A scoping review of interventions to promote workforce diversity, equity, and inclusion at later career stages in medicine, nursing, dentistry, public health, and health science

Proposal: Background and relevance: To promote diversity, equity, and inclusion (DEI) among faculty and academic leadership, it is necessary to understand what interventions have been trialed to promote DEI at later career stages, differences and similarities between interventions, and assessment of outcomes.

Methods: We performed a scoping review of interventions to promote workforce DEI for graduate education through leadership career stages in medicine, nursing, dentistry, public health, and health science. To do so, we searched Ovid MEDLINE(R) for English language articles published from 1/1/2000 to 11/3/2023. Articles were eliminated if they were not relevant or did not detail interventions in the United States Puerto Rico.

Results: We identified 55 articles detailing interventions to promote workforce DEI for career stages of graduate education through leadership. Of these articles, four were cross-sectional examinations of interventions at multiple locations. The remaining 51 articles detailed 51 interventions across 23 states and Puerto Rico that ranged in size from a single person to an entire healthcare system. These 51 interventions differed by profession (28 [54.9%] medicine, 10 [19.6%] nursing, 8 [15.7%] health science, 1 [2.0%] dentistry, 1 [2.0%] public health, and 3 [5.9%] multiple professions); intervention type (13 [25.5%] development or training programs, 13 [25.5%] mentorship programs, 11 [21.6%] interventions involving institutional change, and eight [15.7%] other types of interventions); career stage of participants (19 [37.3%] students, 14 [27.5%] faculty/staff, 2 [3.9%] leadership, 13 [25.5%] multiple career stages, and 3 [5.9%] not specified); and type of diversity targeted (31 [60.8%] race or ethnicity, 4 [7.8%] sex or gender, 10 [19.6%] multiple types of diversity, and 6 [11.8%] not specified). Of the 51 studies, there were 34 cohort studies, one randomized controlled trial, one cross-sectional study, one case report, and 14 studies that contained only descriptive information. Most studies (36, 70.6%) had no pre/post, external, or other comparison group.

Conclusion: Over the past 23 years, many different types of interventions have been trialed to promote workforce DEI at later career stages. Most studies detailed interventions in medicine, focused on racial and ethnic diversity, and included student and/or faculty/staff participants.

Expertise: Dr. Hill is a neurology intern and studies DEI. Mr. Austin is a DEI practitioner responsible for designing, leading, and implementing DEI strategic priorities and initiatives. Dr. Enders is a professor of biostatistics who has extensive experience in clinical areas across the translational science spectrum. Her personal research focuses on health equity and DEI.