I'm part of the DEI task force. When we initially started the task force about a few years ago, one of the original questions that we had was, is DEI actually an issue amongst our research publications? So I took that to heart and was able to help lead a team, kind of take a deep dive into our recent sports medicine literature to try to get some data and see how we're doing from a DEI perspective in our publications. So the first systematic review we put together took a look at how often we are reporting and analyzing sex, race, and ethnicity in our sports medicine publications. So we looked at AJSM, OJSM, and sports health over a four-year time period, looking at only original sports medicine research studies that isolated athletes. And we found overall we're doing a very good job at reporting sex as a demographic, almost 94 percent. But in our publications, we've done a pretty poor job in reporting race, only at 3.8 percent of studies, and ethnicity at 2 percent. When we look at how often we're analyzing these factors, sex was analyzed in 53 percent of the studies, race, when it was presented, in 40 percent, and ethnicity, 17.6 percent. When race was provided as a demographic feature, 67 percent were listed as white, 21 percent Hispanic, 8 percent black, 2 percent Asian, and 0.3 percent Pacific Islander. So then we went and wanted to dive a little bit further and look at how are we doing in our publications on male sports versus female sports. So how many publications do we have that are isolating just male athletes compared to publications that are isolating female athletes? So again, we looked at, performed a systematic review over the same four-year time period, but included the six sports medicine journals included below, including AJSM, looking at studies that isolated athletes and broke down to male versus female sports. We included 669 studies and ended up finding that 70.7 percent of studies isolated male athletes only, 8.8 percent of studies isolated female athletes, and 20.5 percent of studies evaluated both male and female athletes in their studies. So a significant sway towards male publications in the sports medicine literature. This just shows that softball and volleyball were the only two studies, or only two sports that favored females. And then when we compared direct comparison of the four major co-ed sports that were presented in our literature, you can see here there's still, even though they're co-ed, have a large sway towards male publications compared to females. So specifically in the baseball, softball realm, 91 percent of the studies went towards baseball and only 5 percent of our published studies went towards softball. And we have improved. There was a statistically significant decrease in the amount of studies that only published on males over this four-year time period. And then finally we wanted to look at what's driving diversity in our research. So we tried to look at female authorship over the same four-year time period with six sports medicine journals. And looking at the first and senior authors of all the sports medicine publications that were analyzing athletes, we found that 21 percent had a first female author, 16 percent had a female senior author, and almost 20 percent of overall authors were female. The interesting findings from this study, when we looked at the effect of authorship on rates of studying the female athletes, so the studies that were just looking at the studies that isolated female athletes only, we found that when there was a first, first female authors were four times more likely to publish on a study that isolated female athletes. And senior authors were two times more likely. And just another way to look at this, 55 percent of studies that were isolated on females had a first female author. So this just goes to show that female authors are playing a key role in addressing gender disparities in our sports medicine research and increasing diversity. So just some conclusions from everything that we found. Sex is well-reported but poorly analyzed, and race and ethnicity are both poorly reported and analyzed. We could consider in the future encouraging our authors to collect this data when providing analysis, when the data allows it and is appropriate. Sports medicine research has largely favored evaluation of male athletes in most sports, including the majority of our co-ed sports. While this is multifactorial, and I'm not going to go into the details today, it is important to note this because we do know there are differences and injuries between male and female athletes. And finally, female authorship does seem to be driving studies of female athletes in our literature. And this just goes to show that increasing diversity in sports medicine can lead to a more diverse, inclusive study designs and more generalizable findings for our study populations. That's it. Thank you. Thank you very much. designed and carried out the survey on diversity of readership, authorship, and the reviewers. Thank you, I don't have an official slide on this, but we basically designed a survey, tried to kind of like get a sense of demographic distributions among all of our contributors, either as authors, readers, reviewers, and Donna helped us to distribute this among all of our kind of like users. We got around 600 responses with, as we expected, majority of our responders were males, mainly from Canada, mainly clinicians, English speaking, mainly academic, and primarily established, meaning that they had more than 20 years of basically practicing after training. One interesting observation that we had when we repeat this analysis across different kind of like audiences, whether they are users, authors, or reviewers, we had exactly the same distribution. So that's something that we need to kind of like consider when we are trying to address the DEI issues. One, I think, important observation that we had was there was an issue of access when we go outside of US or Canada, and also when we are kind of like trying to reach to audience which are non-English speaking. And aside from these distributions, we also ask whoever is taking these surveys to provide us for any additional comments. There were obviously some kind of like praises for these type of efforts, and kind of like willingness to help us out with these movements, but there was a general sense of confusion of what is the purpose of this initiative? What do we want to do with this survey? Is it just another one of those DEI surveys that we just collected, or we have to collect it, or what do we want to do with this? And I think this speaks to the fact that we need to clarify what do we want to do with collecting this data? What is the overall mission when we talk about DEI? Thank you. So, one of the questions from one of the inclusion team members in our very first meeting was, Don, is there a problem? Like, is this in our heads or, you know, what is the problem? And so, I was asked that question before the first meeting, so I said, I'm a white male, I can't tell you because of my blind spot. So, I threw that open, and clearly there are barriers to advancement in the academic world and in our realm in particular. And so, those barriers, mentorship came up as one of the primary things that is needed. It's reassuring to know that the survey shows that our reviewer pool reflects the readership and the authorship pool. So, we are reflecting the population that we are currently serving, but there are gaps in our literature as Megan's research has pointed out. So, we have work to do, it's important, and we hope that as time goes on in the reviewer pool with this mentorship program and this open application process, which complicates Bruce's job and Donna's job and the job of the editors considerably because in the past it was relatively informal, right? Bruce would go to a meeting or he'd read a paper and somebody's not on the reviewer pool, he'll invite them to become a reviewer. I will say that the survey produced one volunteer who's now going to review for AJSM, the person said, I'd love to review for the journal, I'm a radiologist, and so we now have their profiles in. So, one more reviewer. I'd like to throw it open to questions, if any of you have questions or concerns, Mike. So, but you can catch a little bit. For those of you who have volunteered to be mentors or expressed willingness, thank you very much for doing that. You may be solicited to mentor people going forward because we expect a number of responses to this open application process. We have a workflow in place. We have policies and procedures to handle all of this changing entry pathway to reviewership, but hopefully, who knows, people who are already reviewing may avail themselves of the mentorship as well. David? I think you may have touched on this earlier, but what level are you targeting to try to get people in this pool? Is it people who are in residency, or fellowship, or after fellowship, because it seems like getting people very early is probably the best way, because if you've already gone to a certain fellowship or in practice, you may have developed your interests a little bit at that point, and it seems like capturing people as early as possible with that exposure maybe could change their trajectory and get the end goal of what we want, of being sort of more diverse and inclusive. That's a great point. Bruce's letter every year goes out to graduating fellows, but that's your only official solicitation, right? That's the most general it's been, but it's still invitational. So we're trying to reduce that barrier, but not lose any quality in the reviews themselves. So we would like to target young people, and in promoting this in the related societies, we're hoping to target young people, and in targeting them, hopefully the recruiter that's making that approach is either capable of mentoring them, because you would select a mentor that looks like you or has maybe, well, at least understand your life experiences to show you the way. That's the idea. So yes, we're targeting young people, but we're not going to discriminate based on age, so older people are welcome as well. Keith.

DEI task force

diversity

equity

inclusion

sports medicine research