Wicked Problem Solvers.

Strategic shifts that build executive leadership

ConspectusWe introduce the term discipline-based diversity research (DBDR) to capture the emerging field of research advancing diversity, equity, inclusion, and belonging with specificity to a given discipline. Contextualizing a human dynamic through a disciplinary lens has already given rise to discipline-based education research (DBER). The modalities through which students and practitioners think and process information are a reflection of a given discipline, and it tends to give rise to its professional practices. Through DBER, such specification is necessary in addressing evidence-based practices that are effective for teaching a particular subject. Likewise, the inequities and opportunities within a given field (and its professional culture) must be addressed within a disciplinary lens. Thus, the findings from social science in diversity in arbitrary contexts must be analyzed, interpreted, applied, and researched within a given discipline.One specific challenge to academic chemistry is the lack of inclusion in the sense that the faculties in research-active chemistry departments are far from diverse. We recapitulate the percentage of women and under-represented person of color (URPOC) professors over the past 20 years reported by us and other sources. The data admits to linear fits with high confidence. Assuming this linearity holds, the gender gap in representation would be bridged only in 2062, and the threshold of 20% of the faculty as URPOC would be reached only in 2113. While the community has actively engaged in modifying practices and procedures to redress this grim projection, it should be clear that more needs to be done.Toward this objective, we have been driven by the top-down hypothesis that solutions must be led intentionally through the top─that is, by department heads and chairs─because they are the stewards of the infrastructure. Department chairs and the chemistry community have engaged in DBDR through biennial workshops─that is, through the Open Chemistry Collaborative in Diversity Equity (OXIDE)'s National Diversity Equity Workshops (NDEWs)─to survey and evaluate existing policies and practices aimed at advancing inclusive excellence. This has led to research-based recommendations for the implementation of solutions in chemistry departments. This includes (i) engaging in community, (ii) conducting authentic and open searches, and (iii) recognizing and rewarding inclusive excellence. What makes them DBDR in chemistry is that we have to articulate and contextualize these solutions in terms of practices and procedures that we conduct in chemistry, assess their efficacy, and promote them across our discipline. Furthermore, we must offer theories of change for reforming them while offering frameworks that fit within how chemists think and practice.In this Account, we demonstrate how DBDR has taken root in chemistry, forecast where this emerging field may go, and provide a blueprint for how it might be replicated in other disciplines.

Equity is fundamental to public health practice. However, limited work has evaluated public health units, as employers, in ensuring equitable workplaces. Public health units must examine their policies for promoting equity, diversity, and inclusiveness. We suggest strategies that these organizations may adopt to establish a diverse workforce, including programs of responsibility, broader advertisement of employment opportunities, and standardized application processes. These practices are site dependent and are more effective when supported by senior management. By considering these strategies, institutions of public health can improve equity, diversity, and inclusion in their workplaces while addressing health equity in the communities they serve.

Increasingly, businesses are eager to partner with nonprofit organizations to benefit their communities. In spite of good intentions, differences between nonprofit and business organizations can limit the ability of potential partnerships to respond to a changing economic and public health landscape. Using a retrospective, multiple-case study, we sought to investigate the managerial behaviors that enabled businesses and nonprofits to be themselves together in sustainable partnerships. We recruited four nonprofit-business partnerships in the Boston area to serve as cases for our study. Each was designed to address social determinants of health. We thematically analyzed qualitative data from 113 semi-structured interviews, 9 focus groups and 29.5 h of direct observations to identify organizational capacities that build resilient partnerships. Although it is common to emphasize the similarities between partners, we found that it was the acknowledgement of difference that set partnerships up for success. This acknowledgement introduced substantial uncertainty that made managers uncomfortable. Organizations that built the internal capacity to be responsive to, but not control, one another were able to derive value from their unique assets.

In the study of women in academia, the focus is often particularly on women’s stark underrepresentation in the math-intensive fields of natural sciences, technology, and economics (NTE). In the non-math-intensive of fields life, social and behavioral (LSB) sciences, gender issues are seemingly less at stake because, on average, women are well-represented. However, in the current study, we demonstrate that equal gender representation in LSB disciplines does not guarantee women’s equal opportunity to advance to full professorship—to the contrary. With a cross-sectional survey among N = 2,109 academics at mid-level careers (i.e., assistant and associate professors) in the Netherlands, we test the hypothesis that in LSB (more than NTE), female academics perceive to hit a “thicker” glass ceiling—that is, they see a sharper contrast between the high representation of women at the lower compared to the top levels. We test whether this predicts female academics’ lower estimated chances to reach full professorship relative to men in LSB (but not NTE). We introduce a novel perceived glass ceiling index (GCI), calculated based on academics’ perceptions of the share of women and men in their direct work environment minus their perceptions of gender ratio among full professors in their field. Results confirm that the perceived glass ceiling is thicker in the non-math-intensive LSB compared to math-intensive NTE fields. Furthermore, only in LSB (but not NTE), women perceived a thicker glass ceiling than men. Moreover, only among female academics, the thicker the perceived glass ceiling, the lower their estimated chances to become full professor 1 day. Combined, a moderated mediation showed that for women only, a thicker perceived glass ceiling in LSB compared to NTE disciplines predicted their lower estimated chances to advance to full professor level. No such mediation occurred for men. We conclude that women’s higher numerical representation in LSB disciplines does not negate a male-dominant normative standard about academic leadership and success. Paradoxically, the perceived odds for female academics to reach the top of their field are lower in fields where they are relatively highly represented, and this may pose unique barriers to women’s perceived opportunities for career success.

