Browsing by Author "Scott, Nicole"

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    Advancing Equity in Graduate Medical Education Recruitment Through a Diversity Equity and Inclusion (DEI) Toolkit for Program Directors
    (Sage, 2023-10-09) Nabhan, Zeina M.; Scott, Nicole; Kara, Areeba; Mullis, Leilani; Dams, Travis; Giblin, Mark; Williamson, Francesca; Wright, Curtis; Pediatrics, School of Medicine
    Objectives: To increase diversity and inclusion in graduate medical education (GME), the Accreditation Council for Graduate Medical Education (ACGME) issued new diversity standards requiring programs to engage in practices that focus on systematic recruitment and retention of a diverse workforce of trainees and faculty. The literature on how program directors (PDs) can incorporate and prepare for this standard is limited. Methods: We developed a diversity, equity, and inclusion (DEI) toolkit for PDs as an example of an institutional GME-led effort to promote inclusive recruitment and DEI awareness among residency and fellowship programs at a large academic center. Results: A survey was sent to 80 PDs before the launch of the toolkit and 6 months afterwards with response rates of 27% (22/80) and 97% (78/80), respectively. At baseline, 45% (10/22) anticipated that the DEI toolkit might provide better resources than those currently available to them and 41% (9/22) perceived that the toolkit might improve recruitment outcomes. At 6 months, 63% (49/78) found the toolkit helpful in the 2021-2022 recruitment season. By contrast, 2% (2/78) of PDs did not find the toolkit helpful, and 33% (26/78) said they did not access the toolkit. When asked if a PD changed their program's recruitment practices because of the toolkit, 31% (24/78) responded yes. Programs that changed recruitment practices started to require unconscious bias training for all faculty and residents involved in the residency interviews and ranking. Others worked on creating a standardized scoring rubric for interviews focused on four main domains: Experiences, Attributes, Competencies, and Academic Metrics. Conclusion: There is a need to support PDs in their DEI journey and their work to recruit a diverse workforce in medicine. Utilizing a DEI toolkit is one option to increase DEI knowledge, skills, awareness, and self-efficacy among PDs and can be adopted by other institutions and leaders in academic medicine.
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    Allies Welcomed to Advance Racial Equity (AWARE) Faculty Seminar Series: Program Design and Implementation
    (Sage, 2021) Tucker Edmonds, Brownsyne; Neal, Chemen; Shanks, Anthony L.; Scott, Nicole; Robertson, Sharon; Rouse, Caroline E.; Bernard, Caitlin; Sotto-Santiago, Sylk
    Introduction: In the wake of George Floyd’s murder, White faculty in our department began to express the desire to gain a greater understanding of structural racism and racial inequity. To facilitate this learning, support allyship, and mitigate the emotional labor and taxation that frequently falls on faculty of color to respond to these appeals, we developed AWARE (Allies Welcomed to Advance Racial Equity), a faculty seminar series primarily designed for and led by a majority White faculty to tackle the topics of structural racism, Whiteness, and Anti-racist action. Methods: We developed a 6-session seminar series, identifying 5 White faculty as lecturers and a cadre of Black and White volunteer facilitators, to lead 60-minute sessions comprised of lecture, facilitated small group reflection, and large group sharing, that reviewed key topics/texts on structural racism, Whiteness, and Anti-racism. Results: Attendance ranged from 26 to 37 participants at each session. About 80% of faculty participated in at least 1 session of the program. The majority of participants (85%) felt “more empowered to influence their current environment to be more inclusive of others” and were “better equipped to advocate for themselves or others.” Most (81%) felt “more connected to their colleagues following completion of the program.” Ultimately, faculty thought highly of the program upon completion with 26/27 (96%) stating they would recommend the program to a colleague. Discussion: We offer a reproducible model to improve departmental climate by engaging in the shared labor of educating our colleagues and communities about structural racism, Whiteness, and Anti-racism to create a point of entry into reflection, dialogue, and deliberate actions for change.
