not surprisingly, is a major factor in why many workers are rethinking their employment situation and want to pursue a more meaningful and fulfilling job. Many of the employees felt their career has been stalled and have seen stagnation in salary growth, career advancement and skills development. This quantitative correlational study determined the relationship between supervisors cooperation, career growth and job satisfaction. Similarly, this research assessed the mediating role of the work atmosphere to the supervisors cooperation, career growth and job satisfaction among manufacturing firms in Batangas. This study used an adapted survey questionnaire. The researcher employed statistical tools such as Weighted Mean, Pearson Correlation, Mediation Analysis following the Baron and Kenny. The study randomly selected 121 respondents using a four-point Likert-type questionnaire. The relationship of independent variables such as supervisors cooperation and career growth were statistically assessed against the dependent variable such as job satisfaction with the mediating variable of work atmosphere. The results presented clearly show that career growth is fully mediated by work atmosphere while supervisors cooperation is partially mediated by work atmosphere. This means career growth indirectly influences job satisfaction through work atmosphere while supervisors cooperation directly influences job satisfaction through work atmosphere.