Spectrum of Perceptions Regarding Professional Climate: A National Survey of U.S. Cardiologists and Trainees.
BACKGROUND: Characterizations of cardiology's professional climate often focus on negative experiences. OBJECTIVES: The study's primary objective was to broadly characterize cardiology climate. METHODS: The American College of Cardiology surveyed 1805 cardiologists online in 2022. Agreement with cardiology 7 workforce statements could be categorized into 4 attitudinal profiles (A-D) in 1513 (84%), using a 2-step cluster analysis maximizing log-likelihood measures of agreement. Multivariable modeling described respondents' alignment with profiles. ORs compared perceptions across profiles. RESULTS: Most respondents were men (n = 1,095, 72%), heterosexual/cisgender (n = 1,380, >90%), and identified as White (n = 800, 53%). Profile A (441, 29%) perceived cardiology's climate as empowering/inclusive/no change needed. Profile D (n = 278; 18%) felt climate was stifling/exclusionary/change needed. Intermediate were B: inclusive/change needed (n = 501; 33%) and C: stifling/uncertain about change (293; 19%). Profile A was independently associated with male sex, White race, late career, and no mistreatment, C-statistic = 0.73 (95% CI: 0.70-0.75). Profile D was associated with female sex, Black, Asian, Hispanic or other race individuals, early/mid-career, and experience of mistreatment, C-statistic = 0.80 (95% CI: 0.77-0.83). Men were respected by most (93%; range across profiles 90%-96%) with less agreement about people identifying as Black, Asian, Hispanic, or other (68%; 27%-90%); women (68%; 25%-95%); people with a disability (54%; 22%-77%); and nonheterosexual (48%; 19%-69%) or transgender/sex nonconforming people (23%; 5%-36%). Primary workplace culture was perceived more positively, while organizations were seen as ineffective in improving climate. CONCLUSIONS: Cardiologists' perceptions of professional climate differ widely with 37% viewing it as stifling/exclusionary and 51% desiring change. These findings, plus perceived organizational ineffectiveness, support efforts to improve the cardiology workplace climate.
