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Journal ArticleDOI

Females and Minority Racial/Ethnic Groups Remain Underrepresented in Emergency Medical Services: A Ten-Year Assessment, 2008-2017.

01 Mar 2020-Prehospital Emergency Care (Prehosp Emerg Care)-Vol. 24, Iss: 2, pp 180-187
TL;DR: The underrepresentation of females and minority racial/ethnic groups observed during this 10-year investigation of EMTs and paramedics earning initial certification suggests that EMS workforce diversity is unlikely to undergo substantial change in the near future.
About: This article is published in Prehospital Emergency Care.The article was published on 2020-03-01. It has received 34 citations till now. The article focuses on the topics: Emergency medical services & Population.
Citations
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Journal ArticleDOI
TL;DR: This is the most comprehensive study evaluating the demographics of the national EMS workforce of active patient care providers and found similarities and differences of the demographics and practice settings of the three major certification levels.

22 citations

Journal ArticleDOI
TL;DR: Almost 73% of the US adult population lives within 30 miles of an existing paramedic education program; however, this decreases to 22% in rural areas, a challenge for ongoing efforts to address the rural EMS workforce shortage.

9 citations

Journal ArticleDOI
TL;DR: In this paper, a cross-sectional analysis of programs from well-known national conferences, specifically for EMS providers, which were held in the US from 2016-2020 was performed.
Abstract: Introduction: Gender disparities between Emergency Medicine physicians with regards to salary, promotion, and scholarly recognition as national conference speakers have been well-documented. However, little is known if similar gender disparities impact their out-of-hospital Emergency Medical Services (EMS) colleagues. Although there have been improvements in the ratio of women entering the EMS workforce, gender representation has improved at a slower rate for paramedics compared to emergency medical technicians (EMTs). Since recruitment, retention, and advancement of females within a specialty have been associated with the visibility of prominent, respected female leaders, gender disparity of these leaders as national conference speakers may contribute to the “leaky pipeline effect” seen within the EMS profession. Gender representation of these speakers has yet to be described objectively. Study Objective: The primary objective of this study was to determine if disparity exists in gender representation of speakers at well-known national EMS conferences and trade shows in the United States (US) from 2016-2020. The secondary objective was to determine if males were more likely than females to return to a conference as a speaker in subsequent years. Methods: A cross-sectional analysis of programs from well-known national conferences, specifically for EMS providers, which were held in the US from 2016-2020 was performed. Programs were abstracted for type of conference session (pre-conference, keynote, main conference) and speakers’ names. Speaker gender (male, female) was confirmed via internet search. Results: Seventeen conference programs were obtained with 1,709 conference sessions that had a total of 2,731 listed speaker names, of whom 537 (20%) were female. A total of 30 keynote addresses had 39 listed speaker names of whom six (15%) were female. No significant difference was observed in the number of years males returned to present at the same conference as compared to females. Conclusion: Gender representation of speakers at national EMS conferences in the US is not reflective of the current best estimate of the US EMS workforce. This disparity exists not only in the overall percent of female names listed as speakers, but also in the percent of individual female speakers, and is most pronounced within keynote speakers. Online lecture platforms, as an unintentional consequent of the COVID-19 pandemic, coupled with intentional speaker development and mentorship initiatives, may reduce barriers to facilitating a new pipeline for more females to become speakers at national EMS conferences.

