Practical Diversity, Equity, and Inclusion

Presented at the 2022 ARRS Annual Meeting, this course covers key diversity, equity, and inclusion topics and their importance in serving the needs of the workforce, profession, and patients.

  • ARRS Diversity, Equity, & Inclusion Session Introduction – Daniel Burje Chonde, MD, PhD
  • Mitigating Bias in Recruiting and Hiring – Carolynn M. DeBenedectis, MD
  • Moving From Bystander to Upstander – Christopher P. Ho, MD
  • Disability: An Important Dimension of Diversity – Juan D. Guerrero-Calderon, MD
  • Microaggressions in the Workplace – Ann Jay, MD
  • Academic Promotion, Networking, Mentorship, and Sponsorship – Faisal Khosa, MD, MBA, FFR, FRCPC
  • How to Support Our LGBTQ Colleagues – Gloria J. Guzman Perez-Carrillo, MD, MSc
  • Welcome; Moderated Q&A – Nolan Jack Kagetsu, MD
  • Moderated Q&A – Faisal Khosa, MD, MBA, FFR, FRCPC

Keys to Creating and Maintaining a High-Functioning Team Culture

All members have a voice, that is heard

Getting your voice heard can give you so much, especially in the way of meeting others and exposing yourself to a greater audience of people, where you will have the chance to interact with a greater spectrum of culturally diverse people, much like, or different to yourself.

Wellness initiatives

Leaders of high functioning teams recognize the stresses inherent in our contemporary work environment, as well as their downstream impacts and the many manifestations of burnout. Efforts should be made to mitigate the many and ever-expanding factors contributing to stress and burnout. Recognized solutions include finding meaning in work, learning to be resilient, providing resources to support efficiency in work, and while not always practical, working less.

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Just culture

Just culture is a concept related to systems thinking which emphasizes that mistakes are generally a product of faulty organizational cultures, rather than solely brought about by the person or persons directly involved. In a just culture, after an incident, the question asked is, “What went wrong?

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Speak up safely programs

Healthcare practitioners are expected to speak up about patient safety concerns to help intercept errors and avoid adverse patient outcomes. By ‘speaking up,’ we mean raising concerns for the benefit of patient safety and quality of care upon recognizing or becoming aware of a risk or a potential risk.

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Codes of conduct

To assure a collaborative and inclusive culture, radiologists, interventional radiologists, radiation oncologists, and medical physicists should conduct themselves in a professional manner, respecting all individuals, including patients and colleagues, and advocate for those who cannot advocate for themselves.

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Environment of professionalism

Medical professionalism is a belief system in which group members (“professionals”) declare (“profess”) to each other and the public the shared competency standards and ethical values they promise to uphold in their work and what the public and individual patients can and should expect from medical professionals.

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Dignity and respect

Dignity and respect in the workplace follows the “golden rule” of treating others the way you want to be treated. A workplace where everyone shows each other dignity and respect usually has plenty of laughter, a free-flow of ideas and clear policies on expected work results and behavior.

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Collaboration and team science

Team science is a collaborative effort to address a scientific challenge that leverages the strengths and expertise of professionals trained in different fields. Although traditional single-investigator driven approaches are ideal for many scientific endeavors, coordinated teams of investigators with diverse skills and knowledge may be especially helpful for studies of complex social problems with multiple causes.

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A shared vision

Strategic planning is the process of documenting and establishing a direction—by assessing both where you are and where you’re going. The strategic plan gives you a place to record your mission, vision, and values, as well as your long-term goals and the action plans you’ll use to reach them.

Strategic planning

Strategic planning is an organization’s process of defining its strategy, or direction, and making decisions on allocating its resources to pursue this strategy. It is here that priorities are set. It may also extend to control mechanisms for guiding the implementation of the strategy.

SWOT analysis

SWOT analysis is a strategic planning technique used to help a person or organization identify strengths, weaknesses, opportunities, and threats related to business competition or project planning.

Team functions as a learning organization

Peter Senge stated in an interview that a learning organization is a group of people working together collectively to enhance their capacities to create results they really care about. Peter Senge’s 5 characteristics: systems thinking, personal mastery, mental models/open culture, shared vision and transform from individual to team learning approaches.

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Scenario planning

Scenario planning is making assumptions on what the future is going to be and how your business environment will change overtime in light of that future. More precisely, Scenario planning is identifying a specific set of uncertainties, different “realities” of what might happen in the future of your business.

Resources for Promoting Diversity, Equity, and Inclusion in your Radiology Team

Cultural sensitivity and awareness

Cultural sensitivity, also sometimes referred to as cross-cultural sensitivity or simply cultural awareness, is the knowledge, awareness, and acceptance of other cultures and others’ cultural identities.

Cultural humility training

Team members are culturally aware and demonstrate cultural humility. Instead of being knowledgeable or “culturally competent” of the many different cultures and backgrounds of colleagues and patients, cultural humility allows us to enquire and learn more about experiences and cultural identities of others. This increases the quality of interactions with each other and our patients. By practicing self-humility one can focus on self-reflection and lifelong learning and improvement.


Important and necessary actions that can foster a professional environment include practices of allyship learned through bystander and upstander training. Allyship is the practice of emphasizing social justice, inclusion, and human rights by members of an ingroup, to advance the interests of an oppressed or marginalized outgroup. Allyship is part of the anti-oppression or anti-racist conversation, which puts into use social justice theories and ideals.

Bystander effectiveness

An upstander is a person who speaks or acts in support of an individual or cause, particularly someone who intervenes on behalf of a person being attacked or bullied. An upstander is a person who speaks or acts in support of an individual or cause, particularly someone who intervenes on behalf of a person being attacked or bullied.

