A
Data Sources and Methods

In order to respond to the study charge, several steps were undertaken to assess data regarding strategies for increasing diversity in the health professions. Sources of data and information included the assembly of a committee with appropriate knowledge and expertise; review of literature regarding admissions practices, accreditation policies, financing arrangements, community benefit principles, and the institutional climate; commissioned papers; and public workshops.

STUDY COMMITTEE

A 15-member study committee was convened to assess available data and respond to the study charge. The committee comprised members with expertise in areas such as health professions education, minority health, health-care service delivery, economics, law, statistics, and health policy. The committee convened for five 2-day meetings between November 2002 and September 2003.

LITERATURE REVIEW

The committee’s review of the literature included, but was not limited to, articles published in peer-reviewed journals. The review focused on data regarding trends in minority health; underrepresented minority (URM) representation in the targeted health professions fields; admissions and accreditation policies for psychology, nursing, medicine, and dentistry; fed-



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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce A Data Sources and Methods In order to respond to the study charge, several steps were undertaken to assess data regarding strategies for increasing diversity in the health professions. Sources of data and information included the assembly of a committee with appropriate knowledge and expertise; review of literature regarding admissions practices, accreditation policies, financing arrangements, community benefit principles, and the institutional climate; commissioned papers; and public workshops. STUDY COMMITTEE A 15-member study committee was convened to assess available data and respond to the study charge. The committee comprised members with expertise in areas such as health professions education, minority health, health-care service delivery, economics, law, statistics, and health policy. The committee convened for five 2-day meetings between November 2002 and September 2003. LITERATURE REVIEW The committee’s review of the literature included, but was not limited to, articles published in peer-reviewed journals. The review focused on data regarding trends in minority health; underrepresented minority (URM) representation in the targeted health professions fields; admissions and accreditation policies for psychology, nursing, medicine, and dentistry; fed-

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce eral and private sources of funding for health professions students, including a review of evidence of their efficacy; and the role of institutional climate and community benefit standards in supporting and increasing diversity. COMMISSIONED PAPERS The study committee commissioned several papers, which were intended to provide in-depth information on the benefits of diversity, accreditation standards, admissions policies, financing of health professions, and institutional climate. Some of these papers are published with this report volume. These topics and the paper authors were determined by the study committee. The commissioned papers were not intended to serve as a sub-stitute for the committee’s own review and analysis of the literature. The committee independently deliberated on data regarding these topics, prior to receiving the draft commissioned papers. PUBLIC WORKSHOPS The study committee hosted six one-day public workshops in conjunction with its February, April, and June 2003 meetings in order to gain additional information from the public on key aspects of the study charge. Two workshops were conducted at each of these three meetings. The topics and nature of the workshops were determined by the study committee. The first workshop was intended to allow the committee to hear the perspectives of racial and ethnic minority and nonminority health professions organizations on the importance of diversity. Subsequent workshops were focused on admissions policies and practices; the role of accreditation standards in increasing diversity; the potential application of community benefits standards; ways in which the climate of institutions can support diversity; and the financing of health professions education, including federal and nonfederal sources of support. The agendas, with lists of participants, are presented in Boxes A-1 through A-3.

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce BOX A-1 Public Workshop IOM Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the U.S. Health Care Workforce Wednesday, February 5, 2003 The National Academies, 500 Fifth Street, NW, Room 109 AGENDA 10:00 a.m. WELCOME AND INTRODUCTIONS   Lonnie R. Bristow, M.D. Chair, IOM Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the U.S. Health Care Workforce 10:15 a.m. PRESENTATIONS FROM INTEREST GROUPS AND STAKEHOLDERS   L. Natalie Carroll, M.D. President, National Medical Association   David Johnsen, D.D.S. President, American Dental Education Association   Hilda Richards, Ed.D., R.N. President, National Black Nurses Assocation, Inc.   Charles Terrell, Ed.D. Vice President, Division of Community Minority Programs Association of American Medical Colleges   Barbara Blakeney, M.S., A.P.R.N., B.C., A.N.P. President, American Nurses Association   Phyllis Kopriva Director, Women and Minority Services and   Kevin McKinney, M.D. Chair, Minority Affairs Consortium American Medical Association   Geraldine Bednash, Ph.D., R.N., F.A.A.N. Executive Director, American Association of Colleges of Nursing   Elena Rios, M.D. National Hispanic Medical Association   Ben Muneta, M.D. President, Association of American Indian Physicians

