Equity on the frontlines of trauma surgery: An #EAST4ALL roundtable

Abstract

BACKGROUND Inequity exists in surgical training and the workplace. The Eastern Association for the Surgery of Trauma (EAST) Equity, Quality, and Inclusion in Trauma Surgery Ad Hoc Task Force (EAST4ALL) sought to raise awareness and provide resources to combat these inequities. METHODS A study was conducted of EAST members to ascertain areas of inequity and lack of inclusion. Specific problems and barriers were identified that hindered inclusion. Toolkits were developed as resources for individuals and institutions to address and overcome these barriers. RESULTS Four key areas were identified: (1) harassment and discrimination, (2) gender pay gap or parity, (3) implicit bias and microaggressions, and (4) call-out culture. A diverse panel of seven surgeons with experience in overcoming these barriers either on a personal level or as a chief or chair of surgery was formed. Four scenarios based on these key areas were proposed to the panelists, who then modeled responses as allies. CONCLUSION Despite perceived progress in addressing discrimination and inequity, residents and faculty continue to encounter barriers at the workplace at levels today similar to those decades ago. Action is needed to address inequities and lack of inclusion in acute care surgery. The EAST is working on fostering a culture that minimizes bias and recognizes and addresses systemic inequities, and has provided toolkits to support these goals. Together, we can create a better future for all of us.

Bias in the trauma bay: A multicenter qualitative study on team communication

“…The perceived impact on patient care highlights the need for trauma teams and their institutions to not only recognize bias but also take actionable steps to mitigate it. In 2021, the #EAST4ALL roundtable found that the best ways to take action include “recognizing our own implicit bias, acting positively as an ally…, raising awareness of cultural competency, and ensuring institutional policies are inclusive 32 http://implicit.harvard.edu) could help team members identify these unconscious thoughts that may influence communication in the trauma bay.…”

“…In 2021, the #EAST4ALL roundtable found that the best ways to take action include "recognizing our own implicit bias, acting positively as an ally…, raising awareness of cultural competency, and ensuring institutional policies are inclusive. 32 " Institutional requirements for employees to take their own implicit bias association test (http://implicit.harvard.edu) could help team members identify these unconscious thoughts that may influence communication in the trauma bay. After a foundation of identifying these biases exist, institutional education and support using an Implicit Bias Toolkit, like the one provided by the National Association of Student Financial Aid Administrators (https://www.nasfaa.…”

To leave or not to leave: American Association for the Surgery of Trauma (AAST) panel discussion on personal, parental, and family leave

“…Women Surgeons 31 and Eastern Associations for the Surgeon of Trauma, 32 play an instrumental role in raising awareness and advocacy. These efforts should be unified to attain the desired positive impact.…”

And Miles to Go Before We Sleep: EAST Diversity and Inclusivity Progress and Remaining Challenges

“…12 This survey sought to characterize the demographics of EAST membership, their association with academia, role in EAST, and what types of discrimination they face in their daily practice. 13,14 The purpose of this study was to provide a current assessment of how women and SOC were represented within EAST and compare this with available organizational leadership data. We hypothesized that women and SOC are underrepresented as EAST members and in organizational leadership roles.…”