#Diversityinplasticsurgery: Analysis of Representation of Ethnic and Gender Diversity on Plastic Surgery Residency Instagram Accounts
Vaishali Ravikumar, BS, Kailash Kapadia, MD, Nikita Patel, BS, Aretha Zhu, BS, Rose S. Maisner, BS, Meeki K. Lad, BS, Lauren Zingaro, BS, Haripriya S. Ayyala, MD, Edward S. Lee, MD
Division of Plastic and Reconstructive Surgery, Rutgers, New Jersey Medical School, Newark, NJ
Background: Increasing diversity in healthcare is critical to improving health disparities and minority patient satisfaction. Plastic surgery has been working to improve diversity through various awareness efforts, including social media movements like Diversify PRS and #Ilooklikeasurgeon. Since residency programs’ social media platforms serve as a public symbol of the programs’ values, we sought to analyze their Instagram posts for content highlighting ethnic and gender diversity.
Methods: Integrated plastic surgery residency programs were identified from the American Council of Academic Plastic Surgeons (ACAPS) website. Associated Instagram accounts were found through Instagram and Google searches. All posts’ images and captions were reviewed between 11/15/20 and 11/22/20 by authors for content regarding ethnic and gender diversity. Relevant posts were then characterized as “Implicit” or “Explicit”. Explicit posts included those with a purposeful statement about ethnic or gender diversity. Implicit posts for the ethnic diversity analysis included those with hashtags about ethnic diversity or mentioned a surgeon’s ethnic background in the post. Implicit posts for the gender diversity analysis included posts listing hashtags celebrating gender diversity, images showing an all-women team, or captions specifically highlighting women plastic surgeons.
Results: 76 of 82 (92.68%) programs had Instagram accounts. Of the 7897 posts that were reviewed, 137 (1.73%) featured ethnic diversity. 78 posts(56.93%) were categorized as explicit and 59 (43.07%) as implicit. The most common categories were “Diversity-referencing and social movement” (74.4%) and “Education/curricular” (74.6%). Of all hashtags, the most utilized were #diversifyprs (18.56%) and #diversity (16.49%). When examining gender diversity, 1170 (14.82%) explicitly or implicitly featured women. Of these, 144 (12.31%) were categorized as explicit, while 1026(87.69%) were categorized as implicit. The most common categories for the posts were “Holiday- based” (27.1%) and “Education/curricular”(42.0%). Of all hashtags used, the most used were #ilooklikeasurgeon (32.57%) and #womeninsurgery (18.32%). When comparing number of posts displaying gender diversity versus ethnic diversity, programs had more posts displaying the former (15.39 vs 1.80, t75=7.34, p<0.001) both explicitly (1.89 vs 1.03, t75=2.73, p=0.008) and implicitly (13.5 vs 0.78, t75=7.62, p<0.001). When programs were analyzed geographically, the South had the greatest percentage of posts displaying ethnic diversity (2.90%, p<0.001), while the West had the greatest percentage of posts displaying gender diversity (16.77%, p<0.001).
Conclusion: Recent initiatives to promote gender and ethnic diversity within plastic surgery are poorly translated to representation of diversity on plastic surgery residency Instagram accounts. There is a significantly better representation of gender diversity than ethnic diversity. There are significant regional differences in representation of diversity.
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