5 citations

Journal ArticleDOI
TL;DR: In this paper, the authors conducted an exploratory evaluation of employee professional quality of life and factors associated with it at an emergency medical service (EMS) agency in northeast Texas in the United States.
Abstract: Introduction The purpose of this study was to conduct an exploratory evaluation of employee professional quality of life and factors associated with it at an emergency medical service (EMS) agency in northeast Texas in the United States. Initially, we intended to evaluate typical day-to-day factors, however we ended up capturing these factors during the unique environment of the COVID-19 pandemic. Methods We conducted an exploratory cross-sectional survey at an EMS agency in northeast Texas in November 2020. Surveys were web-based and anonymous. They included the ProQOL 5, the Survey of Perceived Organizational Support, the Brief Resilience Survey, the RAND Social Support Survey Instrument, the Kessler-6, the Workplace Incivility Scale-Revised, the General Self-Efficacy Scale and the Brief Cope Scale. Results The survey had a response rate of 19% (38 participants). Findings suggest a positive relationship between utilising religion as a coping mechanism and higher compassion satisfaction. There was also a relationship associated between increased perceived organisational support leading to an increase in compassion satisfaction. The most significant predictors of burnout were two different coping mechanisms. Those who relied more heavily on behavioral disengagement and those who employed humour as a coping mechanism displayed average increased levels of burnout. Finally, those who experienced workplace incivility and those who relied on self-blame as a coping mechanism experienced on average higher levels of secondary traumatic stress. Conclusion This study adds to the limited literature examining coping mechanisms, stress and burnout in EMS personnel. It is also unique for examining how EMS personnel are coping with stress during a prolonged pandemic. © 2021, Paramedics Australasia. All rights reserved.

5 citations


Cites background from "Females and Minority Racial/Ethnic ..."

  • ...4 years, although the range was less than one year to 29 years; 18% of the respondents had previously served in the armed forces; 87% of the respondents were Caucasian, which is also typical of the industry (42)....

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Journal ArticleDOI
TL;DR: Existing EMS workforce research demonstrates continued underrepresentation of women and non-White personnel, which raises concerns for pervasive negative workplace experiences including sexual harassment and factors that negatively affect recruitment and retention, including bias in candidate testing, a gender pay gap, and unequal promotion opportunities.

5 citations

References
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Journal ArticleDOI
11 Aug 1999-JAMA
TL;DR: The data suggest that African American patients rate their visits with physicians as less participatory than whites, however, patients seeing physicians of their own race rate their physicians' decision-making styles as more participatory.
Abstract: ContextMany studies have documented race and gender differences in health care received by patients. However, few studies have related differences in the quality of interpersonal care to patient and physician race and gender.ObjectiveTo describe how the race/ethnicity and gender of patients and physicians are associated with physicians' participatory decision-making (PDM) styles.Design, Setting, and ParticipantsTelephone survey conducted between November 1996 and June 1998 of 1816 adults aged 18 to 65 years (mean age, 41 years) who had recently attended 1 of 32 primary care practices associated with a large mixed-model managed care organization in an urban setting. Sixty-six percent of patients surveyed were female, 43% were white, and 45% were African American. The physician sample (n=64) was 63% male, with 56% white, and 25% African American.Main Outcome MeasurePatients' ratings of their physicians' PDM style on a 100-point scale.ResultsAfrican American patients rated their visits as significantly less participatory than whites in models adjusting for patient age, gender, education, marital status, health status, and length of the patient-physician relationship (mean [SE] PDM score, 58.0 [1.2] vs 60.6 [3.3]; P=.03). Ratings of minority and white physicians did not differ with respect to PDM style (adjusted mean [SE] PDM score for African Americans, 59.2 [1.7] vs whites, 61.7 [3.1]; P=.13). Patients in race-concordant relationships with their physicians rated their visits as significantly more participatory than patients in race-discordant relationships (difference [SE], 2.6 [1.1]; P=.02). Patients of female physicians had more participatory visits (adjusted mean [SE] PDM score for female, 62.4 [1.3] vs male, 59.5 [3.1]; P=.03), but gender concordance between physicians and patients was not significantly related to PDM score (unadjusted mean [SE] PDM score, 76.0 [1.0] for concordant vs 74.5 [0.9] for discordant; P=.12). Patient satisfaction was highly associated with PDM score within all race/ethnicity groups.ConclusionsOur data suggest that African American patients rate their visits with physicians as less participatory than whites. However, patients seeing physicians of their own race rate their physicians' decision-making styles as more participatory. Improving cross-cultural communication between primary care physicians and patients and providing patients with access to a diverse group of physicians may lead to more patient involvement in care, higher levels of patient satisfaction, and better health outcomes.

