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Assessing Faculty Commitments to Diversity, Equity and Inclusion through the Performance Review Process
By Cleveland Piggott, MD, MPH; Gilbert Achay; Vanessa Owen, MA; Carlee Kreisel, MPH; Department of Family Medicine; University of Colorado Anschutz Medical Campus, Aurora, CO
Background
As leaders, faculty are core to advancing diversity, equity and inclusion (DEI) within academic medical institutions. They contribute to the receptivity and climate for DEI activities1 and are thus critical to implementing DEI strategies across the department. Since 2018, when formal commitments to DEI began at the University of Colorado Department of Family Medicine (DFM), our faculty have engaged in DEI through various skills building and leadership development opportunities. Still, incentive programs and surveys have provided limited information about the actual content and scope of these activities. To better understand faculty engagement in DEI, the DFM partnered with faculty affairs at the School of Medicine (SOM) to advocate for permanent DEI-related changes to its annual performance review process. Referred to as Performance Reviews in the School of Medicine, or PRiSM, this system is used by 5,000 faculty at the SOM.
Methods
The DFM created DEI-related questions that were subsequently approved by the SOM and added to PRiSM in time for the year-ending 2021 performance reviews. The questions aimed to gauge the breadth of DEI activities among faculty, who were apprised of the DFM’s commitment to DEI since a departmental mission area on DEI was first launched in 2018. This included the appointment of a Vice Chair of DEI, creation of a DEI-focused team, and allocation of resources to support cross-cutting DEI programming.
The questions consisted of two standardized and one open text question:
Standardized
“I completed implicit bias or anti-racism training in the past two years.”
“I have completed other diversity training this year.”
Open Text
“Diversity, equity and inclusion are core values and priorities of the Department and the School of Medicine (SOM). Describe how you have helped support a diverse and inclusive culture within the SOM.”
Prior to the 2021 performance review process, DFM leaders and SOM faculty affairs leadership created a user’s guide and offered training sessions to reinforce the DFM’s vision and goals for advancing DEI, share the new PRiSM questions, explain the anticipated utilization of respondents’ data, and provide supervisors guidance to optimize conversations during the performance review process.
Results
DFM faculty responses were obtained from SOM’s human resources team and analyzed by DFM staff. Faculty of all ranks are included in data from the 2021 (N=195) and 2022 (N=236) performance review cycles. Table 1 summarizes data from the standardized questions. The open text responses in Table 2 capture major themes with illustrative examples.
Table 1:
Table 2:
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Reflection: "This is an area where I should strive to be more mindful. While I support a diverse and inclusive environment, I have not done all that I could do to embrace and demonstrate that.” |
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Incorporation into clinical practice: "Through my work as a clinician at a FQHC with a large immigrant and refugee population, I have reflected on my own identity and privilege and have strived to learn from my patients the unique challenges and successes they face that are different than my own." |
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Mentorship of underrepresented groups: "I serve as a mentor to a resident from an under-represented background and have spearheaded her inclusion as an author and lead presenter on scholarly activity, as well as helped a team successfully nominate her for [name of award]." |
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Board, taskforce, or committee service: "I'm part of a national anti-racism taskforce where we're helping to incorporate this lens into family medicine education and support dyads across the country to do the same at their institutions." |
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Trainings: "I completed two trainings/reviews in 2022 on bias and diversity that were related to serving on hiring committees" |
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Human resources (HR) and policy decision making and development: "We have made specific efforts to focus on DEI during our recruitment process for prospective fellows. This includes a scoring system to acknowledge URMs (underrepresented minorities in medicine) and those with other hardships who have shown resilience." |
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Incorporation into research: "We are engaging in applied research to improve practices especially for our transgender and non-binary populations. We are working to improve our testing practices to look at norming for the populations we serve to ensure recommendations are considerate of cultural contexts." |
Our data shows an increase in faculty response to the DEI questions from 2021-2022. While there were no significant differences in gender or race/ethnicity in completion of the questions, we found slightly lower response rates from non-promotion track faculty (not shown). The questions created an opportunity for faculty to provide detailed information about their DEI activities, including trainings, completed, contributions to changes in policy and practice, board and committee service, and awards and recognitions. Other than the additions of the DEI questions and trainings regarding their rationale and purpose, there were no other significant changes in the overall approach to DEI performance or goals in the department. We surmise the changes in outcomes resulted from building the query into the performance review process, hence giving it increased attention to the department’s commitment to DEI priorities, and encouraging faculty to provide more thoughtful responses in this area, since it was imputed to affect their annual evaluations.
Conclusion
We found the performance review process to be a standardizable approach to assess current-state engagement in DEI activities. By working through our institution’s existing performance review infrastructure, we obtained easily accessible data containing insights about our faculty’s commitment to DEI that informs our progress on DEI strategy. Responses to standardized questions provide baseline information on yearly trends in DEI involvement, while the open text responses offer substantive input on underlying challenges and opportunities for DEI growth. Additionally, this provides an opportunity to build systemic culture change regarding the importance of DEI in our department and institution. Moving forward we plan to continue monitoring these trends and explore ways of supporting our faculty to expand from learning about DEI to integrating changes within their domains of responsibility.
References
- Marchiondo, L. A. , Verney, S. P. & Venner, K. L. (2023). Academic Leaders’ Diversity Attitudes. Journal of Diversity in Higher Education, 16 (3), 323-332. doi: 10.1037/dhe0000333
