Review of Best Practices for Diversity, Equity, and Inclusion Committees Within Colleges of Pharmacy

Incorporation Into Colleges of Pharmacy

To be successful, DEI committees need to be recognized, accepted, supported, and integrated within the organizational structure. When these activities are carried out well, DEI committees can become instrumental in developing, implementing, and evaluating the college’s strategic initiatives in this area. Notably, DEI committees can help promote the change in culture and perspectives that are much needed to support diversity at academic institutions.¹² Structure and support for the committee should include both internal and external stakeholders. Incorporating DEI as a priority within an institution’s strategic plan ensures commitment and support at all levels of the college. This may also help facilitate access to adequate human resources, appropriate time allocated for the committee’s work, and the required financial support needed to enable it to be successful in creating long-term sustainable initiatives.¹³ Overall, DEI committees should develop strategies to enable the development of institutional change in culture over time, further enabling success in increasing diversity and inclusion within the college.¹⁴

Establishing Diversity, Equity, and Inclusion Committees

The goals of the DEI committee must be well thought out to meet the diversity needs of the college. These needs may be different from college to college depending on their current diversity, mission and vision, strategic goals, and the community they serve. Irrespective of the differences, DEI committees within colleges of pharmacy should have intentionally defined roles and responsibilities that include all key stakeholders. A DEI committee will not be successful without adequate resources; hence, the resource allocation must be intentional and aligned with clearly committed DEI goals.^9,15-17 Communication channels must be well established both within the college as well as with the university, and between all schoolwide committees. The role of a DEI committee is to implement and lead changes to ensure that faculty, staff, and students are representative of their communities and that pharmacy graduates are well prepared to provide care to these diverse communities.

When determining DEI committee membership, colleges should consider the unspoken or implicit messages conveyed by membership choices and the selection process, as they may communicate intended and sometimes unintended messages to those both inside and outside the organization.¹⁸ For example, establishing a DEI committee exclusively run by volunteers may signal a lack of true commitment by the college due to the absence of actual representation of the college’s human capital. Alternatively, if a significant portion of a committee’s membership includes only underrepresented minority members, it may be perceived that the college is leaving this important work to underrepresented minority members alone to bring diversity. Some underrepresented minority faculty may perceive institutional pressure to participate on the committee, leading to a sense of obligation and potential exhaustion and burnout.¹⁹ Not involving members of traditionally overrepresented groups may lead to these individuals feeling undervalued, threatened, and potentially less likely to accept policies or practices that are developed by the committee.¹⁸ Given these potential challenges, careful thought should be given to the makeup of DEI committees. An analysis of the structure of diversity committees from 10 research institutions suggested that members should be appointed very broadly beyond underrepresented minority groups.^11,19,20 Along with traditional faculty membership, college-level DEI committees may include campus leaders, members from campus governance or advocacy groups, and representatives from the community.¹¹

The optimal size for a DEI committee is about 10-15 members, including members from college leadership; individuals representing different entities (committees, offices, units) based on their interest, knowledge, skills, and experiences; alumni; and community partners.¹¹ Change agents representing each of these areas should be included in the design of processes that are capable of driving effective and sustainable change related to DEI in the workplace.²¹ Change agents who are department chairs, college administrators, or others with leadership roles may be suited to perform this role through their job responsibilities and may have the ability to affect the culture of the organization.⁸

Regarding DEI committees’ roles and responsibilities, these committees should provide oversight for diversity initiatives, connecting various offices, committees, and other stakeholders.¹⁵ Key DEI committee responsibilities include developing a plan to encourage diversity in each department as a part of the overall strategic plan, facilitating the integration of diversity and inclusion concepts into curricula, participating in faculty recruitment and development, contributing to procedures for student recruitment, admission, and progression, collecting and reviewing data for continuous improvement, and examining the practices and policies that produce inequities.¹⁷ A more detailed listing of potential DEI committee roles and responsibilities are listed in Table 1.¹¹ These responsibilities emphasize the need for DEI committees to work within the institutional structure at every level to advance their initiatives.

Principles of Success

To achieve the goals of increasing diversity, equity, and inclusion, a DEI committee must engage leadership and ensure their support.^20,22,23 Starting with the executive committee, leaders of the college can help with the committee’s success.^13,24 Including the DEI committee chair on the executive committee, or a similar leadership body within the college, as a standing committee member allows for meaningful input on the college’s initiatives and strategic plan to ensure alignment with DEI principles. Time during executive committee meetings should be devoted to discussing DEI progress and ways that leadership can help support or improve the current efforts. Having the DEI committee chair present can allow them to render expertise and insights in the development of charges for all standing committees and key offices at the college to include diversity goals as shown in Figure 1. The reports from the standing committees may also be evaluated through the DEI lens at the executive committee level to ensure the implementation of DEI principles and values.

