Dedication to Health Equity and Well-being - Recent Updates

Committed to serving our diverse communities, Department of Anesthesia and Perioperative Care faculty members, trainees, and staff are engaged in a variety of activities in support of health equity, diversity, inclusion and wellbeing. A brief update of recent work is outlined below.

Appointments

Karen Fleming, MD. UC Berkeley - UCSF Undergraduate Research Internship (URI) Summer Research Program Co-Associate Director

Awards

Alexendar Perez, MD, PhD, Foundation for Anesthesia Education and Research (FAER) Research Fellowship Grant

• Primary Mentor: Judith Hellman, MD
• Secondary Mentor: Joana Vidigal, PhD
• Tertiary Mentor: Matthieu Legrand, MD, PhD
• Project Title: Role of Transposable Elements in Septic Immune Aging

Alexendar Perez, MD, PhD. Finalist, Burroughs Wellcome Fund (BWF) Career Awards for Medical Scientists (CAMS) https://www.bwfund.org/funding-opportunities/biomedical-sciences/career-awards-for-medical-scientists/ 

Lee-lynn Chen, MD, FASA, Jeremy Juang, MD, PhD. American Society of Anesthesiologists (ASA) Mentoring Grant: Advancing Equity and Inclusion in Labor and Delivery: A Comprehensive Analysis of the MPOG Database

Julien Cobert, MD awarded the 2024 Society of Critical Care Medicine Weil grant for his proposal, "Racialization of ICU Notes and Debiasing Strategies to Lead to Fairer ICU Mortality Prediction."

Anne L. Donovan, MD, Joyce Chang, MD, Amreen Rahman, MD. American Society of Anesthesiologists (ASA) Mentoring Grant: Identifying Barriers to Career Advancement and Retention for Women in Critical Care Medicine

Odi Ehie, MD. Foundation for Anesthesia Education and Research (FAER) Funding, DEI Curriculum. Publicly accessible for free. Manuscript for Unconscious Bias Workshop Microaggression Workshop

Jina Sinskey, MD, Rachel Schwartz, PhD. NIH R25 Award. Training to Enhance Researcher Resilience and Adaptability (TERRA)

Department-Funded Scholarly Projects

Mentorship Study 

Study Team: Odmara Barreto Chang, MD, PhD, and Laura Soriano, MD (CA3) 

Study Description: It is well known that mentorship provides benefits to both mentor and mentee such as career advancement, increased rate of promotion, psychosocial support, and increased academic productivity. Additionally, mentorship has the potential to help alleviate many of the gender and ethnic disparities that are still pervasive in medicine. However, studies have found that physicians who are women and/or from underrepresented in medicine backgrounds often face barriers in obtaining adequate mentorship. Despite the known benefits of mentorship and the barriers to achieving mentorship, there is a relative paucity of anesthesia-specific literature related to mentorship. To our knowledge, no larger survey exists querying anesthesiologists on their experiences with mentorship. We aim to study the prevalence of mentor-mentee relationships and to understand how a mentor and mentee pick each other in anesthesia with the goal of identifying key socio-demographics that are linked to the choice of mentor-mentee and both facilitators and barriers to finding mentorship. Additionally, better understanding the barriers certain groups of anesthesiologists face in finding mentorship may help structure mentorship programs to make mentorship more accessible and equitable in the field of anesthesia. 

Addressing Biased AI Algorithms

Study Team: Julien Cobert, MD

Study Description: Cobert, an anesthesiologist and intensivist at the SF VAMC, recently received a Society of Critical Care Medicine Weil Research Award. This award aims to create fair and debiased mortality risk prediction algorithms using text-based data from patients in the intensive care unit. Biased data used for risk prediction can lead to unfair and inequitable algorithms, as seen in examples of bias and prejudice in artificial intelligence models in non-medical contexts. Natural language processing algorithms have also shown bias and prejudicial outputs, raising concerns about the potential transmission of disparities and perpetuation of inequities in healthcare.

