2016 INSIGHT Into Diversity Health Professions HEED Award Application
GENERAL INFORMATION
1. Please provide the complete, formal name of your institution.
2. Check which class applies to your institution. Please select one.
/ Dental school/ Medical school
/ Nursing school
/ Osteopathic medical school
/ Pharmacy school
/ Veterinary school
/ Other, please specify: ______
3. What is your full-time student enrollment?
/ 0-999/ 1,000-1,999
/ 2,000-2,999
/ 3,000-4,999
/ Over 5,000
STUDENT DEMOGRAPHICS
4. What is the breakdown by gender of your full-time student enrollment?
Male /Female /
5. What is the breakdown by race/ethnicity of your full-time student enrollment?
White/Caucasian /African American/Black /
Hispanic/Latino /
Native American /
Asian American /
Native Hawaiian or Pacific Islander /
Multiracial /
Nonresident alien /
LEADERSHIP DEMOGRAPHICS
6. What is the breakdown by gender of your administrative leadership (deans, department chairs/heads, and top hospital administrators)?
Male /Female /
7. What is the racial/ethnic composition of your administrative leadership (deans, department chairs/heads, and top hospital administrators)?
White/Caucasian /African American/Black /
Hispanic/Latino /
Native American /
Asian American /
Native Hawaiian or Pacific Islander /
Multiracial /
Nonresident alien /
FACULTY AND STAFF DEMOGRAPHICS
8. What is the breakdown by gender of your associate professor and professor faculty?
Male /Female /
9. What is the breakdown by race/ethnicity of your associate professor and professor faculty?
White/Caucasian /African American/Black /
Hispanic/Latino /
Native American /
Asian American /
Native Hawaiian or Pacific Islander /
Multiracial /
Nonresident alien /
10. What is the breakdown by gender of your instructor and assistant professor faculty?
Male /Female /
11. What is the breakdown by race/ethnicity of your instructor and assistant professor faculty?
White/Caucasian /African American/Black /
Hispanic/Latino /
Native American /
Asian American /
Native Hawaiian or Pacific Islander /
Multiracial /
Nonresident alien /
12. What is the breakdown by gender of your full-time administrative staff (do not include admissions staff)?
Male /Female /
13. What is the breakdown by race/ethnicity of your full-time administrative staff (do not include admissions staff)?
White/Caucasian /African American/Black /
Hispanic/Latino /
Native American /
Asian American /
Native Hawaiian or Pacific Islander /
Multiracial /
Nonresident alien /
14. What is the breakdown by gender of your admissions review committee?
Male /Female /
15. What is the breakdown by race/ethnicity of your admissions review committee?
White/Caucasian /African American/Black /
Hispanic/Latino /
Native American /
Asian American /
Native Hawaiian or Pacific Islander /
Multiracial /
Nonresident alien /
16. Does your school have the following? Check all that apply.
/ Dean of faculty affairs/ Professional development funds
STUDENT RECRUITMENT, CURRICULUM, AND RETENTION
17. What efforts do you use to recruit historically underrepresented and first-generation students? Check all that apply.
/ Community outreach efforts/ Admissions officers with a diversity focus
/ On-campus diversity recruitment efforts
/ Social media outreach
/ Race-conscious scholarships
/ Economic-conscious scholarships
/ Exhibits at national meetings and conferences that focus on underrepresented students
/ Summer exposure and enrichment programs focused on underrepresented students
/ Holistic admissions process
18. What efforts do you use to improve retention and graduation rates for historically underrepresented students? Check all that apply.
/ Strategic retention plan/ Institutional research on student success patterns
/ Cohort-based academic success and leadership program
/ Supplemental instruction
/ Free tutoring support
/ Culturally relevant advising
/ Summer bridge programs
/ Early warning systems
/ First-year experience programs
19. Please provide the following information regarding your graduates.
What percentage of your graduates have accepted first-year GME appointments in teaching health centers? /What percentage of your graduates have accepted first-year GME appointments in underserved communities (nationally and internationally)? /
20. Indicate which of the following topics are included in your curriculum. Check all that apply.
N/A / No / Yes / Included in ongoing classroom curriculumCommunity health / / / /
Cultural diversity / / / /
LGBTQ health issues / / / /
Global health / / / /
Health disparities / / / /
Interprofessional studies / / / /
Minority health issues / / / /
Women's health issues / / / /
Social determinants of health / / / /
Religious beliefs affecting healthcare / / / /
Linguistic diversity / / / /
Collecting patient demographics / / / /
21. Indicate which of the following scholarship/grant/loan opportunities your institution provides for students. Check all that apply.
