دانلود رایگان مقاله انگلیسی تاثیر فرهنگ سازمانی در تنوع مدارس پزشکی - 2017

In this issue, Young et al. present a six-point framework for pipeline and program development, intended to increase diversity in Canadian medical schools [1]. Using a framework of knowledge translation, the authors emphasize the key role of collecting and monitoring longitudinal diversity-related data in designing, implementing and evaluating diversity-related initiatives. Young et al. argue the use of such data will not only improve best practice, but will also help build more tailored structures for lasting change.

We wholeheartedly agree that such data are essential. However, Young et al.’s focus on processes, new initiatives and structural change positions the article at the level of organizational and systems-level change. This is potentially problematic as, while systems-level changes may be an important initial step towards reducing functional barriers (to, in this case, increasing diversity within medicine), unless these barriers are also addressed at a cultural level, it is unlikely change will be effective, lasting or genuine [2, 3].

Institutional culture is loosely understood to be the shared assumptions, meanings, beliefs, understandings and ideas held within an organization, school or team – with a focus on values and judgements, rather than procedures and practices [4]. In established institutions, culture often errs towards stability and the status quo, largely allowing people to stay within their comfort zones and use estab lished approaches rather than challenging these with innovation and growth [5]. Furthermore, medicine, and selection into medical school, are influenced by a pervasive culture based on meritocracy, where the prior academic achievements of applicants may be over-emphasized. Therefore, although an admissions system may be perceived to be effective by those in the institution, (for example, because it processes large numbers of applications efficiently or admits students who historically have low dropout rates), it may not be conducive to achieving ‘newer’ goals, such as those of increased diversity.