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce 11:00 a.m. QUESTION AND ANSWER PERIOD 12:00 p.m. LUNCH SERVED IN MEETING ROOM 1:00 p.m. ADMISSIONS POLICIES AND PRACTICES   Speakers will present for 30 minutes. Committee members will participate in a 15-minute question and answer period following each presentation. 1:00 p.m. Dean Whitla, Ph.D. Director, National Campus Diversity Project Harvard Graduate School of Education 1:45 p.m. Ella Cleveland, Ph.D. Association of American Medical Colleges 2:30 p.m. BREAK 2:45 p.m. Gabriel Garcia, M.D. Associate Dean of Medical School Admissions Stanford University 3:30 p.m. Joshua Aronson, Ph.D. Assistant Professor, Department of Applied Psychology New York University 4:15 p.m. ADJOURN BOX A-2 Public Workshop IOM Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the U.S. Health Care Workforce Wednesday, April 9, 2003 The National Academies, 500 Fifth Street, NW, Room 109 AGENDA 8:30 a.m. WELCOME AND INTRODUCTIONS   Lonnie R. Bristow, M.D. Chair, Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the Health Care Workforce

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce 8:45 a.m. WORKSHOP—WHAT IS THE ROLE OF ACCREDITATION STANDARDS IN PROMOTING RACIAL AND ETHNIC DIVERSITY IN HEALTH PROFESSIONS TRAINING PROGRAMS? 8:45 a.m. Barbara Grumet National League for Nursing Accrediting Commission 9:30 a.m. Dr. Charlotte Beason Commission on Collegiate Nursing Education 10:15 a.m. Karen Hart Commission on Dental Accreditation 11:00 a.m. BREAK 11:15 a.m. Dr. David Stevens Liaison Committee on Medical Education 12:00 p.m. Dr. Susan Zlotlow American Psychological Association Committee on Accreditation 12:45 p.m. LUNCH SERVED IN MEETING ROOM 1:15 p.m. WORKSHOP—WHAT IS THE ROLE OF COMMUNITY BENEFIT STANDARDS IN PROMOTING RACIAL AND ETHNIC DIVERSITY IN HEALTH PROFESSIONS TRAINING PROGRAMS?   Presentation—Community Benefit: Policies, Practices, and Potential Application to Health Professions Education   Dr. Kevin Barnett Public Health Institute   Dr. Paul Hattis Tufts University   Panel Discussion   Dr. JudyAnn Bigby Brigham and Women’s Hospital and Harvard Medical School   Dr. Bradford Gray New York Academy of Medicine   Dr. William Vega UMDNJ–Robert Wood Johnson Medical School 4:15 p.m. ADJOURN

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce BOX A-3 Public Workshop IOM Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the U.S. Health Care Workforce Monday, June 30, 2003 The National Academies, 2101 Constitution Avenue, NW, Room 150 AGENDA 9:00 a.m. WELCOME AND INTRODUCTIONS   Lonnie R. Bristow, M.D. Chair, Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the Health Care Workforce 9:15 a.m. WORKSHOP—WHAT IS THE ROLE OF INSTITUTIONAL CLIMATE IN PROMOTING RACIAL AND ETHNIC DIVERSITY IN HEALTH PROFESSIONS TRAINING PROGRAMS?   Enacting Diversity on Campus: A Framework for Conceptualizing and Assessing the Campus Racial Climate   Jeffery F. Milem, Ph.D. Associate Professor Department of Education Policy and Leadership University of Maryland and Eric L. Dey, Ph.D. Associate Professor Center for the Study of Higher and Postsecondary Education University of Michigan School of Education   Efforts to Retain Ethnic Minority Health Professions Students   Michael Rainey, Ph.D. Associate Dean for Academic Advisement Stony Brook University School of Medicine   Efforts to Recruit and Retain Ethnic Minority Faculty   Daryl G. Smith, Ph.D. Professor of Education and Psychology School of Educational Studies Claremont Graduate University   Efforts to Recruit and Retain Ethnic Minority Faculty—ACE Perspective   William B. Harvey, Ed.D. Vice President and Director Office of Minorities in Higher Education American Council on Education

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce 12:00 p.m. LUNCH SERVED IN MEETING ROOM 1:00 p.m. WORKSHOP—WHAT IS THE ROLE OF FINANCING OF HEALTH PROFESSIONS TRAINING IN PROMOTING RACIAL AND ETHNIC DIVERSITY IN HEALTH PROFESSIONS TRAINING PROGRAMS?   Federal and Nonfederal Sources of Financial Assistance for Health Professions Students   Karen Matherlee Consultant to the Study Committee President, KRM Policy   Bureau of Health Professions Programs That Address Financial Barriers   Henry Lopez, Jr. Director, Division of Health Careers Diversity and Development Bureau of Health Professions, Health Resources and Services Administration   Potential of Two Colorado Programs to Increase Access to and Interest in Dental Careers Among Underrepresented Students   Howard Landesman, D.D.S., M.Ed. Dean, School of Dentistry University of Colorado Health Science Center 3:30 p.m. ADJOURN