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Health care workers at the Hospital of the University of Pennsylvania were applauded as they headed in for their shifts in July 2020. Credit: Kylie Cooper

Marginalized groups of people value professionalism in the health care workforce more than their white, male counterparts, according to a recent Penn Medicine study.

The study, published in JAMA Network Open on Nov. 23, surveyed faculty, staff, and students affiliated with a large, academic health system in 2015 and 2017. Researchers found that members of marginalized groups — including women, people of color, and LGBTQ individuals — were more likely to value professionalism and more likely to have been exposed to unprofessional behavior, Penn Medicine News reported

This study is part of a series of research projects launched at Penn Medicine in an effort to foster inclusive learning and work environments.

“We wanted to look at the ways that marginalized groups perceive and experience professionalism, so that we could move toward standardizing policies in a way that is really inclusive for all,” Jaya Aysola, assistant dean of Inclusion and Diversity at the Perelman School of Medicine and executive director at the Penn Medicine Center for Health Equity Advancement, told Penn Medicine News. 

Professionalism — how physicians conduct themselves with patients and with peers — is regarded as a core competency in medical education, but the definition of professionalism remains vague and is often misused, Penn Medicine News reported. The current definition of professionalism has historically centered around white, heterosexual male identities, and may therefore be discriminatory towards workplace groups. 

In order to closely understand the perceptions of professionalism among faculty, staff, and students, the researchers analyzed responses from the Diversity Engagement Survey administered by DataStar, which was conducted from February to April 2015. The survey gathered responses from 3,506 people — faculty, trainees, staff, and students — working at two Philadelphia-area health systems and four medical and health professional schools.

In the survey, respondents were asked to rate their agreement with three statements about professionalism. The statements asked if respondents considered changing jobs due to "inappropriate, disruptive, or unprofessional behavior" by a coworker or supervisor, if the respondent values institutional resources related to professional workplace behavior, and if the respondents' institution supports a culture of professionalism. 

Women, non-Hispanic Black individuals, and LGBTQ individuals agreed to the first two of these statements at higher rates than white, heterosexual men. No statistically significant differences were found among respondents who agreed with the last statement in the survey.

Several respondents who self-identified as members of marginalized populations expressed that coworkers had infringed on their professional boundaries during their interactions in work or learning environments, Penn Medicine News reported. Members of marginalized groups also felt they were generally subject to greater scrutiny in the workplace.

The study suggests that educational and health care institutions must structurally redefine medical professionalism standards in order to successfully develop a welcoming, inclusive culture for women and minorities, researchers found.

“Inclusion and diversity cannot exist in silos; they must be designed into the fabric of an institution,” Aysola said, adding that the findings stress the importance of more closely governing engagement between members of the medical profession to ensure equality. 

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