1,995 citations


"Females and Minority Racial/Ethnic ..." refers background in this paper

  • ...Furthermore, physician-patient gender concordance has been associated with increased trust and provision of preventative screenings and services to patients (5, 6)....

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Journal ArticleDOI
TL;DR: It is concluded that increasing the number of African American/Black physicians could reduce the impact of implicit bias on health care disparities because they exhibit significantly less implicit race bias.
Abstract: Although the medical profession strives for equal treatment of all patients, disparities in health care are prevalent Cultural stereotypes may not be consciously endorsed, but their mere existence influences how information about an individual is processed and leads to unintended biases in decision-making, so called “implicit bias” All of society is susceptible to these biases, including physicians Research suggests that implicit bias may contribute to health care disparities by shaping physician behavior and producing differences in medical treatment along the lines of race, ethnicity, gender or other characteristics We review the origins of implicit bias, cite research documenting the existence of implicit bias among physicians, and describe studies that demonstrate implicit bias in clinical decision-making We then present the bias-reducing strategies of consciously taking patients’ perspectives and intentionally focusing on individual patients’ information apart from their social group We conclude that the contribution of implicit bias to health care disparities could decrease if all physicians acknowledged their susceptibility to it, and deliberately practiced perspective-taking and individuation when providing patient care We further conclude that increasing the number of African American/Black physicians could reduce the impact of implicit bias on health care disparities because they exhibit significantly less implicit race bias

889 citations


"Females and Minority Racial/Ethnic ..." refers background in this paper

  • ...The converse is also true as implicit biases, which involve cultural stereotypes that may not be consciously endorsed, can lead providers to unintentionally make decisions that perpetuate healthcare disparities (7)....

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Journal ArticleDOI
TL;DR: The long-term solution to achieving adequate diversity in the health professions depends upon fundamental reforms of the precollege education system, and affirmative action tools in health professions schools are critical to achieving a diverse health care workforce.
Abstract: Increasing the racial and ethnic diversity of the health care workforce is essential for the adequate provision of culturally competent care to our nation’s burgeoning minority communities. A diver...

622 citations


"Females and Minority Racial/Ethnic ..." refers background in this paper

  • ...Benefits of a diverse healthcare provider workforce include reduced language, cultural, and other communication barriers that lead to reduced inequalities in the delivery of care (2, 3)....

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Journal ArticleDOI
TL;DR: This study aims to demonstrate the importance of knowing the carrier and removal status of canine coronavirus, as a source of infection for other animals, not necessarily belonging to the same breeds.
Abstract: Author Contributions: Dr Willard had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: All authors. Acquisition of data: Willard. Analysis and interpretation of data: All authors. Drafting of the manuscript: Willard. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: Willard, Leung. Administrative, technical, or material support: Leung. Study supervision: Leung, Pearce.

413 citations

Journal ArticleDOI
TL;DR: A rationale for increasing the diversity and cultural competency of the health and health-care workforce is offered, and key strategies led by the U.S. Department of Health and Human Services' Office of Minority Health are described.
Abstract: Despite major advances in medicine and public health during the past few decades, disparities in health and health care persist. Racial/ethnic minority groups in the United States are at disproportionate risk of being uninsured, lacking access to care, and experiencing worse health outcomes from preventable and treatable conditions. As reducing these disparities has become a national priority, insight into the social determinants of health has become increasingly important. This article offers a rationale for increasing the diversity and cultural competency of the health and health-care workforce, and describes key strategies led by the U.S. Department of Health and Human Services' Office of Minority Health to promote cultural competency in the health-care system and strengthen community-level approaches to improving health and health care for all.

204 citations


"Females and Minority Racial/Ethnic ..." refers background in this paper

  • ...Racial/ethnic diversity in the healthcare workforce has been correlated with improved cultural competence, reduced communication barriers and improved delivery of quality care to minority patient populations (26, 27)....

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