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Figure 1.

Engaging the Diversity, Equity, and Inclusion Committee Throughout the College and University.

Further, effective delivery of DEI initiatives requires a change in the college’s culture. A DEI committee can help foster this change through its initiatives, but in order to realize consistent and long-term sustainable change, DEI needs to be embedded into day-to-day campus activities.²⁵ In academia, there is often a desire to be autonomous, making it difficult to change baseline biases.^12,24 A top-down approach from leadership alone is not always effective in making such a change in the long term and may not result in relevant changes to attitudes and behaviors.¹² A DEI committee that is neutral in nature can help facilitate awareness and professional development to address implicit bias within the institution.¹⁷ Also, diversity training and education are needed for pharmacy faculty and staff to adapt to change, meeting the college’s mission and vision, including diversity. This is also applicable to professional student organization leaders and external representatives, such as preceptors, adjunct faculty, and other college volunteers. As diversity within an organization starts to change, managing this change is also important for success. Consideration should be given to enhance the cultural intelligence of members to include components related to cognitive, physical, and emotional or motivational aspects.¹⁴ Assessment of DEI initiatives is important to be able to measure change and effectiveness of the committee’s work.¹⁶

Interactions With Key Committees of the College

A significant portion of a college’s strategic goals are accomplished through its committees, so DEI must be embraced by all committees in their charges and the work they do. The DEI committee has a vital role in collaborating with all committees within the college to make a constructive, evidence-based impact on health care outcomes. Committee strategies must be multipronged and embedded within all committees’ charges so that there is buy-in from all with day-to-day ownership bidirectionally.²³ Embedding the work of the DEI committee within each college-level committee and clinical practice is important, especially as pharmacy schools are training students to provide direct patient care. Specifically, DEI committees can work with student services committees, faculty committees (recruitment, retention, and development), and curriculum assessment committees. Interactions with these types of committees are described below.

A DEI committee can work with student services committees through various mechanisms to increase diversity of applicants and matriculating students into the college, and it can contribute to progression and retention efforts. An example of this collaboration could include using pipeline programs from underrepresented regions and schools to recruit and retain representative students. Colleges can also work with diversity-focused associations such as the National Pharmaceutical Association, National Hispanic Pharmacists Association, and the Association of Black Health-System Pharmacists to help recruit minority pharmacy students and to support them while in school through grants or educational programs.^15,26-29 Also, a DEI committee can work with the human resources office to provide implicit bias training for search committee and admissions committee members, which has been shown to be successful in diversifying student bodies.^13,17

In working with the admissions committee, a DEI committee can help improve recruiting and ensure student applications, admission offers, and the matriculated student body is representative of the local community they serve. The DEI committee can help in recruiting efforts via both in-person and virtual events tailored to best reach underrepresented minority students who otherwise may not consider the pharmacy profession or have the opportunity to interact with college personnel. With most pharmacy students being recruited from two- or four-year universities, DEI committees and college leadership should first look at the demographic makeup of the undergraduate institutions they primarily recruit from.⁶ As methods for recruitment, DEI committees can help network and establish relationships with the local community via outreach programs, student/faculty panels, summer camps, co-op programs, or research opportunities.^10,30,31 The DEI committee should be involved in reviewing admissions policies and procedures to ensure an equitable and fair review using a holistic process.⁹ As the DEI committee starts to ensure enough diversity in admissions, it can then focus on progression processes. Data on barriers for student matriculation into pharmacy school after acceptance can be reviewed by the DEI committee to target strategic imperatives to combat those barriers. Once matriculated, the progression of underrepresented minority students should be a major concern to the DEI committee, as underrepresented minority students have shown to have a more negative racial experience compared to peers.³⁰ Lastly, DEI committees should track progression rates of underrepresented minority students to ensure they are similar to non–underrepresented minority students.

