{"id":461,"date":"2022-09-22T12:33:26","date_gmt":"2022-09-22T12:33:26","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmjleader\/?p=461"},"modified":"2022-09-22T12:33:26","modified_gmt":"2022-09-22T12:33:26","slug":"commissioning-editor-introductory-blog-living-up-to-more-diversity-and-inclusion-in-health-care-leadership-research-by-jamiu-o-busari","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmjleader\/2022\/09\/22\/commissioning-editor-introductory-blog-living-up-to-more-diversity-and-inclusion-in-health-care-leadership-research-by-jamiu-o-busari\/","title":{"rendered":"Commissioning Editor Introductory Blog: Living up to more diversity and inclusion in health care leadership (research) by Jamiu O. Busari"},"content":{"rendered":"

Introduction<\/strong><\/p>\n

BMJ Leader <\/a>(BMJL) is one of the BMJ’s journals and is co-owned by BMJ and the\u00a0Faculty of Medical Leadership and Management<\/a>. It is an international, peer-reviewed, online-only journal that focuses on healthcare management and leadership. BMJL is constantly expanding its scope and taking bold steps to be a more inclusive search<\/strong> journal. We are recruiting more contributions from underrepresented groups and communities. There is also a renewed focus on diversifying the journal’s pool of editors, reviewers, and contributors. With these efforts and more, BMJL aims to be an academic outlet that resonates with and is accessible to a global healthcare (leadership) community.<\/p>\n

So why is a renewed focus on diversity and inclusion (DI) in research important to BMJL? Let us first examine some facts about DI in scientific research. In 2021, the National Science Board <\/a>reported that countries with high-and upper-middle-income economies accounted for 90% of the 2.9 million scientific articles published globally. Six countries China, the united states, India, Germany, the united kingdom, and Japan together, accounted for 54% of this number, with China ranking number one on the list. Over the past two decades, high-income economies like the United States, the United Kingdom, Germany, France, and Japan have steadily increased their large base of scientific publications.<\/p>\n

Meanwhile, lower-middle-income and upper-middle-income economies such as India, China, Iran, Russia, and Brazil have rapidly increased their outputs, starting from a lower base of scientific publications in 1996. Data on article citations have also shown that the United States, United Kingdom, Netherlands, and Switzerland, are some countries with reported high-impact research papers. As academics and scientific researchers, we constantly seek to improve, explore, develop and disseminate (new) knowledge within our communities. In the field of medicine, these aspirations are reflected in the way we design our health services, develop medical curricula (Canmeds<\/a>, UK<\/a>)\u00a0 and implement our management and leadership systems. Central to these focus areas is the need for continuous, credible, and robust scientific research to help guide equitable healthcare decision-making. So, besides upholding the morals and ethics of scientific research, an essential prerequisite for equitable decision-making is ensuring sufficient diversity and representation in the way scientific research is conducted and disseminated<\/p>\n

The ethos\u00a0 of scientific research<\/strong><\/p>\n

In 1942, sociologist Dr. Robert Merton proposed the ethos that should be applied to science, later called the Mertonian norms<\/a>. In his writing “A Note on Science and Technology in a Democratic Order,”\u00a0 Merton argued that while no formal scientific code exists, the values and norms of modern science can be inferred from standard codes of scientific practice and widely held attitudes.\u00a0 To explain this, he described four idealized norms, namely:\u00a0Universalism – <\/em>The idea that scientific claims must be held to objective and “preestablished impersonal criteria,\u00a0Communality or Communalism – <\/em>the findings of science are common property to the scientific community, and that scientific progress depends on open communication and sharing,\u00a0Disinterestedness – <\/em>Science should limit the influence of bias as much as possible and should be done for the sake of science, rather than self-interest or power, and\u00a0Organized Skepticism<\/em>– the necessity for proof or verification of our discoveries, which subjects science to more scrutiny than any other field. This last norm emphasizes the need for peer review and the value of reproducibility.<\/p>\n

Limiting bias and promoting inclusion in scientific research<\/strong><\/p>\n

Of the four norms of the scientific ethos, upholding disinterestedness (i.e., limiting the influence of bias and doing science for the sake of science) seems to be the most challenging in Academia, research, and scientific publications. Over the years,\u00a0 bias in science has gradually grown and expanded beyond the performance of research to include practices that systematically disadvantage, exclude, or limit the participation of certain groups of scientists. For example, Hofstra et al., 2020 <\/a>explored the diversity-innovation paradox in science. The authors investigated why, despite the premise that diversity breeds innovation, underrepresented researchers that diversify organizations are less successful in their careers.\u00a0 They were also interested in knowing if the diversity paradox holds for scientists. They used a near-complete population\u00a0of approximately 1.2 million US doctoral recipients (1977 to 2015), following their careers into publishing and faculty positions. Their findings revealed that underrepresented groups produced higher rates of scientific novelty. However, their novel contributions were devalued and discounted.\u00a0 For example, novel contributions by gender and racial minorities were taken up by peers at lower rates than novel contributions by gender and racial majorities. Equally, impactful contributions of gender and racial minorities did not necessarily result in successful scientific careers compared to majority groups. The findings suggest that there are unwarranted reproductions of stratification in Academia. Unfortunately, these reproductions disregard the underrepresentation of certain groups in Academia. These stratifications also seemed to ignore the diversity in scientific research (innovation).\u00a0 This fact and more shows that the world of science is (still) unfair, and disparities<\/a> are persistent among underrepresented groups<\/a> in both science and publishing due to inequalities within our scientific communities.<\/p>\n

BMJ and Equity, Diversity and Inclusion (EDI)<\/strong><\/p>\n

As far back as 2006, affirmative initiatives such as #MeToo <\/a>and Black lives matter <\/a>have emerged to tackle inequitable and unjust systems in our societies.\u00a0 Many of these observed inequities are not limited to health care, entertainment, and corporate industries but also involve (higher) education, scientific research, and publications. With this knowledge, the BMJ\u00a0 made a public commitment<\/a> on the 23rd of July 2021 to\u00a0take proactive steps to promote EDI across its company and journals. In a series of public commitments <\/a>that followed, the company promised through its journals to stand up for equality, diversity, and inclusion in research, clinical practice, and scholarly communication. <\/em>Some concrete steps <\/a>were mapped out to achieve this, which included developing inclusive guide styles for BMJ journals, diversifying editorial boards, encouraging diversity of authors and reviewers, and monitoring the gender and ethnicity distribution in submissions received.<\/p>\n

Commissioning editor at BMJ Leader<\/strong><\/p>\n

The overarching aim of BMJL is to improve the outcome and experience of health and care delivery systems for patients, populations, and workforces. To deliver on this purpose,\u00a0 BMJL focuses on building better leaders who are resilient and equipped with practical leadership skills and knowledge. The journal strives to achieve this by showcasing original research and reviews, interpretations of the evidence base, reflections, and debates by practitioners on key healthcare management and leadership themes. The commissioning editor (CEd) participates in achieving these goals but, in particular, is responsible for commissioning high-quality, topical articles and special issues. In addition, the CEd actively drives the recruitment of contributors and the peer review process of manuscripts submitted to these issues. I have recently taken over the CEd role at\u00a0 BMJ Leader, succeeding my predecessor Dr. Anthony Berendt. I am grateful to Dr. Berendt for the foundation he laid during his tenure as CEd, which I shall be building on. As the new commissioning editor, my primary goal would be to expand the\u00a0 Journal’s set objectives – to make it more inclusive and ensure more diversity in content, contributors, and reviewers. Specific activities I intend to undertake\u00a0 to achieve this include:<\/p>\n