Belongingness in Medicine - ACGME Equity Matters Webinar - June 2024
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We presented this webinar to the ACGME Equity Matters Alumni on June 27, 2024. We defined belonginess and reviewed two theoretical frameworks for belongingness. We discussed the reasons for conducting research about belongingness in medicine and presented findings from our study. "Belongingness among first-generation medical students at Stanford School of Medicine" (MedEdPublish, 2023, Delgado et al.) We then led the audience in small group discussions about potential interventions to improve trainee belongingness by medical schools and residency programs
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Belongingness in Medicine - ACGME Equity Matters Webinar - June 2024
- 1. Belongingness in First-Generation Medical Students Adrian Delgado, MD, MAEd Sean Dowling, MD Mijiza M. Sanchez-Guzman, MPA, EdD Michael A. Gisondi, MD Moderated by Sunny Nakae, MSW, PhD Presented to ACGME Equity Matters Alumni June 27, 2024
- 2. Disclosures The presenters have no disclosures, financial or otherwise. Adrian Delgado is a Pediatrics resident at Packard Children's Hospital of Stanford. Sean Dowling is an Emergency Medicine resident at Stanford University. Mijiza M. Sanchez-Guzman is Associate Dean for Medical Student Affairs at Stanford School of Medicine and Assistant Professor of Medical Education at California University of Science and Medicine. Michael A. Gisondi is Professor and Vice Chair of Education in the Department of Emergency Medicine and Assistant Dean for Academic Advising at Stanford School of Medicine. @MikeGisondi Sunny Nakae is Associate Professor of Medical Education and Senior Associate Dean for Equity, Diversity, Inclusion, and Partnership at California University of Science and Medicine. @DrNakae Delgado AC, Dowling S, Sanchez-Guzman M, Sebok-Syer SS, Gisondi MA. Belongingness among first-generation students at Stanford School of Medicine. MedEdPublish. 2023. Nov 23;13:288. doi: 10.12688/mep.19912.1. PMID: 38694949; PMCID: PMC11061589.
- 3. Part 1 BELONGINGNESS, DEFINED WHY STUDY BELONGINGNESS? Our Study: Methods, Results, Conclusion Part 2 STANFORD’S FIRST-GEN MENTORSHIP PROGRAM Small Group Discussion: What can my institution do? Part 3 BELONGING: INSTITUTIONS vs PROGRAMS Small Group Discussion: What can my program do? Agenda
- 4. What is Belongingness? Goodenow C, Grady KE (1993): "...the extent to which students feel personally accepted, respected, included, and supported by others in the school social environment"
- 5. Belongingness v. Inclusion Inclusion (Oxford Dictionary, 2024): “practice or policy of providing equal access to opportunities and resources for people who might otherwise be excluded or marginalized” Belongingness (Goodenow C, Grady KE, 1993): "...the extent to which students feel personally accepted, respected, included, and supported by others in the school social environment"
- 7. Theoretical Models of Belongingness Identity - Proximity Theory Kohut (1984) “children need a parental figure to whom they are allowed to feel similar… to feel part of a group (e.g., family) that surrounds and protects them” - Banai et al, 2005 “identity is understood through proximity to other groups... through affiliation or relationships with the other, or lack thereof, one determines a sense of belonging.” - Delgado et al, 2024
- 8. Theoretical Models of Belongingness Environment Satisfaction Theory Bronfenbrenner (1984) “the way in which an individual interacts with others and how they experience their environment leaves them with a sense of either satisfaction and belonging or dissatisfaction and not belonging… therefore, school belongingness can be understood as a product of the daily lived experiences of medical students as determined by their interactions with one another, their engagement with environmental factors such as diversity and inclusion programming, and their satisfaction with institutional culture and policies.” - Delgado et al, 2024
- 9. Why study belongingness? A lack of belonging is linked with lower levels of academic and career success Historically-marginalized groups tend to experience lower levels of belongingness than their peers If marginalized clinicians don’t succeed, then neither do marginalized patients Interventions on Diversity, Equity, and Inclusion can be minimally effective without Belongingness
- 12. Our Study Belongingness among first-generation students at Stanford School of Medicine MedEdPublish. 2023. Nov 23;13:288. Delgado AC, Dowling S, Sanchez-Guzman M, Sebok-Syer SS, Gisondi MA
- 13. Study Aim Are there disparities in belongingness amongst first-generation Stanford medical students?