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    Allies Welcomed to Advance Racial Equity (AWARE) Faculty Seminar Series: Program Design and Implementation
    (Sage, 2021-07-24) Tucker Edmonds, Brownsyne; Neal, Chemen; Shanks, Anthony L.; Scott, Nicole; Robertson, Sharon; Rouse, Caroline E.; Bernard, Caitlin; Sotto-Santiago, Sylk; Obstetrics and Gynecology, School of Medicine
    Introduction: In the wake of George Floyd's murder, White faculty in our department began to express the desire to gain a greater understanding of structural racism and racial inequity. To facilitate this learning, support allyship, and mitigate the emotional labor and taxation that frequently falls on faculty of color to respond to these appeals, we developed AWARE (Allies Welcomed to Advance Racial Equity), a faculty seminar series primarily designed for and led by a majority White faculty to tackle the topics of structural racism, Whiteness, and Anti-racist action. Methods: We developed a 6-session seminar series, identifying 5 White faculty as lecturers and a cadre of Black and White volunteer facilitators, to lead 60-minute sessions comprised of lecture, facilitated small group reflection, and large group sharing, that reviewed key topics/texts on structural racism, Whiteness, and Anti-racism. Results: Attendance ranged from 26 to 37 participants at each session. About 80% of faculty participated in at least 1 session of the program. The majority of participants (85%) felt "more empowered to influence their current environment to be more inclusive of others" and were "better equipped to advocate for themselves or others." Most (81%) felt "more connected to their colleagues following completion of the program." Ultimately, faculty thought highly of the program upon completion with 26/27 (96%) stating they would recommend the program to a colleague. Discussion: We offer a reproducible model to improve departmental climate by engaging in the shared labor of educating our colleagues and communities about structural racism, Whiteness, and Anti-racism to create a point of entry into reflection, dialogue, and deliberate actions for change.
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    Describing Self-confidence in Ultrasound Performance with Increased Exposure
    (2020-03-06) Shanks, Anthony L.; Schultz, Katherine; Bhamidipalli, Surya; Rouse, Caroline; Scott, Nicole
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    Emergent Intervention of a Non-Communicating Rudimentary Uterine Horn Pregnancy
    (2023-03-24) Friel, Rylee; Evelyn, Crowley; Ali, Yasmin; Bell, Libby; Tian, Wendy; Scott, Nicole
    Background: Non-communicating rudimentary uterine horns (NRCH) arise from Mullerian duct malformations during embryonic development. Pregnancies of the rudimentary horn account for 0.0013% to 0.00067% of all pregnancies. Such pregnancies are non-viable and pose major risks to the mother. Without early detection and management, maternal mortality rates can be as high as 88% due to rupture. Case Description: A 22-year-old G1P0 female at 7 weeks gestation presented to the emergency department with abdominal pain for 3 weeks. A transvaginal ultrasound (TVUS) was performed and a fetal pole with cardiac activity was seen in the right adnexa, suspicious for ectopic pregnancy. She had an unremarkable TVUS 1 year ago. A diagnostic laparoscopy was performed for presumed treatment of ectopic pregnancy. During the procedure, patient was found to have a right non-communicating rudimentary uterine horn with pregnancy noted inside. The left horn was connected to the cervix and otherwise normal. Intraoperatively, the right ureter was not identified. Due to high risk of rupture, the rudimentary right horn with pregnancy and the right fallopian tube were resected. A postoperative CT urogram revealed a solitary renal kidney and single left ureter. Clinical Significance: The high mortality rate of ruptured NCRH pregnancies highlights the importance of early detection and proper management of such pregnancies. Mullerian duct anomalies are usually detected with ultrasound or magnetic resonance imaging prior to conception. In this case, the NRCH was formerly unknown and treated as an ectopic pregnancy with fetal cardiac activity. The complete resection of the rudimentary horn with pregnancy and fallopian tube proved to be an appropriate management for this emergent situation. Conclusion: In emergent situations of an undetected NRCH until pregnancy, resection of rudimentary horn with ipsilateral fallopian tube is not only therapeutic, but also preventative for potential future ectopic pregnancies.