In this project, Cobert and his team will investigate how text encodes intrinsic race and ethnicity information that could contribute to biased AI algorithms if left unaddressed. The research will focus on whether explicit (e.g. “Black”) and implicit aspects (e.g. “Spanish-speaking”) in clinical notes are predictive of social constructs, such as race and ethnicity. Implicit descriptors that indicate contextual relationships between words may also encode patterns related to race or ethnicity. By understanding how language can encode for social constructs and potentially perpetuate biases, the team aims to demonstrate that clinical notes are not immune to human biases and that structural racism can exist in language itself.

To ensure that NLP-based clinical prediction tools do not contribute to a racist healthcare structure, the team will identify and eliminate structurally racist and racialized elements from clinical notes. By debiasing the notes, they will then construct mortality prediction models to evaluate the impact on predictive performance. This research will inform interventions to promote antiracism in note writing processes and create fair and equitable algorithms for risk prediction in the ICU.

Improving the Care of LGBTQIA+ Patients in the Perioperative Period

Study Team: Arthur Chyan, DO, Justin Libaw, MD, MPH, Rachel Schwartz, PhD

Study Description: Chyan, Libaw and Schwartz are aiming for a multipronged approach to improving the care for our LGBTQIA+ patients in the perioperative period.

In parallel, they will (1) carry out a scoping review on this topic, (2) perform structured interviews with perioperative care professionals and patients, and (3) increase education and awareness among our current teams. The scoping review will involve experts across more than one institution and will help identify not only best practices but also gaps in knowledge. Our structured interviews will highlight the current state of our own clinical system, which will allow us to target specific areas for improvement while supporting the current strengths. Educational initiatives will be focused on the entire perioperative spectrum from the preop team to learners and more.

There will be an initial focus on patients coming for gender-affirming surgical care before broadening to patients who identify as LGBT and are coming for any procedure/surgery.

Education and Training

LGBTQ+ Allyship Training with San Francisco's Inaugural Drag Laureate, D'Arcy Drollinger. July 22, 2024

Sponsored by the UCSF departments of orthopaedic surgery, anesthesia and perioperative care, ophthalmology, surgery and otolaryngology, we will hold a collaborative grand rounds on disability, featuring guest speaker Oluwaferanmi O. Okanlami, MD, MS, director of Student Accessibility and Accommodation Services in the Division of Student Life at the University of Michigan. The session will be co-moderated by Drs. Odi Ehie and Melissa Zimel. July 31, 2024.

Honors

Odmara Barreto Chang, MD, PhD received the Harold Amos Medical Faculty Development Program Award from the Robert Wood Johnson Foundation.

Julien Cobert, MD awarded the 2024 Society of Critical Care Medicine Weil grant for his proposal, "Racialization of ICU Notes and Debiasing Strategies to Lead to Fairer ICU Mortality Prediction."

Elena Haight, MD. UCSF Muriel Steele Society Honor Roll, 2024

Leah Pimentel, MBA. Chancellor’s Award for Diversity. Dr. Martin Luther King, Jr. Leadership

Leah Pimentel, MBA. St. Ignatius Alumni Black Excellence Award. January 2024  

Prasad Shirvalkar, MD, PhD, Recipient of the 2024 North American Neuromodulation Society (NANS) Kumar Award. The award is given to a primary investigator in the first 10 years after their training for a manuscript that advances the field of neuromodulation. As part of the award, Shirvalkar will present his winning manuscript on First-in-human prediction of chronic pain state using intracranial neural biomarkers at the NANS 2024 plenary session.

Inclusive Programs

Arab American Heritage Month Celebration – I Was Their American Dream, by Malaka Gharib. Copies of book provided to department at all campuses.

Asian, Native Hawaiian and Pacific Islander American Heritage Month Celebration. Chinatown Friday Experience with Dear Community. This fun department-sponsored morale event was held in collaboration with local non-profit Dear Community, and included a Bruce Lee tour, dinner, and karaoke at the Lion’s Den.

Juneteenth Celebration – O Freedom, Afro American Emancipation Celebrations, by William H. Wiggins, Jr. Copies of book provided to department at all campuses.