/ Scholarships for disadvantaged students/ National Health Service Corps
/ Armed forces health professions scholarships
/ Indian Health Service
/ AmeriCorps
/ Loans for disadvantaged students
/ Outside-funded need-based scholarships without a service commitment
/ Institution-funded need-based scholarships without a service commitment
Tell us about any other programs not listed above.
22. Tell us about any pipeline programs your school has with other institutions. Include the names of those institutions.
23. Indicate the extent to which your institution has made progress in the following areas.
Strongly Agree / Agree / Undecided / Disagree / Strongly DisagreeHealth promotion / / / / /
Preventive care / / / / /
Linguistic competence / / / / /
Cultural competence / / / / /
FACULTY RECRUITMENT AND RETENTION
24. What strategies does your school have in place to increase the ethnic, racial, and gender diversity of your instructional faculty on campus? Check all that apply.
/ Faculty diversity strategic plan/ Dedicated faculty diversity recruitment specialist
/ National partnership efforts
/ Advertisements in diversity-only publications and/or job boards
/ Participation in diversity recruitment events
/ Strategic funds to increase financial offers to diverse job candidates
/ Grant-funded initiatives to increase retention (e.g., NSF Advance program)
/ Strategic funds to hire diverse candidates
/ Hosting future faculty diversity symposiums on campus
Please list diversity publications and job boards you use. (Do not include The Chronicle of Higher Education, Inside Higher Ed, or Higher Ed Jobs, as these are not diversity job boards.)
25. What strategies does your school use to retain ethnically, racially, and gender-diverse faculty on your campus? Check all that apply.
/ Mentor programs for diverse junior faculty/ Cohort-driven leadership programs for diverse junior faculty
/ Graduate research support for new diverse faculty
/ Start-up research funds for new diverse faculty
/ Family-flexible tenure time lines
/ Affinity or employee resource groups for employees
LEADERSHIP AND ACCOUNTABILITY
26. Indicate the role the dean plays in your school's diversity policies.
Strongly Agree / Agree / Undecided / Disagree / Strongly DisagreeEstablishes the vision for diversity / / / / /
Charges the diversity committee / / / / /
Creates a culture of accountability / / / / /
Ensures that resources (funding and staff) are available to drive campus diversity efforts / / / / /
Shows a visible commitment to diversity in speeches, written correspondence, and public appearances / / / / /
Ensures that senior leadership is engaged in school's diversity agenda / / / / /
Provide further commentary on the dean's role in ensuring the placement and execution of your school's diversity efforts. Include any additional efforts not listed above, explain any existing weaknesses, and include any suggestions for improvement.
27. What strategies does your school have in place around diversity planning and accountability? Check all that apply.
/ Our school's official mission statement includes diversity and inclusion language./ Our diversity and inclusion goals and plans are embedded in our strategic plan.
/ Our school has a diversity planning committee or taskforce.
/ Our school uses a diversity scorecard process to measure our diversity progress.
/ Our diversity office has the opportunity to formally report on campus diversity plans, successes, challenges, and opportunities at meetings of the board of governors, trustees, or regents.
28. Does your school have diversity training programs for the following groups?
Voluntary / Required / Upon Hiring / Start of Academic Year / Annually / Every Two Years / No Diversity Training / Unconscious Bias TrainingSenior administrators / / / / / / / /
Full-time faculty / / / / / / / /
Full-time staff / / / / / / / /
Search committee heads / / / / / / / /
Board of trustees or regents / / / / / / / /
Full-time students / / / / / / / /
29. Please indicate the degree to which you agree or disagree with the following statements regarding activation of your diversity plan.
Strongly Agree / Agree / Undecided / Disagree / Strongly Disagree / N/AOur dean is highly involved in diversity implementation efforts. / / / / / /
Our chief diversity officer provides point leadership in the diversity implementation process. / / / / / /
Our diversity committee ensures that many different people are involved in shaping the school's diversity strategy. / / / / / /
Students play a key role in leading diversity change efforts on our campus. / / / / / /
Diversity efforts are data-driven and evidence-based. / / / / / /
Adequate financial resources exist to drive diversity efforts. / / / / / /
Participation in diversity-related programs is considered in the tenure and promotion process. / / / / / /
Add any additional comments about the diversity plan activation process for your school.