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    Increasing Diversity in Residency Training Programs
    (Springer Nature, 2022-06-15) Crites, Kundai; Johnson, Jasmine; Scott, Nicole; Shanks, Anthony L.; Obstetrics and Gynecology, School of Medicine
    Improving diversity in the healthcare workforce holds promise in improving the health outcomes of our diverse patient population. Attracting, recruiting, and retaining physicians from races and ethnicities that are historically underrepresented in medicine are vital in this effort. Increasing diversity at the graduate medical education level has the potential to positively reshape our physician personnel. In this editorial, we discuss the current state of diversity-oriented recruitment strategies for residency programs and present opportunities for future efforts.
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    I’m supposed to be a helper: Spiritual distress of abortion providers after Dobbs v. Jackson
    (2024-04) Bode, Leah; Kumar, Komal; McQuillan, Josie; Scott, Nicole; Bernard, Caitlin
    On June 24, 2022, the Supreme Court of the United States voted to overturn Roe v. Wade, the 1970 landmark case protecting abortion rights in America, in Dobbs v. Jackson Women’s Health Organization. The decision has the potential to affect the way that physicians and learners in the field of Obstetrics and Gynecology (OBGYN), and specifically abortion providers, practice their specialty by interacting with patients and making meaning from their work. Meaning making in one’s work has been shown to be integral in fostering spiritual well-being and preventing burnout in medicine. We sought to demonstrate the spectrum of spirituality of abortion providers and their subsequent spiritual distress in the aftermath of Dobbs. We conducted thirty-minute interviews on Zoom with 26 abortion providers from 17 states from November 2022 to February 2023. Demographics collected included age, racial identity, location of practice (by state), years in practice, fellowship training, and practice setting (community, academic, hybrid). States were then classified according to the Guttmacher Institute classifications of Most Restrictive, Restrictive, Some restrictions/protections, Protective, and Very protective as of December 2022. Interviews consisted of questions such as "What are the major tenants of your spiritual beliefs (if none, how you make meaning)?” and “Tell me about any spiritual distress or alienation from your religious or spiritual community as a result of the Dobbs decision.” Interviews were transcribed using the closed caption feature on Zoom and coded by LB, KK, and JM. After achieving consensus, interviews were analyzed using NVivo 14. Sixteen providers were fellowship trained (14 Complex Family Planning and 2 Maternal Fetal Medicine), one was a family medicine physician, and one was a Nurse Practitioner. Practice type was equally distributed amongst community (34.6%), academic (34.6%), and hybrid (30.8%). Location of practice (state) was well-distributed across the restrictive-protective spectrum: 7.7% Most Restrictive, 30.8% Restrictive, 15.4% Some restrictions/protections, 30.8% Protective, and 15.4% Very Protective. The majority of participants identified a personal spirituality, while less than half were tied to an organized religion, such as Christianity, Judaism, Hinduism, or Buddhism. Fifteen participants (57.7%) identified a concept of “good” in their spirituality, using words such as “greater good” or “common good”. Sixteen participants (61.5%) cited ethical principles of justice, non-maleficence, respect for human life, or autonomy as major tenets of their spirituality. The subject of abortion care as related to spirituality was brought up in a number of ways. Ten subjects (38.5%) felt spiritually called to provide abortion care; 11 others (42.3%) perceived abortion care as an obligation born from their spiritual beliefs. Twelve participants (46.2%) noted the act of providing an abortion as a spiritual act, for provider and/or patient. Most participants experienced spiritual distress relating to the Dobbs decision. Spiritual distress was related to conflict with differently minded community members (30%), the perceived inability to live out their calling by providing abortion care (38%), and their physical location (38%). Those who did not experience spiritual distress (26%) noted location and alignment with spiritual values as protective factors. 