Meetings and Presentations

Odi Ehie, MD. Visiting Professor, Grand Rounds, Department of Surgery, Stanford University School of Medicine, January, 2024  

Odi Ehie, MD. Visiting Professor, Cleveland Clinic. “The Importance of Allyship - Strategies to Foster Inclusivity.” May, 2024

Leah Pimentel, MBA. Session Leader, Ragan Employee Communications & Culture Conference. Purpose and Safety in Harmony: Cultivating Meaningful and Secure Workplaces.

Jina Sinskey, MD, Visiting Professor, UCLA Anesthesiology and Perioperative Medicine:

• Well-Being Workshop: “Quality of Life Improvement” (12/5)
• Grand Rounds: “Beyond Resilience: How Do We Support Our People?” (12/6)

Jina Sinskey, MD. Wellness Champs Virtual Summit. Beyond Resilience: How to Operationalize Clinician Well-Being with the Quality of Life Improvement (QOLI) Approach. 

American Society of Anesthesiologists (ASA) Annual Meeting 2023

2023 Doctor's Back to School Program. Odmara Barreto Chang, MD, PhD, Niti Pawar.

Snap Talk: Mentorship Matters: The Power of Pipelines. Odmara Barreto Chang, MD, PhD.

Best of Abstracts: Clinical Science. Co-moderator Martin London, MD. Real-World Clinical Study of Pulse Oximeter Accuracy Across Different Skin Colors: The EquiOx Trial. Philip Bickler, MD, PhD, Carolyn M. Hendrickson, MD, Tyler J. Law, MD, Michael S. Lipnick, MD, Caroline Hughes, BS, Seif Elmankabadi, BS, Kelvin Lamont Moore, BS, Celine Chou, BS, John R. Feiner, MD, Gregory Leeb, MBBS.

Implementing Inclusive Leadership: Mitigating Unconscious Bias, Addressing Microaggression, and Enhancing Allyship. Charlene Blake, MD, PhD; Odi Ehie, MD, FASA, Rondall Lane, MD, et al.

Organ transplantation in the elderly – How old is too old? “Lung transplant outcomes in the elderly” Marek Brzezinski, MD, PhD.

Geriatric Anesthesia. Surgical Risk Prediction Using Machine Learning For Major Postoperative Complications After Urgent And Emergent Non-Cardiac Surgery In The Geriatric Population.  Joshua Chiu, MD, et al.

What is Diversity Equity and Inclusion in the global context? Moderator Adrian Gelb, MBChB. Speaker: Odi Ehie, MD, FASA, “DEI Initiatives for Leaders: Implementation of a DEI Curriculum”

Teaching Leadership: Educating Future Leaders Panel. Implementation of a DEJ curriculum. Odi Ehie, MD, FASA.

Global Health and Health Equity for All: From Residency through Retirement Panel. Health Equity Home and Abroad. Odi Ehie, MD, FASA.

Feasibility of various skin color quantification methods and implications for reducing pulse oximeter bias. Seif Elmankabadi, BS, Yu Chou, BS, Tyler J. Law, MD, Leonid Shmuylovich, MD, Gregory Leeb, MBBS, Caroline Hughes, BS, Philip E. Bickler, MD, PhD, Olubunmi Okunlola, MD, Michael S. Lipnick, MD, Carolyn M. Hendrickson, MD, MPH.

Practical Patient Safety and Practice Management. The Trans Airway Consideration (tac) Card: A Cognitive Aid To Improve Healthcare Equity. Raina Khan, MD, Jennifer Hong Woodbury, MD, Naveed Khan, MD, Inna Hussain, MD, P. Daniel Knott, MD, Gabriel E. Sarah, MD, Ronald George, MD.

Equipment, Monitoring and Engineering Technology. Performance Of 11 Fingertip Pulse Oximeters In Human Subjects With Varied, Quantified Skin Pigment. Gregory Leeb, MB, BS, Isabella Catherine Auchus, MD, Philip E. Bickler, MD, PhD, John R. Feiner, MD, Olubunmi E. Okunlola, MD, Jana Fernandez, BSc, Leonid Shmuylovich, MD, PhD, Caroline Hughes, BA, Deleree Schornack, BA, Michael S. Lipnick, MD.

