Evaluating Targeted Recruitment Interventions and Outcomes to Measure Diversity in Emergency Medicine: A Scoping Review.

As the US national population continues to diversify, there have been access and engagement efforts within emergency medicine (EM) to help create a workforce that is more representative of the patients we treat. While the importance of diversity is well recognized, there has not been an established way to measure the effectiveness of diversity interventions beyond demographics. This scoping review aims to identify targeted interventions to recruit underrepresented groups in EM and to determine appropriate outcomes to measure diversity in any field that can be applied to EM. We conducted a literature search in March 2023 using the PubMed, Scopus, and Web of Science databases for articles published from 2008 to the present. Abstracts were independently reviewed by two reviewers to identify potentially relevant articles, and the full text of articles meeting the inclusion criteria was subsequently reviewed. Selected articles were organized into two categories: interventions within EM or measurable outcomes. The reported outcomes were then grouped into themes. The literature search identified 4,696 total abstracts for the review, of which 53 were for interventions in EM and 4,643 for outcomes. Of the 157 abstracts selected for full-text review, 69 articles were selected for inclusion. Fourteen articles identified strategies to recruit underrepresented groups into EM at all levels through pipeline programs, recruitment initiatives, transparent compensation/promotion, and faculty development programs. A total of 55 articles provided measurable outcomes, with 74.5% focused on gender, 7.3% on underrepresented minorities in medicine, and 18.2% focused on both. The derived outcomes from the 55 articles were organized into the following themes in order of most commonly mentioned: promotion/rank (35 out of 55, 63.6%), leadership positions (32 out of 55, 58.2%), H-indices (21 out of 55, 38.2%), number of publications (18 out of 55, 32.7%), and compensation (14 out of 55, 25.5%). Additional outcomes to consider included authorship (first vs. last), national speaking opportunities, national awards, and grant funding. Overall, this scoping review discovered diversity initiatives within EM and appropriate outcomes to measure diversity. The next step is to use these outcomes to determine whether our efforts are having the intended effect of promoting equity and inclusion in EM.