Equity, diversity, and inclusion code of conduct for anesthesiology departments
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CORRESPONDENCE
Equity, diversity, and inclusion code of conduct for anesthesiology departments John K. Peel, BHSc, MD . Gianni R. Lorello, BSc, MD, MSc (Med Ed), CIP, FRCPC
Received: 11 September 2020 / Revised: 22 October 2020 / Accepted: 24 October 2020 Ó Canadian Anesthesiologists’ Society 2020
To the Editor, Equity and diversity are fundamental to the medical profession’s commitment to treat everybody with dignity, respect, and value. Nevertheless, imbalances in representation, remuneration, and promotion of individuals from diverse backgrounds persist.1,2 Initiatives to support equity, diversity, and inclusion in anesthesiology are increasingly prominent, but it is imperative that departments address not only biased policies but also the culture of what is considered acceptable.3 Workplace culture encompasses the shared values, attitudes, and consequent behaviours of a group; culture defines ‘‘the rules for how [a group] will work together.’’1 A code of conduct explicitly directs what is the expected workplace culture; it is a tool to foster equity, diversity, and inclusion within a department. Herein, we outline the rationale for, and production of, a departmental code of conduct that is intended to cultivate a culture of equity, diversity, and inclusion within the University of
J. K. Peel, BHSc, MD Department of Anesthesiology and Pain Medicine, The University of Toronto, Toronto, ON, Canada G. R. Lorello, BSc, MD, MSc (Med Ed), CIP, FRCPC (&) Department of Anesthesiology and Pain Medicine, The University of Toronto, Toronto, ON, Canada e-mail: [email protected] University Health Network, Toronto Western Hospital – Department of Anesthesia and Pain Medicine, Toronto, ON, Canada The Wilson Centre, Toronto, ON, Canada Women’s College Research Institute, Toronto, ON, Canada
Toronto, Department of Anesthesiology and Pain Medicine. The culture in medical specialties, including anesthesiology, is reinforced during training by observation and emulation of ones’ ‘‘superiors.’’2 Knowledge and skills aligning with a biomedical framework are usually taught in medical training. Nevertheless, specific training of professionalism— including equity, inclusion, and respect for diversity—is inadequate.4 By leaving the expectations for professionalism undefined, lapses in professional behaviour are often ignored. This gap in training leaves physicians without the language or skills to address unprofessional discriminatory behaviours.1,2,4 A code of conduct defines acceptable professional behaviour to dismantle discriminatory ideologies.2 Our code of conduct (Table; also available at https:// www.anesthesia.utoronto.ca/professionalismcode-conduct) intentionally is aligned with institutional standards for professional behaviour and the CanMEDS competencies.A Our incorporation of familiar terminology and concepts into a code of conduct is a technique grounded in ‘‘change management’’ frameworks that have been previously effective in changing physician behaviours and practices.5 By positioning an intervention in the co
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