Lahia Yemane

All Publications

• Upholding our PROMISE: Increased representation is not enough to foster belonging in graduate medical education. Medical education Poitevien, P., Kas-Osoka, O., Burns, A., Prakash, L. K., Marbin, J., Schwartz, A., Lucas, C. T., Yemane, L., Blankenburg, R. 2024

  Abstract

  Sense of belonging supports academic achievement and encourages career endurance. The purpose of this study was to characterize what individual and institutional factors influence one's sense of belonging by describing the experiences of underrepresented in medicine (UIM) paediatric and internal medicine-paediatric residents in the United States.The authors conducted a national survey of paediatric and internal medicine-paediatric residents. The 23-item anonymous web-based survey was distributed between October 2020 and January 2021 and included questions on socio-demographic characteristics and individual perceptions on sense of belonging, value, common mission or values at a program or institution and respect. The authors used linear mixed models and fitted regression models to examine individual factors and environmental factors that impact sense of belonging, value and respect.Across 29 residency programs, 938 (53%) of 1748 residents completed the survey. One hundred sixty-seven (18%) self-identified as UIM. UIM residents had a lower sense of belonging than non-UIM residents [mean (SD) 3.6 (0.87) vs. 4.0 (0.57)]. Black/AA and Hispanic/Latinx residents had the lowest sense of belonging [3.5 (0.82) and 2.8 (0.93), respectively]. UIM residents demonstrated decreased sense of belonging in programs that lacked bias training and where peers discriminated against them. Sense of belonging was increased in programs where they perceived a sense of support, respect or values alignment. Surprisingly, individual UIM resident sense of belonging was not improved by having more UIM residents in a program.UIM paediatric residents experience a decreased sense of belonging during training. Programs can support sense of belonging for UIM residents by demonstrating respect and support for them and by offering systems for bias training and reporting bias and discrimination. Recruiting a greater number of UIM trainees remains important; however, compositional diversity alone does not improve a sense of belonging for UIM residents. There is continued need for structural/institutional change, including addressing institutional culture and structural racism.

  View details for DOI 10.1111/medu.15546

  View details for PubMedID 39317675

• JAMA Network Open Health Equity Fellowship Commentary-What We Gained and What We Hope to Give. JAMA network open Fritz, C. D., McMillan, R., Mateo, C., Ruiz, J., Yemane, L., Jindal, M. 2024; 7 (9): e2436376

  View details for DOI 10.1001/jamanetworkopen.2024.36376

  View details for PubMedID 39348125

• Underrepresented in Medicine Trainees' Sense of Belonging and Professional Identity Formation after Participation in the Leadership Education in Advancing Diversity Program. Academic pediatrics Yemane, L., Powell, C., Edwards, J., Shumba, T., Alvarez, A., Bandstra, B., Brooks, M., Brown-Johnson, C., Caceres, W., Dunn, T., Johnson, C., Perez, F. D., Reece-Nguyen, T., Thomas, R. P., Watkins, A. C., Blankenburg, R. 2024

  Abstract

  There are persistent structural barriers that threaten inclusion and retention of underrepresented in medicine (UIM) residents and fellows (trainees) as future faculty in academic medicine. We developed the Leadership Education in Advancing Diversity (LEAD) Program at a single, academic institution, to address these barriers through a 10-month longitudinal curriculum across GME for trainees to develop leadership and scholarship skills in DEI.Explore how participation in LEAD impacted UIM trainees' sense of belonging and professional identity formation in academic medicine; as well as perceptions about pursuing a career in academic medicine and future leadership roles.IRB-approved qualitative study in August 2020-August 2021 with individual, semi-structured interviews of UIM LEAD graduates from the first 4 cohorts (2017-2021). Data were analyzed by two authors using modified grounded theory.14 UIM trainees were interviewed; seven themes emerged. Critical aspects of the program: (1) Creation of a community of shared DEI values (2) Mentorship (3) Role of allies. Results of the program: (4) Deepened appreciation of personal and professional identity as UIM (5) Fostered belonging in academic medicine (6) Appreciation of different careers in academic medicine and how to integrate DEI interests (7) Inspired trainees to pursue leadership roles.LEAD can serve as a model for other institutions that seek to support UIM trainees' sense of belonging, professional identity formation, and perceptions about pursuing careers in academic medicine and future leadership roles.