Geriatric Anesthesia - Comparing Postoperative Cognitive Decline In Older Adults To Subjective Cognitive Complaints. Jacqueline M. Leung, MD, MPH, et al. 10/15, 8-9 am PT.

Perioperative Management of the Aging patient-A practical guide to Frailty, Cognition, Shared Decision Making. Jacqueline Leung, MD, MPH, “Cognitive screening as part of your preop assessment-Made quick and easy”

Patient Safety and Practice Management II. Anesthesia Breathing Circuit Reuse is Common Globally, But Rare in the United States: An International Cross-Sectional Survey. Charlotte Young, Kaiyi Wang, Patience Atumanya, Michael Lipnick, MD, Adrian Gelb, MBChB, Seema Gandhi, MD.

History and Education II. Delayed Childbirth and Low Well-Being among Female-Identifying Residents in Anesthesiology. Niti Pawar, Christy Boscardin, PhD, Odmara Barreto Chang, MD, PhD.

Transforming Organizational Culture to Support Well-Being: How You Can Be Part of the Solution. Jina Sinskey, MD, Joyce Chang, MD.

ASA Well-Being Committee. Jina Sinskey, MD.

Quality Improvement: Optimizing Perioperative Dynamics and Team Flow. Jina Sinskey, MD, Joyce Chang, MD, Matthieu Legrand, MD, PhD, Rachel Schwartz, PhD

Critically Ill Limited English Proficient Patients Receive Less Sedation. Thanh-Giang Vu, MD, Aaron W. Scheffler, PhD, Romain C. Pirracchio, MD, PhD, Elizabeth L. Whitlock, MD, MS.

Practical Patient Safety and Practice Management. Mismatched Discharge Opioid Prescription To Patients After Cardiac Surgery. Lingyi Zhang, MD, Erica M. Langnas, MD, MPH, Wulin Tan, MD, Arthur Wallace, MD, Tom Nguyen, MD, Zhonghui Guan, MD.

Pipeline and Mentorship Programs

ZSFG Anesthesia will be hosting local students for the FACES for the Future Program.

Students Capturing the OR Experience (SCORE) Program. Charlene Blake, MD, PhD, Creator and Planning Committee Chair. April 19, 2024

The Latino Medical Student Association (LMSA) Conference. 

The Student National Medical Association (SNMA) Conference. 2 anesthesia residents sponsored to attend. In addition, the department has contributed to the SNMA conference fundraiser to help support our medical students in attending this conference for the past two years (2022 – 2023, 2023 – 2024).

UCSF Bays Mentorship Program. Irfan Kathiriya, MD, PhD, Mentor. Summer 2024.

American Society of Anesthesiologists’ (ASA) Doctors Back to School Program. Odmara Barreto Chang, MD, PhD, participant.

UC Berkeley - UCSF Undergraduate Research Internship Shadowing Experience.. Odi Ehie, MD, serves as head of Clinical Skills for the UC Berkeley - UCSF Joint Medical Program.

Karen Fleming, MD. UC Berkeley - UCSF Undergraduate Research Internship (URI) Summer Research Program Co-Associate Director. URI Welcome Dinner June 3, 2024.

Odi Ehie, MD, and Karen Fleming, MD. American Medical School Association (AMSA), UC Berkeley Chapter, Physician Panel. Panelists talking to UC Berkeley undergraduate students about our pathways in medicine with the hope to inspire them to apply. April 18, 2024

Odi Ehie, MD, Fekir Negussie, MPH. Center for Health Equity in Surgery and Anesthesia (CHESA) Interns (2), in partnership with FirstGen Interns, a summer pathway program for high school students. https://www.emersoncollective.com/our-work/internships/first-gen

Odi Ehie, MD, Nyemachi Chikere, MD (CA3 resident) attended the Ujima summer camp as part of a panelist of Black female physicians speaking to junior and high school kids about STEM and our career pathways. This was done in collaboration with the ortho department so we are partnered with black female orthopedic surgery residents as well as a UCSF pedi rehab doctor and an adult psychiatrist that practices at Kaiser SF. July 8, 2024

Publications

Mia Gisselbaek, Sonia Hontoir, Anaîs E. Pesonen, Laurence Seidel, Benedicte Geniets, Evi Steen, Odmara L. Barreto Chang, Sarah Saxena. Impostor syndrome in anaesthesiology primarily affects female and junior physicians.  British Journal of Anaesthesia. Available online 25 October 2023.

