Student Surgical Skills Training with PRIDE: Preclinical Redesign with Inclusion, Diversity and Equity

<b>Introduction: setting, background and identification of needs leading to the initiative</b><br/>Surgery is notorious for its lack of inclusivity and diversity. A recent scoping review reports that women do not feel safe, and feel a lack of good mentorship, leading to a loss of diversity [1]. A major barrier is surgical training, and can therefore be tackled by innovative educational redesign.<br/>Next, diversity in people of colour and inclusivity is lacking in leadership positions in Dutch academic medical centres, and leads to selective hiring of new staff [2].<br/>Visibility of LGBTQ+ role models for students is poor, as many feel unequally treated or even discriminated [3]. People with disabilities form the largest of all minority groups, with a major impact on school access for e.g. persons with a walking disability [4].<br/>Everyone experiences and interacts with the environment in their own way, without one “right” way [5]. Unfortunately, learning environments are often not designed to accommodate sensory needs, not allowing for neurodiversity in a student population.<br/>Specifically for simulation-based training, manikin simulators modelling the human body (i.e. cardiac resuscitation, vein puncture arms) are predominantly young pale-skinned male models [6]. Medical training scenarios have unconscious bias towards mainstream individuals and groups. Best-practices are available around the world, but are not yet adopted<br/>in higher education in the Netherlands or more specifically, in mandatory Technical Medicine student surgical training courses.<br/>Thus, there is a need for increased accessibility for people with physical, visual, and hearing impairment, and for fostering neurodiversity, racial and sexual equality, and improve LGBTQ+ inclusion in education, which should ultimately lead to a more diverse profession.<br/><br/><b>Description of initiative and approach/methods used</b><br/>A multi-axes SIM-EDI tool will be used [7], including accessibility for people with physical, visual, and hearing impairment, fostering neurodiversity, racial and sexual equality, and LGBTQ+ inclusion. Students and staff from these domains, and educational consultants are included in both assessment and redesign as co-creators. A self-assessment<br/>on equity-focused teaching will follow. Course redesign for academic year 2024-2025 will be evaluated after next year’s course.<br/><br/><b>Discussion of the impact/outcome, and novelty of the initiative</b><br/>Developed teaching materials, activities and practical models to improve accessibility are shared with the educational, medical, and Diversity, equity and inclusiveness (DE&amp;I) community under Open Access, and during the SESAM 2026 conference as workshop.<br/><br/><b>Keywords</b><br/>Surgery; Diversity, equity and inclusiveness (DE&amp;I); course redesign; student learning<br/><br/><b>References/Acknowledgements</b><br/>1. Ferrari L, Mari V, Parini S et al. Discrimination Toward Women in Surgery: A Systematic Scoping Review. Annals of surgery. 2022;276(2):246-55.<br/>2. Yakar D, Schuit S, Kahmann M, Kwee T, Mourits M. Zo komen we er niet met diversiteit in de UMC’s. Ned Tijdschr Geneeskd. 2022;166(D6659):1-4.<br/>3. Renkema M. Inclusiviteit van LHBTQ+-medewerkers vraagt meer dan een regenboogvlag: Chief Human Resources Officer (CHRO). 2021/07/08. Available from:<br/>https://chro.nl/artikel/inclusiviteit-van-lhbtq-medewerkers-vraagt-meer-dan-een-regenboogvlag.<br/>4. Rochette A, Loiselle F. Successfully performing a university student's role despite disabilities: challenges of an inclusive environment and appropriate task modification. Disabil Rehabil. 2012;34(25):2201-6.<br/>5. Mkatini S, Pascual-van der Landen L, Neys M. Diversity | Equity | Inclusion (DE&amp;I) Action Plan 2022 - 2024. Enschede: University of Twente, Team DI; 2022/07/11.<br/>6. O'Connor P, Byrne D. Fostering diversity in healthcare simulation. International Journal of Healthcare Simulation. 2022:1–2.<br/>7. Purdy E, Brazil V, Symon B. International Clinician Educators (ICE). 2021 2021/09/14/. Available from: https://icenetblog.royalcollege.ca/2021/09/14/equity-diversity-and-inclusion-in-simulation-a-reflexive-tool-for-simulation-delivery-teams.