  View details for DOI 10.1016/j.acap.2024.08.003

  View details for PubMedID 39117029

• Decoding the Reference Letter: Strategies to Reduce Unintentional Gender Bias in Letters of Recommendation. MedEdPORTAL : the journal of teaching and learning resources Mieso, B. R., Barnett, J. F., Otero, T. M., Berquist, S. W., Perez, F. D., Han, P., Bhargava, S., Atasuntseva, A., Yemane, L. 2024; 20: 11419

  Abstract

  There is a growing body of literature on gender bias in letters of recommendation (LORs) in academic medicine and the negative effect of bias on promotion and career advancement. Thus, increasing knowledge about gender bias and developing skills to mitigate it is important for advancing gender equity in medicine. This workshop aims to provide participants with knowledge about linguistic bias (focused on gender), how to recognize it, and strategies to apply to mitigate it when writing LORs.We developed an interactive 60-minute workshop for faculty and graduate medical education program directors consisting of didactics, reflection exercises, and group activities. We used a postworkshop survey to evaluate the effectiveness of the workshop. Descriptive statistics were used to analyze Likert-scale questions and a thematic content analysis for open-ended prompts.We presented the workshop four times (two local and two national conferences) with one in-person and one virtual format for each. There were 50 participants who completed a postworkshop survey out of 74 total participants (68% response rate). Ninety-nine percent of participants felt the workshop met its educational objectives, and 100% felt it was a valuable use of their time. Major themes described for intended behavior change included utilization of the gender bias calculator, mindful use and balance of agentic versus communal traits, closer attention to letter length, and dissemination of this knowledge to colleagues.This workshop was an effective method for helping participants recognize gender bias when writing LORs and learn strategies to mitigate it.

  View details for DOI 10.15766/mep_2374-8265.11419

  View details for PubMedID 38974126

  View details for PubMedCentralID PMC11224141

• Race and Ethnicity Data in Electronic Health Records-Striving for Clarity. JAMA network open Yemane, L., Mateo, C. M., Desai, A. N. 2024; 7 (3): e240522

  View details for DOI 10.1001/jamanetworkopen.2024.0522

  View details for PubMedID 38466312

• Reimagining Leadership: Amplifying Diverse Voices and Welcoming Healthy Conflict. Academic pediatrics Han, P., Chang, C., Yemane, L., Jackson, J. A., Omoruyi, E. A., Umoren, R. A. 2023

  View details for DOI 10.1016/j.acap.2023.12.005

  View details for PubMedID 38135249

• Upholding Our PROMISE: Discrimination and Lack of Belonging Negatively Influence Pediatric Residents' Desire to Stay at Home Institution. Academic medicine : journal of the Association of American Medical Colleges Burns, A. M., Kester Prakash, L., Yemane, L., Blankenburg, R., Kas-Osoka, O. A., Poitevien, P., Marbin, J., Schwartz, A., Taylor Lucas, C. 2023; 98 (11S): S195-S196

  View details for DOI 10.1097/ACM.0000000000005379

  View details for PubMedID 37882002

• Upholding Our PROMISE: Underrepresented in Medicine Pediatric Residents' Perspectives on Interventions to Promote Belonging. Academic medicine : journal of the Association of American Medical Colleges Yemane, L., Kas-Osoka, O., Burns, A., Blankenburg, R., Prakash, L. K., Poitevien, P., Schwartz, A., Lucas, C. T., Marbin, J. 2023

  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.

  View details for DOI 10.1097/ACM.0000000000005443

  View details for PubMedID 37643583

• Building an Anti-Racist Department through an Experiential Department-Wide Anti-Racism Curriculum. Academic pediatrics Guerin, A., Lee, J., Floyd, B., Yemane, L., Fassiotto, M., Griffith, E., Blankenburg, R., Hilgenberg, S. L., Dali, S., De Araujo, M., Jones, K., Kuo, K., Rassbach, C. E. 2023

  View details for DOI 10.1016/j.acap.2023.06.001

  View details for PubMedID 37422256

• Sparking a Movement, Not a Moment: Framework and Outcomes from a Pediatrics Department-Wide Coalition to Advance Anti-Racism: Running Title: Pediatrics Department Coalition to Advance Anti-Racism. Academic pediatrics Yemane, L., Ramirez, M., Guerin, A., Floyd, B., Okorie, C. U., Ling, W., Addala, A., Figg, L., Talley, E. M., Chamberlain, L. 2022

  Abstract

  BACKGROUND: The Stanford Pediatrics Advancing Anti-Racism Coalition (SPAARC) was created to promote a culture of anti-racism through immediate action, development of nimble systems, and longitudinal commitment towards equity.OBJECTIVE: Evaluate gaps in the Stanford Department of Pediatrics (DoP) efforts to advance anti-racism and form a coalition of faculty, staff, and trainees to prioritize, design, and implement targeted activities with immediate and long-term measurable outcomes.METHODS: A needs assessment was conducted across all DoP members in July-August 2020 to identify gaps in anti-racism efforts. Listening sessions were recorded and transcribed to extrapolate key themes and two rounds of consensus surveys were done to identify and prioritize actions. Actions teams were created and co-led by faculty-staff dyads with trainee representation. A final activity survey was conducted in January 2021 to determine the specific activities (i.e., interventions) each team would design and implement.RESULTS: Ten small group listening sessions (70 participants) and three surveys (1005 responses) led to the creation of seven action teams with associated activities (1) training (2) community engagement and research (3) communication (4) faculty and staff recruitment and advancement (5) leadership representation (6) human resources, and (7) staff engagement. 443 (41%) DoP members were directly involved in SPAARC through participation in the needs assessment, action teams, and/or implementation of activities.CONCLUSION: SPAARC can serve as an adaptable framework for how a DoP can create a coalition to identify gaps in anti-racism efforts and create and implement targeted activities with associated outcomes.

