September 8, 2022
New findings from UNC-Chapel Hill shed light on the ways inclusive leadership training can support institutional change and reduce racial inequities perpetuated by health care systems.
Since 2016, researchers from the UNC Gillings School of Global Public Health and UNC School of Medicine have led the Clinical Scholars program, which gives healthcare providers the tools to create actionable policies and practices that promote health equity.
These strategies have been gaining increasing attention since the spring of 2020. While many professional and educational organizations have made statements of renewed commitment to social justice in health care, these efforts are often led by small groups of people seeking to drive large-scale institutional change. .
The Clinical Scholars Program, with support from the Robert Wood Johnson Foundation, aims to help these changemakers create lasting impact through a three-year program of mentorship, networking and leadership. They have supported more than 150 fellows and 44 projects in 28 states and territories.
Program co-directors Giselle Corbie, MD, MSc, and Claudia Plaisted Fernandez, DrPH, MS, RD, LDN, led the development of a case study, published recently in the Journal of General Internal Medicine, which describes how the first cohort of clinician-scientists were able to develop their skills to advance health equity. The program framework, which emphasizes 25 core leadership skills, includes eight skills related to equity, diversity and inclusion (EDI).
Over the course of three years, 27 program participants – who came from sectors including medicine, nursing, social work, dentistry and pharmacy – were assessed on their level of knowledge, attitude, self-efficacy and their intention to use the eight EDI skills:
- Practice of multiculturalism
- Organizational capacity to advance health equity
- Diversity and Inclusion
- Health Equity
- Meaningful community engagement
- Social determinants of health
- Commitment to intercultural development
- Social justice
The results showed that participants demonstrated significant growth in all eight skills. While most of the program participants already had some training or an interest in EDI concepts, the program has enabled many of them to evolve their understanding of personal biases or awareness of topics hitherto unexplored.
Participants also tracked and reported examples of how they implemented the skills in their work during the program. This included advocating for institutional policies and organizational structures, promoting inclusive environments, creating easier access to resources, engaging with the community, and training others.
After graduation, participants continued to report activities that promoted EDI: giving interviews on podcasts or at events, expanding programs to increase access to needed care services, leading training initiatives and create research. Some have been recognized with honors for their outstanding commitment to EDI or have advanced their careers through advocacy work.
“Health disparities have been comprehensively examined as an individual inaction deficit with a nod to structural inequalities. We need more public health efforts based on solutions that leverage the ‘action,” the research team said. “Equity-focused leadership training is one of the tools needed to address racial inequality. This case study describes how intense interdisciplinary leadership development prepares health system leaders to work together and within systems to adapt and create organizational practices and policies consistent with health equity.
According to the researchers, the findings in this case study are based on leadership development under “normal stressors” that occurred before COVID-19. The team published on pivots to support cohort connectivity and leadership development during volatile, uncertain, complex and ambiguous times of the pandemic. Additional leadership topics can look at team leadership, the skills leaders lean on during the most uncertain times, and adapting the model with new team setups.
The equity-focused model is currently being piloted with community and university teams working in rural North Carolina through Whole Community Connection.
Read the full case study online.
Study authors include Corbie, Gaurav Dave, MD, DrPH, and Melissa Green, DHSc, MPH, from the School of Medicine; Kathleen Brandert, MPH, of the University of Nebraska Medical Center; Cheryl Noble, MSPH, MSW, Leadership Assessment Consultant; and Ellison Henry, MPH, Rachel Berthiaume, MPH, and Fernandez of the Gillings School.
Contact the communications team at UNC Gillings School of Global Public Health at [email protected].