Building High Performance Teams in Pediatric Orthopaedics: Is Diversity the Problem or the Antidote?

Orthopaedic surgery is the least diverse surgical specialty based on race and ethnicity. Pediatric orthopaedics has become more diverse than other orthopaedic subspecialties, but there remains room for improvement. Strategies to improve diversity in orthopaedics focus on diversifying the candidate pipeline for orthopaedic residency, reducing attrition among residents from diverse backgrounds, creating supportive and enriching work environments for all team members, and promoting data-driven diversity initiatives. All of these are underpinned by the belief, supported by recent interdisciplinary research, that diverse teams improve decision-making, support employee retention and satisfaction, and objectively enhance institutional performance, which can thus result in improved patient care when employed in pediatric orthopaedics. Key Concepts: (1)Both identity diversity and cognitive diversity should be considered when building teams striving for excellence and high performance.(2)Research on patient perceptions and preferences supports having a diverse physician workforce.(3)Discrimination, harassment, and bullying occur in the workplace for professionals who are underrepresented in medicine.(4)Orthopaedics has an upstream pipeline and retention problem. Pediatric orthopaedics appears relatively better in gender representation, but racial/ethnic diversity remains limited, and leadership representation lags behind membership demographics.(5)Data-driven strategies to design, implement, and evaluate diversity, equity, and improvement initiatives are in line with traditional evidence-based decision-making and the use of professional expertise to advance our profession.