Critical Care Explorations (Jan 2022)

Identification and Assessment of Strategies to Address Gender Inequity in the Specialty of Critical Care Medicine: A Scoping Review, Modified Consensus Process, and Stakeholder Meeting

  • Jeanna Parsons Leigh, PhD,
  • Chloe de Grood, MSc,
  • Rebecca Brundin-Mather, MASc,
  • Alexandra Dodds, MPH,
  • Emily A. FitzGerald, MSc,
  • Laryssa Kemp, MSc,
  • Sara J. Mizen, MA,
  • Liam Whalen-Browne, MBT,
  • Henry T. Stelfox, MD, PhD,
  • Kirsten M. Fiest, PhD,
  • on behalf of the Canadian Critical Care Gender Equity Forum Panel,
  • Jeanna Parsons Leigh,
  • Sofia Ahmed,
  • Rebecca Aslakson,
  • Kali Barrett,
  • Jill Ola Barter,
  • Rosaleen Baruah,
  • Marie-Claude Battista,
  • Karen J. Bosma,
  • Karen E. A. Burns,
  • Laurent Jean Brochard,
  • Han-Oh Chung,
  • Deborah Cook,
  • Andréanne Côté,
  • Joanna C. Dionne,
  • John Drover,
  • Ghislaine Douflé,
  • James Downar,
  • Shelley Duggan,
  • Robert Fowler,
  • Allan Garland,
  • Elaine Gilfoyle,
  • Gillian Hawker,
  • Margaret Herridge,
  • Kimia Honarmand,
  • Tim Karachi,
  • Joann Kawchuk,
  • Rachel G. Khadaroo,
  • Abigail Lara,
  • Sangeeta Mehta,
  • Tina Mele,
  • Kusum Menon,
  • Srinivas Murthy,
  • David Neilipovitz,
  • Kendiss Olafson,
  • Tony O’Leary,
  • Bojan Paunovic,
  • Clare Ramsey,
  • Alison Fox-Robichaud,
  • Francesca Rubulotta,
  • Khara Sauro,
  • Damon Scales,
  • Sharon Straus,
  • Jennifer Tsang,
  • Hannah Wunsch,
  • Samara Zavalkoff,
  • Janice Zimmerman,
  • Kirsten Fiest,
  • and,
  • Henry Thomas Stelfox

Journal volume & issue
Vol. 4, no. 1
p. e0612


Read online

OBJECTIVES:. We sought to identify and prioritize improvement strategies that Critical Care Medicine (CCM) programs could use to inform and advance gender equity among physicians in CCM. DESIGN:. This study involved three sequential phases: 1) scoping review that identified strategies to improve gender equity in all medical specialties; 2) modified consensus process with 48 CCM stakeholders to rate and rank identified strategies; and 3) in-person stakeholder meeting to refine strategies and discuss facilitators and barriers to their implementation. SETTING:. CCM. SUBJECTS:. CCM stakeholders (physicians, researchers, and decision-makers; mutually inclusive). INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. We identified 190 unique strategies from 416 articles. Strategies were grouped thematically into 20 categories across four overarching pillars of equity: access, participation, reimbursement, and culture. Participants prioritized 22 improvement strategies for implementation in CCM. The top-rated strategy from each pillar included: 1) nominate gender diverse candidates for faculty positions and prestigious opportunities (equitable access); 2) mandate training in unconscious bias and equitable treatment for committee (e.g., hiring, promotion) members (equitable participation); 3) ensure equitable starting salaries regardless of sex or gender (equitable reimbursement); and, 4) conduct 360° evaluations of leaders (including their direct work circle of supervisors, peers, and subordinates) through a diversity lens (equitable culture). Interprofessional collaboration, leadership, and local champions were identified as key enablers for implementation. CONCLUSIONS:. We identified stakeholder-prioritized strategies that can be used to inform and enhance gender equity among physicians in CCM under four overarching equity pillars: access, participation, reimbursement, and culture. Implementation approaches should include education, policy creation, and measurement, and reporting.