38% of participants identified some other form of distress (e.g., moral) but did not identify it as spiritual distress. Of note, 92% of participants described their spirituality as helpful in coping with the fall of Roe v. Wade. Sources of strength included advocacy (34.6%), agency (e.g., “I feel strength knowing that I’m still able to do this job”) (57.7%), legislative work (30.8%), and community (50%). Community strength was further broken down into the abortion provider community (57.7%), family and friends (53.8%), and a faith or spiritual community (26.9%). Eight participants (30.8%) identified a perceived conflict, discordance, or lack of discussion between spirituality and medicine. Five subjects (19.2%) acknowledged that their personal spirituality is underexplored. This qualitative study demonstrates that abortion providers are spiritual individuals. For many, the decision to be an abortion provider is motivated by this identity, or in some cases an obligation. Regarding the fall of Roe v. Wade, many abortion providers endorsed feelings of spiritual distress. Many reported being distressed due to not being able to comply with their moral and/or spiritual obligation of providing abortions secondary to new restrictions. Location played a large role in whether providers were experiencing this distress. It can be deduced that state restrictions on provision of abortions have directly impacted the spiritual well-being of abortion providers. As many laws pertaining to abortion are influenced by religious beliefs, it is important to recognize that abortion providers themselves are overwhelming spiritual.
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    “I’m supposed to be a helper”: Spiritual distress of abortion providers after Dobbs v. Jackson
    (2024-04-26) Bode, Leah; Kumar, Komal; McQuillan, Josie; Scott, Nicole; Bernard, Caitlin
    INTRO On June 24, 2022, the U.S. Supreme Court voted to overturn Roe v. Wade, the 1970 landmark case protecting abortion rights in America, in Dobbs v. Jackson Women’s Health Organization. The decision has the potential to affect the way that abortion providers practice their specialty by interacting with patients and making meaning from their work. Meaning making in one’s work has been shown to be integral in fostering spiritual well-being and preventing burnout in medicine. We sought to demonstrate the spectrum of spirituality of abortion providers and their subsequent spiritual distress in the aftermath of Dobbs. METHODS We conducted thirty-minute interviews on Zoom with 26 abortion providers from 17 states from November 2022 to February 2023. Demographics collected included age, racial identity, location of practice (by state), years in practice, fellowship training, and practice setting (community, academic, hybrid). States were then classified according to the Guttmacher Institute classifications of Most restrictive, Restrictive, Some restrictions/protections, Protective, and Very protective as of December 2022. Interviews consisted of questions such as "What are the major tenants of your spiritual beliefs (if none, how you make meaning)?” and “Tell me about any spiritual distress or alienation from your religious or spiritual community as a result of the Dobbs decision.” Interviews were analyzed using NVivo 14. RESULTS Providers were equally distributed amongst community (34.6%), academic (34.6%), and hybrid (30.8%) settings. Location of practice (state) was well-distributed across the restrictive-protective spectrum: 7.7% Most restrictive, 30.8% Restrictive, 15.4% Some restrictions/protections, 30.8% Protective, and 15.4% Very protective. The majority of participants identified a personal spirituality, while less than half were tied to an organized religion. Sixteen participants (61.5%) cited ethical principles of justice, non-maleficence, respect for human life, or autonomy as major tenets of their spirituality. Ten subjects (38.5%) felt spiritually called to provide abortion care, 11 others (42.3%) perceived abortion care as a spiritual obligation, and 12 participants (46.2%) noted the act of providing an abortion as a spiritual act, for provider and/or patient. Most participants experienced spiritual distress relating to the Dobbs decision. Those who did not experience spiritual distress (26%) noted location and the alignment of their work with spiritual values as protective factors. Of note, 92% of participants described their spirituality as helpful in coping with the fall of Roe v. Wade. Sources of strength included advocacy, agency (e.g., “I feel strength knowing that I’m still able to do this job”), legislative work, and community; 57.7% specifically cited the abortion provider community. CONCLUSION The decision to be an abortion provider is often motivated by one’s spiritual identity. Many abortion providers endorsed feelings of spiritual distress related to not being able to comply with their moral and/or spiritual obligation of providing abortions secondary to new restrictions. Location factored heavily into whether providers were experiencing this distress, suggesting that state restrictions on abortions have directly impacted the spiritual well-being of abortion providers. As many laws pertaining to abortion are influenced by religious beliefs, it is important to recognize that abortion providers themselves are overwhelming spiritual.
