Table 1 Student participant responses to the post-program survey
Source: Hastings K, et al., “High-impact Remote Summer Program to Improve Diversity, Equity, and Inclusion in Orthopaedic Surgery.”

AAOS Now

Published 3/25/2022
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Ariel DeMaio

Pilot Research Program Helps Bridge Gap between Access and Opportunity for Underrepresented Minority Students

Increasing the diversity of orthopaedic surgery, well recognized as one of the least diverse fields of medicine, has been a key goal of AAOS since the Board of Directors approved the society’s five-year strategic plan in December 2018. From an orthopaedic residency program perspective, one of the greatest barriers to improving diversity is the underrepresentation of minority populations among faculty.

Recently, the Department of Orthopaedics at Stanford University developed a remote research program for summer students interested in orthopaedics to improve diversity, equity, and inclusion in its residency program. Faculty will present their findings at the AAOS 2022 Annual Meeting.

The purpose of the program was to correct the lack of structured, high-quality research opportunities, with the long-term goal “to improve the accessibility, affordability, and quality of research mentorship for a diverse student population and encourage a pathway into orthopaedics,” explained the study authors, led by Katherine Hastings, MPH, of the Pediatric Orthopaedic Research Program at Stanford Medicine. Based on their experience, they determined, “This program has the potential to serve as a model for other departments or institutions to adopt in order to further expand educational and professional pipelines for underrepresented students interested in orthopaedics.”

As Ms. Hastings detailed in her presentation, the pilot program consisted of three main components:

  • weekly instructional courses on research-related topics led by a content expert
  • weekly guest lectures discussing topics such as orthopaedic conditions, diversity in orthopaedics, residency applications, and more—all led by orthopaedic faculty
  • an eight-week research experience (ranging from literature reviews to data collection and analysis) matched with an assigned faculty and peer mentor

Student participants were expected to engage in all three components throughout the summer program, with mandatory attendance at instructional courses and faculty lectures. Faculty were expected to meet at least weekly with student participants throughout the eight-week program.

After advertising the pilot program on its department and division websites and on social media, the researchers received 115 applications for the program. A total of 17 students were selected to participate, based on their status as members of an underrepresented group in orthopaedics (e.g., female, underrepresented racial or ethnic group, and/or first-generation college student), research experience, ability to access courses and materials remotely, and research interest fit with available faculty mentors. Nine faculty mentors were matched with one or two students based on research projects available and overall fit with the student participant’s experience and orthopaedic interests.

“Mentorship is the foundation of this program, so it was important to build a range of highly structured and engaging opportunities for students,” Ms. Hastings and coauthors noted. The program included a peer-to-peer mentorship component, as learners with more research experience served as mentors for those with little to no research experience prior before they entered the program.

Student participants represented a range of racial/ethnic backgrounds and research experience, with a high rate of participation from female (42 percent) and Black (35 percent) individuals. A range of subspecialty areas was represented in the faculty mentors, and they also had a wide range of years in practice (range, 3-20).

All components of the program, including an orientation session, were delivered fully remotely from June to August 2021. The style of course delivery varied by instructor (e.g., lecture-based, discussion-based, or breakout rooms with activities).

All 17 students completed the post-program evaluation survey (scale of 1–10, with 10 being extremely likely). They generally responded favorably to the program (Table 1). Faculty mentor feedback was similarly positive. Most were able to meet weekly with their students, and all felt they were appropriately matched to their participants and said they would participate in the program in the future.

All participants indicated that they improved research skills, with scientific writing and literature search/review being the skill that improved the most. “Students expressed a strong interest in continuing to improve ‘presentation’ and ‘grant writing’ skills, which could be a course to build out more in future years,” the authors reported.

From the faculty perspective, mentors said they were impressed by the students’ level of engagement and their output.

Notably, most student participants believed that the program further increased their interest and candidacy in orthopaedic surgery and strengthened their likelihood of applying to an orthopaedic residency. Several indicated they are now considering taking a gap year to conduct research based on this experience. Students also reported that they were satisfied with the program, but many indicated that the virtual component was a hindrance.

Of the three program components, the research experience was ranked as the greatest contributor to students’ overall learning. The greatest areas of potential improvement were in better access to course materials (via an online education platform), longer duration of the program, and improvements to specific course content.

“Part of the initiative behind this program was to serve as a pipeline for students who were interested in orthopaedic surgery and clinical research and had yet to be afforded the opportunity to engage with such experiences,” the authors concluded. “We hoped to give them a meaningful foundation in clinical research and a mentor whom they could form a lasting connection with well into their careers in medicine.”

Ms. Hastings also highlighted several improvements that the team plans to incorporate in the program moving forward, including adding more interactive questions to instructional courses and hosting a poster presentation session at the end of the program to allow students to present their work to colleagues and faculty mentors in a low-stakes environment.

The study will be presented as Paper 730 on Friday at 3:35 p.m. in Room S106a.

Ms. Hastings’ coauthors of “High-impact Remote Summer Program to Improve Diversity, Equity, and Inclusion in Orthopaedic Surgery” are Derek F. Amanatullah, MD, PhD; Michael J. Gardner, MD; Kevin Shea, MD; and Steven L. Frick, MD.

Ariel DeMaio is managing editor of AAOS Now