- 14. Methods Cross-sectional, single center study Stanford medical students >1 year Adaptation of General Sense of Belonging tool Definitions of ‘first-generation’
- 15. SOCIAL BELONGING (Items 1-7): I see myself as a part of the medical school community. Students at this medical school are friendly with me. I feel I belong at this medical school. It has been easy for me to make friends in medical school. I can really be myself at this medical school. Other students in this school seem interested in my opinions, ideas, and questions related to coursework. Other students here like me the way I am. ACADEMIC BELONGING (Items 8-11): I feel comfortable asking a question in class. I feel comfortable contributing to class discussions. The professors here respect me. I would feel comfortable asking a professor for help if I did not understand course-related material. INSTITUTIONAL SUPPORT (Items 12-16): I can find resource center support services for individuals like me. I can find counseling support services. I can find career planning support services. I can find tutoring support services. I can find health and wellness support services. To what extent do you agree or disagree with the following statements in regards to the Stanford School of Medicine?
- 16. Results Belongingness: No difference between first-generation and non- first-generation American medical students Lower scores for ‘first-generation to college and graduate school’ medical students
- 17. Results First-generation to medical school students reported significantly lower scores on social belonging and institutional support. Academically, they reported a sense of respect but not a sense of agency.
- 18. Conclusion Stanford medical students who are first-in-family to attend college or graduate school experience lower belongingness.
- 19. Part 1 BELONGINGNESS, DEFINED WHY STUDY BELONGINGNESS? Our Study: Methods, Results, Conclusion Part 2 STANFORD’S FIRST-GEN MENTORSHIP PROGRAM Small Group Discussion: What can my institution do? Part 3 BELONGING: INSTITUTIONS vs PROGRAMS Small Group Discussion: What can my program do? Agenda
- 20. Stanford 1st Generation Mentorship Program Founded in 2015 1:1 Mentorship Program Expectations Community Building Evaluation, Research and Scholarship
- 21. Stanford 1st Generation Mentorship Program Events, Programming, & Workshops: ❖ Kick-off’s ❖ Storytelling ❖ Paint ‘n Sips ❖ Virtual wine tasting ❖ Book signing/reading by 1st Gen authors ❖ Impostor phenomenon workshops ❖ Movie/Documentary screenings ❖ Mentor hosted events at their homes ❖ National 1st Gen Celebration Day in November ❖ Celebrations
- 23. 1st Generation Mentorship Program Highlights ● Currently in our 9th cycle ● We’ve hosted 33 events since the programs inception ● Approximately 74% of our mentors are alumni ● 109 mentees have participated in the program to date ● We currently have nearly 200 mentors in our database ● We’ve presented at 3 AAMC meetings ● Featured in AAMC News July 2019 ● Partnered with UNC School of Medicine since 2019 ● Currently conducting qualitative research ● Participated in Dr. Delgado’s study (2023) ● Launching Vodcast in July 2024
- 25. What can my institution do? Small Group Discussion
- 26. Part 1 BELONGINGNESS, DEFINED WHY STUDY BELONGINGNESS? Our Study: Methods, Results, Conclusion Part 2 STANFORD’S FIRST-GEN MENTORSHIP PROGRAM Small Group Discussion: What can my institution do? Part 3 BELONGING: INSTITUTIONS vs PROGRAMS Small Group Discussion: What can my program do? Agenda
- 28. What can my residency program do? Small Group Discussion
- 29. Summary 1. Belongingness is a feeling. 2. Peers and institutional culture impact student belongingness. 3. First-generation medical students report lower belongingness than peers. 4. Programs to improve belongingness of first- generation trainees are warranted.