Upholding Our PROMISE: Underrepresented in Medicine Pediatric Residents’ Perspectives on Interventions to Promote Belonging

Abstract

Abstract Purpose Underrepresented in medicine (UIM) residents experience challenges during training that threaten their sense of belonging in medicine, therefore residency programs should intentionally implement interventions to promote inclusion and belonging. This study explored UIM pediatric residents’ perspectives on current residency program measures designed to achieve this goal. Method The authors conducted a secondary qualitative analysis as part of a national cross-sectional study, PROmoting Med-ed Insight into Supportive Environments (PROMISE), which explored pediatric residents’ experiences and perspectives during training in relation to their self-identities. A 23-item web-based survey was distributed through the Association of Pediatric Program Directors Longitudinal Educational Research Assessment Network from October 2020 to January 2021. Participants provided free-text responses to the question “What are current measures that promote a sense of belonging for the UIM community in your training program?” The authors used conventional content analysis to code and identify themes in responses from UIM participants. Results Of the 1,748 residents invited to participate, 931 (53%) residents from 29 programs completed the survey, with 167 (18%) identifying as UIM. Of the 167 UIM residents, 74 (44%) residents from 22 programs responded to the free-text question. The authors coded more than 140 unique free-text responses and identified 7 major themes: (1) critical mass of UIM residents; (2) focused recruitment of UIM residents; (3) social support, including opportunities to build community among UIM residents; (4) mentorship; (5) caring and responsive leadership; (6) education on health disparities, diversity, equity, inclusion, and antiracism; and (7) opportunities to serve, including giving back to the local community and near-peer mentorship of UIM premedical and medical students. Conclusions This is the first national study to describe UIM pediatric residents’ perspectives on interventions that promote a sense of belonging. Programs should consider implementing these interventions to foster inclusion and belonging among UIM trainees.