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    “I’m supposed to be a helper”: Spiritual distress of abortion providers after Dobbs v. Jackson
    (2024-04) Bode, Leah; Kumar, Komal; McQuillan, Josie; Scott, Nicole; Bernard, Caitlin
    INTRO On June 24, 2022, the Supreme Court of the United States voted to overturn Roe v. Wade, the 1970 landmark case protecting abortion rights in America, in Dobbs v. Jackson Women’s Health Organization. The decision has the potential to affect the way that abortion providers practice their specialty by interacting with patients and making meaning from their work. Meaning making in one’s work has been shown to be integral in fostering spiritual well-being and preventing burnout in medicine. We sought to demonstrate the spectrum of spirituality of abortion providers and their subsequent spiritual distress in the aftermath of Dobbs. METHODS We conducted thirty-minute interviews on Zoom with 26 abortion providers from 17 states from November 2022 to February 2023. Demographics collected included age, racial identity, location of practice (by state), years in practice, fellowship training, and practice setting (community, academic, hybrid). States were then classified according to the Guttmacher Institute classifications of Most restrictive, Restrictive, Some restrictions/protections, Protective, and Very protective as of December 2022. Interviews consisted of questions such as "What are the major tenants of your spiritual beliefs (if none, how you make meaning)?” and “Tell me about any spiritual distress or alienation from your religious or spiritual community as a result of the Dobbs decision.” Interviews were transcribed using the closed caption feature on Zoom and coded by LB, KK, and JM. After achieving consensus, interviews were analyzed using NVivo 14. RESULTS Providers’ practices were equally distributed amongst community (34.6%), academic (34.6%), and hybrid (30.8%) settings. Location of practice (state) was well-distributed across the restrictive-protective spectrum: 7.7% Most restrictive, 30.8% Restrictive, 15.4% Some restrictions/protections, 30.8% Protective, and 15.4% Very protective. The majority of participants identified a personal spirituality, while less than half were tied to an organized religion. Sixteen participants (61.5%) cited ethical principles of justice, non-maleficence, respect for human life, or autonomy as major tenets of their spirituality. Ten subjects (38.5%) felt spiritually called to provide abortion care, 11 others (42.3%) perceived abortion care as a spiritual obligation, and 12 participants (46.2%) noted the act of providing an abortion as a spiritual act, for provider and/or patient. Most participants experienced spiritual distress relating to the Dobbs decision. Those who did not experience spiritual distress (26%) noted location and the alignment of their work with spiritual values as protective factors. Of note, 92% of participants described their spirituality as helpful in coping with the fall of Roe v. Wade. Sources of strength included advocacy, agency (e.g., “I feel strength knowing that I’m still able to do this job”), legislative work, and community; 57.7% specifically cited the abortion provider community. CONCLUSION The decision to be an abortion provider is often motivated by one’s spiritual identity. Regarding the fall of Roe v. Wade, many abortion providers endorsed feelings of spiritual distress related to not being able to comply with their moral and/or spiritual obligation of providing abortions secondary to new restrictions. Location played a large role in whether providers were experiencing this distress, suggesting that state restrictions on abortions have directly impacted the spiritual well-being of abortion providers. As many laws pertaining to abortion are influenced by religious beliefs, it is important to recognize that abortion providers themselves are overwhelming spiritual.