Managing microaggressions

Microaggressions are common, everyday slights and comments that relate to various intersections of one’s identity such as gender, sex, race, ethnicity, and age, among other aspects.

Resources for Effectively Managing Radiology Personnel

Provide effective feedback

Feedback is vitally important in the workplace. It helps individuals grow and projects stay on track, and in doing so, it helps companies progress. Yet many people find giving and receiving feedback in the workplace to be totally nerve-racking. Observe a specific behavior and then explain what you observed. Tell your colleagues what kind of impact that behavior had on you, the team, and/or the organization. Provide a suggestion or an expectation for future behavior (feedforward approach), or alternatively ask how the other person wants to move forward.

Running effective meetings

An effective meeting is one where it’s objectives where accomplished within the stated timeframe. Being prepared is the most effective way to have a successful meeting.

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People first language

People First Language is a way of communicating that reflects knowledge and respect for people with disabilities by choosing words that recognize the person first and foremost as the primary reference and not his or her disability.

Imposter syndrome

Impostor syndrome (also known as impostor phenomenon, impostorism, fraud syndrome or the impostor experience) is a psychological pattern in which an individual doubts their skills, talents or accomplishments and has a persistent internalized fear of being exposed as a “fraud”.

Improving Communication

TeamSTEPPS® is a teamwork system designed for health care professionals that is: A powerful solution to improving patient safety within your organization. An evidence-based teamwork system to improve communication and teamwork skills among health care professionals.

Ethical behavior, practices and oversight

Examples of ethical behaviors in the workplace includes; obeying the company’s rules, effective communication, taking responsibility, accountability, professionalism, trust and mutual respect for your colleagues at work. These examples of ethical behaviors ensures maximum productivity output at work.

Inter-personal support

Ubuntu can best be described as an African philosophy that places emphasis on ‘being self through others‘. It is a form of humanism which can be expressed in the phrases ‘I am because of who we all are.’

Managing internal conflict

The role of an ombudsperson is to investigate and facilitate resolution of allegations by any staff member of perceived unfair, inappropriate, discriminating or harassing treatment (behavior) by faculty, staff, administrators, or fellow students.

Micro and Macroaggressions: How to Be an Ally

This session focuses on strategies for recognizing and dealing with difficult conversations and microaggressions. The first hour will cover: Introduction to Microaggressions, The Use of Mindfulness in Difficult Conversations, Engaging in Difficult Conversations , and What to Say in the Moment. The second hour will be interactive and include a variety of scenarios and potential responses.

Sessions Included
  • Carolyn DeBenedectis, Introduction to Microaggressions
  • Ann Jay, The Use of Mindfulness in Difficult Conversations
  • Lori Deitte, Engaging in Difficult Conversations
  • Noal Kagetsu, What to Say in the Moment

Practical Guide to Health Equity in Clinical Practice

This course offers a collection of health equity considerations for radiology businesses from academia and private practice. Course faculty address practical facilitators and barriers to achieving health equity in radiology and provide how-to tips for integrating the concept of health equity in everyday radiology practice.

Sessions Included
  • Nabile Safdar, MD (2009 Berlin Scholar): Introduction to Health Equity for Practicing Radiologists
  • Ruth Carlos, MD, MS, FACR: The Business Case for Diversity and Health Equity
  • Samilia Obeng-Gyasi, MD, MPH: Care Equity in Clinical Practice
  • Gelareh Sadigh, MD: Financial Toxicity and Health Equity
  • Efren Flores, MD: Health Equity in Screening
  • Andrew Moriarity, MD: Facilitators and Barriers to Health Equity Initiatives in Private Practice
  • Amy Patel, MD: Community Engagement to Advance Health Equity in Private Practice

How to Structure High-Functioning Radiology Teams

Members must have defined roles and responsibilities

When teams have clear functions and responsibilities, they know what is expected of them and work more efficiently. Knowing their roles will also help them feel encouraged and motivated toward completing their various tasks.

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Break down authority gradients

The term “authority gradient” was first defined in aviation when it was noted that pilots and copilots may not communicate effectively in stressful situations if there is a significant difference in their experience, perceived expertise, or authority. A number of unintentional aviation, aerospace, and industrial incidents have been attributed, in part, to authority gradients.

The concept of authority gradient was introduced to medicine in the Institute of Medicine report To Err Is Human, yet little has been written or acknowledged in the medical literature regarding its role in medical error. The practice of medicine and medical training programs are highly organized, hierarchical structures that depend on supervision by authority figures. The concept that authority gradients might contribute to medical error is largely unrecognized.

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Establish active, intentional inclusion and fairness practices

A high functioning team must be as diverse as is possible and actively foster inclusive practices.

Inclusion is the achievement of a work environment in which all individuals are treated fairly and respectfully, have equal access to opportunities and resources, and can contribute fully to the organization’s success.

Fairness in the workplace drives participation, wellness, retention, safety and outcomes.

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Create pipelines to foster diversity

Pipelining describes specific longitudinal efforts aimed at at producing diverse workforces. In healthcare, such efforts may be aimed at high school or college students, medical students and even residents to interest them in joining our field.

The Value of a High-Functioning Imaging Team

The provision of safe imaging, image-guided procedure and radiation services requires well-functioning and coordinated teamwork. Such high functioning teams are one essential ingredient if we desire to provide effective, safe, high level care to all of our patients.

Teams cannot simply be formed or appointed—extensive human and financial resources are required to build the culture and to sustain the efforts, along with effective and current educational programs and a learning environment. Equally important are policies, guidelines and systems for managing, providing for oversight and for ensuring compliance and accountability.