Recruitment of underrepresented minority faculty is an important step to facilitate the enrollment of a diverse student body and, subsequently, helps expose all students and faculty to diverse perspectives, enabling an enriching learning environment.^16,32 The DEI committee can review recruitment and retention policies to ensure equity in how search committee members are selected, making sure related policies and procedures are conducive to promoting diversity.^15,26 Also, the DEI committee, working with human resources, can ensure all search committee members are trained on implicit bias and cognitive error. These trainings should be requirements before someone is allowed to participate on a search committee. Additionally, current underrepresented minority faculty should be invited to participate in the recruitment and interview process to share experiences and information about the community and social life with potential hires.¹⁶

Retaining underrepresented minority faculty is key to sustaining a diverse faculty workforce. The DEI committee can work with the faculty development committee to facilitate appropriate resources, training programs, and a retention plan to ensure that the underrepresented minority faculty are satisfied with their jobs and feel supported. Members of underrepresented minority groups should not be expected to represent diversity on all committees but should be supported to participate in programs on campus and externally and given equitable access to teaching release and other incentives to compensate their work in promoting diversity.¹⁷ If there is inconsistent and inequitable application of promotion and tenure criteria, retention may be difficult.⁹ Thus, it is important for the promotion and tenure criteria to be clear and frequently reviewed with the DEI committee. For example, adopting policies to stop the tenure clock during parental leaves has been used by some institutions to promote gender-neutral effects.²⁸ The DEI committee should engage in the continuous assessment of faculty and staff hiring and retention data to ensure targets are achieved.

The faculty development committee should collaborate with the DEI committee to develop initiatives that promote a climate of inclusivity for long-term faculty retention.²⁶ This may include diversity discussions, lecture series, and workshops to expand awareness on diversity-related topics such as health care disparities, gender, religion, nationality, and sexuality.¹⁵ The DEI committee can make sure that the faculty development committee supports and implements programs such as a strong mentoring and professional development programs, seed grants, research training, teaching fellowships, leadership programs, and sabbaticals for career advancement to avoid attrition and low satisfaction among minority faculty.^9,17,28,33

Further, the DEI committee should be part of the continuous quality improvement activities of a college’s curriculum committee to ensure students can provide culturally sensitive care that encompasses the diversity students will see in their patients, including diversity in race, abilities, sexual orientation, and health disparities, among others.³⁴ The DEI committee can consider using the Pharmacy Health Equity Anti-Racism Training (Rx-HEART) framework for working through the curriculum committee to ensure a diversity-rich curriculum to address health equity and racism.³⁵ An intentional incorporation of topics surrounding diverse patient populations must be included in didactic lectures, patient cases, clinical settings, and health literacy activities.³⁶ Faculty who are Black, Indigenous, or people of color (BIPOC) may, based on their personal experiences, be effective in helping to promote and facilitate discussions of diversity in the curriculum. However, BIPOC faculty should not be relied on to carry this weight alone, and the entire faculty should be involved in incorporating principles of diversity in what they teach students.³⁵ Experiential education and co-curricular experiences such as health fairs and outreach programs are important for students to take care of patients in the community and to communicate with patients who are different from them. To ensure students interact with diverse patient populations and different cultures, the DEI committee can work with the assessment committee and experiential education leaders to track student placement related to the diversity of their preceptors, practice sites, geographical location, and patient populations they care for. The DEI committee can periodically review programmatic assessment data of the didactic, experiential, and co-curriculum and provide necessary recommendations to ensure DEI in the curriculum and delivery in all settings. The DEI committee may be involved in the creation of a diversity dashboard that can be used by all committees, including the curriculum and assessment committees. This dashboard can help track progress related to diversity, equity, and inclusion goals important to the college.

Interactions Outside the College

Outside of the college, the DEI committee should be in alignment with the DEI office or a committee at the university level for a smoother execution of its diversity initiatives (see Figure 1). The college’s strategic plan, which is inclusive of diversity initiatives, must also be in alignment in a bilateral fashion. There should be two-way communication between university offices such as the president’s cabinet, human resources, external relations office, and provost’s office as needed to support and realize the goals of the DEI committee at the college.

Further, DEI efforts cannot be isolated to just within the college or university but should reach outside the walls with engagement and support in the local community and a strong connection to alumni.^17,37 Establishing DEI initiatives in co-curricular activities that engage alumni as well as increasing outreach in the community may be beneficial. Consistent communication between the DEI committee and alumni, including underrepresented minority community leaders, could be another way to assure the importance of providing equitable health care services to diverse communities.³⁷ This can be done through outreach efforts, provision of scholarships, and partnering with underrepresented business leaders in the community. This type of engagement with underrepresented partners may include serving and promoting economic growth, supporting and advocating for diversity-related interests in government and societal affairs, supporting and assisting other organizations in their DEI initiatives, and in promoting the advancement of DEI and social responsibility with the college’s community.³⁷