PDF(Pubmed)
Abstract：
BACKGROUND: Racialized women clinicians (RWCs) experience the brunt of unfair racial and gendered expectations, which is a direct result of their visible identity. Our study sought to understand how these experiences intersect to impact the personal and professional well-being of RWCs, and their approach to diabetes care.
METHODS: Data were collected from 24 RWCs working within Canadian diabetes care settings, who participated in semi-structured, one-on-one interviews conducted from April 2021 to September 2021. The data were qualitatively analyzed using thematic analysis to develop emergent themes, and interactions were explored using the socioecological model (SEM), adapted to our study context.
RESULTS: We identified three themes: (1) Discordance between self-identity and relational identity impacted how RWCs interacted with others, and how others interacted with them; (2) Tokenistic, \"inclusive\" organizational policies/practices and inherently racist and sexist social norms permitted acts of discrimination and led to the systematic othering and exclusion of RWCs within the workplace; and (3) Differential treatment of RWCs had both positive and negative impacts on participants\' relational, workplace and self-identity. Using the SEM, we also found that differential treatment of RWCs stems from upstream policies, structures, and social norms, percolating through different levels of the SEM, including work environments and communities, which eventually impacts one\'s relational identity, as well as one\'s perception of oneself.
CONCLUSIONS: The differential treatment of RWCs arises predominantly from macro systems of the work environment. The burden to address these disparities must be shifted to the source (i.e., namely systems) by implementing interventions that equitably value diversity efforts, institute policies of accountability and correction of implicit biases, and prioritize an inclusive culture broadly across faculty and leadership.
METHODS: Data were collected from 24 RWCs working within Canadian diabetes care settings, who participated in semi-structured, one-on-one interviews conducted from April 2021 to September 2021. The data were qualitatively analyzed using thematic analysis to develop emergent themes, and interactions were explored using the socioecological model (SEM), adapted to our study context.
RESULTS: We identified three themes: (1) Discordance between self-identity and relational identity impacted how RWCs interacted with others, and how others interacted with them; (2) Tokenistic, \"inclusive\" organizational policies/practices and inherently racist and sexist social norms permitted acts of discrimination and led to the systematic othering and exclusion of RWCs within the workplace; and (3) Differential treatment of RWCs had both positive and negative impacts on participants\' relational, workplace and self-identity. Using the SEM, we also found that differential treatment of RWCs stems from upstream policies, structures, and social norms, percolating through different levels of the SEM, including work environments and communities, which eventually impacts one\'s relational identity, as well as one\'s perception of oneself.
CONCLUSIONS: The differential treatment of RWCs arises predominantly from macro systems of the work environment. The burden to address these disparities must be shifted to the source (i.e., namely systems) by implementing interventions that equitably value diversity efforts, institute policies of accountability and correction of implicit biases, and prioritize an inclusive culture broadly across faculty and leadership.
摘要：
背景：种族化的女性临床医生（RWC）首当其冲的是不公平的种族和性别期望，这是他们可见身份的直接结果。我们的研究试图了解这些经验如何交叉影响RWC的个人和职业福祉，以及他们治疗糖尿病的方法。
方法：数据来自在加拿大糖尿病护理机构工作的24个RWC，参与半结构化的人，从2021年4月至2021年9月进行的一对一访谈。使用主题分析对数据进行定性分析，以开发紧急主题，并使用社会生态模型(SEM)探索相互作用，适应我们的研究背景。
结果：我们确定了三个主题：（1）自我认同和关系认同之间的不一致影响RWC与他人的互动，以及其他人如何与他们互动；(2)令牌，“包容性”的组织政策/做法以及固有的种族主义和性别歧视的社会规范允许歧视行为，并导致工作场所内RWC的系统性干预和排斥；（3）对RWC的区别对待对参与者的关系产生了积极和消极影响，工作场所和自我认同。使用SEM，我们还发现，对RWC的差别待遇源于上游政策，结构,和社会规范，渗透通过不同水平的SEM，包括工作环境和社区，这最终会影响一个人的关系身份，以及一个人对自己的感知。
结论：对RWC的区别对待主要来自工作环境的宏观系统。解决这些差异的负担必须转移到源头(即，即系统)通过实施公平重视多样性努力的干预措施，制定问责和纠正隐性偏见的政策，并在教师和领导层中广泛优先考虑包容性文化。
方法：数据来自在加拿大糖尿病护理机构工作的24个RWC，参与半结构化的人，从2021年4月至2021年9月进行的一对一访谈。使用主题分析对数据进行定性分析，以开发紧急主题，并使用社会生态模型(SEM)探索相互作用，适应我们的研究背景。
结果：我们确定了三个主题：（1）自我认同和关系认同之间的不一致影响RWC与他人的互动，以及其他人如何与他们互动；(2)令牌，“包容性”的组织政策/做法以及固有的种族主义和性别歧视的社会规范允许歧视行为，并导致工作场所内RWC的系统性干预和排斥；（3）对RWC的区别对待对参与者的关系产生了积极和消极影响，工作场所和自我认同。使用SEM，我们还发现，对RWC的差别待遇源于上游政策，结构,和社会规范，渗透通过不同水平的SEM，包括工作环境和社区，这最终会影响一个人的关系身份，以及一个人对自己的感知。
结论：对RWC的区别对待主要来自工作环境的宏观系统。解决这些差异的负担必须转移到源头(即，即系统)通过实施公平重视多样性努力的干预措施，制定问责和纠正隐性偏见的政策，并在教师和领导层中广泛优先考虑包容性文化。