Armaneous M, Boscardin CK, Earnest GE, Ehie O. A Summary of Diversity in Anesthesiology Among Medical Students, Anesthesiology Residents, and Anesthesiology Faculty.  Anesth Analg. 2023 Oct 1;137(4):800-802.

Ehie O, Tesfalidet F, Lane R. Empowering Perioperative Trainees: The Vital Role of a DEI Curriculum in Health Care. ASA Monitor. June 2024, Vol. 88, 36–37. 

Lucy S Guan, MPH, Erica Langnas, MD, MPH, Tasce Bongiovanni, MD, Liam J Campbell, MS, Elizabeth C Wick, MD, Zhonghui Guan, MD. Discharge Opioid Over- and Underprescription to Patients after General Surgery: A Retrospective Cohort Study. Journal of the American College of Surgeons 237(2):332-342, August 2023.

Oppegaard KR, Mayo SJ, Armstrong TS, Kober KM, Anguera J, Hammer MJ, Levine JD, Conley YP, Paul S, Cooper B, Miaskowski C. Adverse Childhood Experiences and Higher Levels of Stress Are Associated With the Co-occurrence of Cancer-Related Cognitive Impairment and Anxiety. Semin Oncol Nurs. 2023 Dec;39(6):151513.

Michael Tan, MD, Jeanine A. Naegle, MD, Christy K. Boscardin, PhD, Denise P. Chang, MD, Joyce M. Chang, MD, Kristina R. Sullivan, MD, and Jina L. Sinskey, MD. Drivers of Well-Being and Burnout in Anesthesiology Residents. J Educ Perioper Med. 2023 Oct-Dec; 25(4): E715.

Sinskey JL, Chang JM, Lu AC, Pian-Smith MC. Patient Safety and Clinician Well-Being. Anesthesiol Clin. 2023 Dec;41(4):739-753.

Tesfalidet F, Armaneous M, Ehie O. Equity: The Importance of Promoting a Diverse Anesthesiologist Workforce. ASA Monitor. December 2023, Vol. 87, 23–25.

Odmara Barreto Chang, MD, PhD, Niti Pawar. The Leaky Pipeline: How Do We Address this Problem? Association of University Anesthesiologists (AUA) Winter 2023 Update Newsletter. 

Odmara Barreto Chang, Niti Pawar. A summary of DEI anesthesia and health sciences-related pipeline initiatives in the U.S. AUA Newsletter. Spring 2024. https://auahq.org/newsletter/a-summary-of-dei-anesthesia-and-health-sciences-related-pipeline-initiatives-in-the-u-s-2024-spring-issue/

Sara Zhou, BA (UCSF 4th year medical student), Darryl P. Brown, MD, Odmara Barreto Chang, MD, PhD. ASA 2023 Doctors Back to School Program Returns to the Classroom. ASA Monitor January 2024, Vol. 88, 32. 

Mervyn Maze, MB ChB. The Role of Cultural Competency Training to Address Health Disparities in Surgical Settings. British Medical Bulletin. January 2024.

Rebecca P. Chen, Janette Tang, LaMisha N. Hill Weller, Christy K. Boscardin, and Odinakachukwu A. Ehie. The Impact of an Interactive Unconscious Bias Training on Perioperative Learners. J Educ Perioper Med. 2024 Jan-Mar; 26(1): E721. 

LaMisha N. Hill Weller, Janette Tang, Rebecca P. Chen, Christy K. Boscardin, Odinakachukwu A. Ehie. Tools for Addressing Microaggressions: An Interactive Workshop for Perioperative Trainees. MedEd Portal. November 28, 2023. https://www.mededportal.org/doi/10.15766/mep_2374-8265.11360