  View details for DOI 10.1016/j.acap.2022.10.003

  View details for PubMedID 36216211

• AIMS: Increasing Diversity in Graduate Medical Education Leadership. Journal of graduate medical education Yemane, L., Omoruyi, E., Poitevien, P., Blankenburg, R. 2022; 14 (3): 340-342

  View details for DOI 10.4300/JGME-D-21-01015.1

  View details for PubMedID 35754647

  View details for PubMedCentralID PMC9200241

• Words Matter: Examining Gender Differences in the Language Used to Evaluate Pediatrics Residents ACADEMIC PEDIATRICS Gold, J. M., Yemane, L., Keppler, H., Balasubramanian, V., Rassbach, C. E. 2022; 22 (4): 698-704

  View details for Web of Science ID 000832839400025

• Underrepresented in medicine in graduate medical education: Historical trends, bias, and recruitment practices. Current problems in pediatric and adolescent health care Yemane, L., Omoruyi, E. 2021: 101088

  Abstract

  Health inequities disproportionately impact children of color in the United States. Research demonstrates that a diverse physician workforce that reflects the demographic profile of the United States population has been associated with better health outcomes and physicians of color are more likely to work in communities that are medically underserved. Therefore, a key driver to reducing health inequities is recruiting a physician workforce that reflects the racial/ethnic composition of the population. Although efforts on increasing UIM applicants and matriculants into medical school and more recently, graduate medical education (GME) programs have shown some small successes, there has still not been significant change in decades. This narrative review examined the historical trends and current landscape of recruitment in GME to better understand the barriers and facilitators that continue to exist and identify successful interventions that might serve as a model to support recruitment of UIM applicants. There is evidence for racial disparities and bias in traditional residency selection metrics (USMLE, Clerkship Evaluations, MSPE, AOA status, etc.) and a need for more holistic recruitment strategies. Along with implementing new holistic recruitment practices, there is a need for ongoing research and collaboration to study inclusive and equitable learning environments and assessments that will eliminate racial disparities in educational outcomes. Additionally, there must be better longitudinal data utilization and transparency across Electronic Residency Application Services (ERAS) and National Resident Matching Program (NRMP) for accountability and tracking of interventions.

  View details for DOI 10.1016/j.cppeds.2021.101088

  View details for PubMedID 34742662

• Trends in Race/Ethnicity of Pediatric Residents and Fellows: 2007-2019. Pediatrics Montez, K., Omoruyi, E. A., McNeal-Trice, K., Mack, W. J., Yemane, L., Darden, A. R., Russell, C. J. 2021

  Abstract

  BACKGROUND AND OBJECTIVES: A diverse pediatric workforce reflecting the racial/ethnic representation of the US population is an important factor in eliminating health inequities. Studies reveal minimal improvements over time in the proportions of underrepresented in medicine (URiM) physicians; however, studies assessing trends in pediatric URiM trainee representation are limited. Our objective was to evaluate longitudinal trends in racial/ethnic representation among a cross-section of US pediatric trainees and to compare it to the US population.METHODS: Repeated cross-sectional study of graduate medical education census data on self-reported race/ethnicity of pediatric residents and subspecialty fellows from 2007 to 2019. To evaluate trends in URiM proportions over time , the Cochran-Armitage test was performed. Data on self-reported race/ethnicity of trainees were compared with the general population data over time by using US Census Bureau data.RESULTS: Trends in URiM proportions were unchanged in residents (16% in 2007 to 16.5% in 2019; P = .98) and, overall, decreased for fellows (14.2% in 2007 to 13.5% in 2019; P = .002). URiM fellow trends significantly decreased over time in neonatal-perinatal medicine (P < .001), infectious diseases (P < .001), and critical care (P = .006) but significantly increased in endocrinology (P = .002) and pulmonology (P = .009). Over time, the percentage of URiM pediatric trainee representation was considerably lower compared to the US population.CONCLUSIONS: The continued underrepresentation of URiM pediatric trainees may perpetuate persistent health inequities for minority pediatric populations. There is a critical need to recruit and retain pediatric URiM residents and subspecialty fellows.

  View details for DOI 10.1542/peds.2020-026666

  View details for PubMedID 34131043

• Outcomes From a Novel Graduate Medical Education Leadership Program in Advancing Diversity, Equity, and Inclusion Journal of Graduate Medical Education Powell, C., Yemane, L., Brooks, M., Johnson, C., Alvarez, A., Bandstra, B., Caceres, W., Dierickx, Q., Thomas, R., Blankenburg, R. 2021; 13 (6): 774–784

  View details for DOI 10.4300/JGME-D-21-00235.1