In 2022, the American Dental Education Association (ADEA) launched the first‐ever dental education‐wide climate assessment survey to establish baseline data on diversity, equity, and inclusion (DEI). This article aims to highlight the historical role of ADEA in supporting oral health education while building the inclusive capacity of leaders and advancing its organizational mission and vision in promoting DEI. The survey is a significant step in assisting academic dentistry in promoting a more humanistic environment while measuring the perception of students, faculty, staff, and leadership regarding DEI.ADEA has significantly contributed to advancing dental education through data collection and the development of initiatives that enhance DEI across dental schools and allied education programs in the United States and Canada. The ADEA's efforts underscore its commitment to enhancing diversity, equity, and inclusion, aligning with its broader mission to improve oral health education.

We present results from a large (n = 3,016) field experiment at a global organization testing whether a brief science-based online diversity training can change attitudes and behaviors toward women in the workplace. Our preregistered field experiment included an active placebo control and measured participants' attitudes and real workplace decisions up to 20 weeks postintervention. Among groups whose average untreated attitudes-whereas still supportive of women-were relatively less supportive of women than other groups, our diversity training successfully produced attitude change but not behavior change. On the other hand, our diversity training successfully generated some behavior change among groups whose average untreated attitudes were already strongly supportive of women before training. This paper extends our knowledge about the pathways to attitude and behavior change in the context of bias reduction. However, the results suggest that the one-off diversity trainings that are commonplace in organizations are unlikely to be stand-alone solutions for promoting equality in the workplace, particularly given their limited efficacy among those groups whose behaviors policymakers are most eager to influence.

BackgroundIn 2024 in the United States there is an attack on diversity, equity, and inclusion initiatives within education. Politics notwithstanding, medical school curricula that are current and structured to train the next generation of physicians to adhere to our profession’s highest values of fairness, humanity, and scientific excellence are of utmost importance to health care quality and innovation worldwide. Whereas the number of anti-racism, diversity, equity, and inclusion (ARDEI) curricular innovations have increased, there is a dearth of published longitudinal health equity curriculum models. In this article, we describe our school’s curricular mapping process toward the longitudinal integration of ARDEI learning objectives across 4 years and ultimately creation of an ARDEI medical education program objective (MEPO) domain.MethodsMedical students and curricular faculty leaders developed 10 anti-racism learning objectives to create an ARDEI MEPO domain encompassing three ARDEI learning objectives.ResultsA pilot survey indicates that medical students who have experienced this curriculum are aware of the longitudinal nature of the ARDEI curriculum and endorse its effectiveness.ConclusionsA longitudinal health equity and justice curriculum with well-defined anti-racist objectives that is (a) based within a supportive learning environment, (b) bolstered by trusted, structured avenues for student feedback and (c) amended with iterative revisions is a promising model to ensure that medical students are equipped to effectively address health inequities and deliver the highest quality of care for all patients.

In this contribution to the Journal of Applied Behavioral Science Special Issue on Understanding Diversity Dynamics in Systems: Social Equality as an Organization Change Issue, I develop and describe design specifications for systemic diversity interventions in upward mobility career systems, aimed at optimizing decision making through mitigating bias by engaging gatekeepers. These interventions address the paradox of meritocracy that underlies the surprising lack of diversity at the top of the career pyramid in these systems. I ground the design specifications in the limited empirical evidence on “what works” in systemic interventions. Specifically, I describe examples from interventions in academic settings, including a bias literacy program, participatory modeling, and participant observation. The design specifications, paired with inspirational examples of successful interventions, should assist diversity officers and consultants in designing and implementing interventions to promote the advancement to and representation of nondominant group members at the top of the organizational hierarchy.

BackgroundChronic obstructive pulmonary disease (COPD) is the the most common disease-specific cause of adult emergency hospital admissions in Ireland. Preliminary groundwork indicated that treatment of acute exacerbations of COPD (AECOPD) in Ireland is not standardised between public hospitals. Applying Institute for Healthcare Improvement Breakthrough Series and Model for Improvement methodologies, Royal College of Physicians of Ireland designed and conducted a novel flexible and adaptive quality improvement (QI) collaborative which, using embedded evaluation, aimed to deliver QI teaching to enable teams to implement bespoke, locally applicable changes to improve and standardise acute COPD care at presentation, admission and discharge stages within their hospitals.MethodsEighteen teams from 19 hospitals across Ireland participated over 13 months. QI teaching was facilitated through inperson learning sessions, site visits, programme manager and coaching support. Teams submitted monthly anonymised patient data (n=10) for 22 measures of AECOPD care for ongoing QI evaluation. A mixed-methods survey was administered at the final learning session to retrospectively evaluate participants’ experiences of QI learning and patient care changes.ResultsParticipants reported that they learnt QI and improved patient care during the collaborative. Barriers included increased workload and lack of stakeholder buy-in. Statistically significant improvements (mean±SD) were seen for ‘documented dyspnoea, eosinopenia, consolidation, acidaemia and atrial Fibrillation (DECAF) assessment’ (7.3 (±14.4)% month(M)1 (n=15 sites); 49.6 (±37.7)% M13 (n=16 sites); p<0.001, 95% CI (14.3 to 66.7)), ‘Documented diagnosis - spirometry’ (42.5 (± 30.0)% M1 (n=16 sites); 69.1 (±29.9)% M13 (n=16 sites); p=0.0176, 95% CI 5.0 to 48.2) and ‘inhaler technique review completed’ (45.6 (± 34.1)% M1 (n=16 sites); 76.3 (±33.7)% M13 (n=16 sites); p=0.0131, 95% CI 10.0 to 65.0). ‘First respiratory review’ demonstrated improved standardisation.ConclusionThis flexible QI collaborative provided adaptive collaborative learning that facilitated participating teams to improve AECOPD patient care based on the unique context of their own hospitals. Findings indicate that involvement in the QI collaborative facilitated teams in achieving their improvements.