30. Identify any diversity-focused financial strategies that exist at your school. Check all that apply.
/ Diversity goals are embedded into the overall budget process./ We have an annual diversity fundraising program.
/ We have diversity incentive grants (e.g., pool of funds for which anyone can compete).
/ We apply for federal diversity grants (e.g., NSF, NIH, U.S. Department of Education).
/ We have a dedicated development officer focused on diversity.
/ We have a qualified diversity endowment.
/ We have a diversity-themed alumni fundraising program.
/ Other: ______
BRANDING
31. Identify any multicultural branding and communication techniques your school uses. Check all that apply.
/ Social media used for multicultural marketing (e.g., YouTube, Instagram, Twitter, Facebook, etc.)/ Multicultural communications officer or specialist
/ Diversity-themed admissions materials and brochures
/ Diversity advertising and outreach campaigns (e.g., display/image advertising in diversity publications like INSIGHT Into Diversity magazine, billboards, commercials)
/ Annual diversity report
/ Student ambassadors communicate campus diversity to prospective students and their parents
/ Display all diversity awards received on website
/ Diversity link on website homepage
List any other diversity branding techniques your school uses that are not listed above.
32. Please identify which of the following diversity-related information appears on your website. Check all that apply.
/ Our procurement office/supplier diversity page lists opportunities for minority- and women-owned businesses./ Our study abroad page includes specific opportunities for underrepresented students (e.g., scholarships).
/ Our disability services office page links to the career services page.
/ Our international office page includes information about student groups that students can join.
/ Our human resources page includes information about affinity groups employees can join.
/ Our human resources page includes information about diversity training.
/ Every job listing on our human resources page includes an AA/EEO statement.
CHIEF DIVERSITY OFFICER'S ROLE (OR SIMILAR TITLE)
33. Please identify which, if any, of the following tactics your school uses to understand issues of campus climate, inclusion, and satisfaction. Check all that apply.
/ Climate survey for faculty — How often is this conducted? ______/ Climate survey for students — How often is this conducted? ______
/ Climate survey for administrative staff — How often is this conducted? ______
/ Satisfaction survey for students — How often is this conducted? ______
/ Satisfaction survey for employees — How often is this conducted? ______
/ Diversity mapping of school's capabilities
/ Diversity benchmarking efforts
/ Exit interviews for students
/ Exit interviews for employees
34. How is your chief diversity officer's role situated for success? Check all that apply.
/ We don't have a dedicated chief diversity officer./ Our chief diversity officer reports to the dean.
/ Our chief diversity officer position is an executive-level role.
/ Our chief diversity officer has a dedicated staff — How many? ______
/ Our chief diversity officer has other titles (e.g., Title IX coordinator, EEO officer) — Please list: ______
/ Our chief diversity officer has his/her own budget
/ Our chief diversity officer has a deciding vote on the diversity council.
/ Our chief diversity officer can attend board of trustee meetings to present the case for diversity.
/ Our chief diversity officer has input in the budget for his/her office.
35. Identify the employee resource or affinity groups you have at your school. Check all that apply.
/ African American/Black affinity group/ Hispanic/Latino affinity group
/ Asian American/Pacific Islander affinity group
/ LGBTQ affinity group
/ Disability affinity group
/ Religious-affiliated affinity groups
/ Veteran's affinity group
/ Women's affinity group
/ Native American affinity group
36. Does your school have or offer the following (currently or in the near future)? Check all that apply.
/ Gender-neutral bathrooms/ Same-sex partner healthcare benefits for employees
DIVERSITY PROGRESS
37. We would like to know the degree to which you have successfully increased minority and female representation at your school. Using the most recent information from your annual diversity report or campus climate survey, identify statements that apply to your school.
Less than 1% / 1-3% / 4-6% / 7-10% / 11-15% / Over 16% / N/AWe have increased the number of underrepresented minorities in full-time professor positions over the past five years. / / / / / / /
We have increased the number of women in full-time professor positions over the past five years. / / / / / / /
We have increased the number of underrepresented minorities in top administrative leadership positions over the past five years. / / / / / / /
We have increased the number of women in top leadership positions over the past five years. / / / / / / /
We have increased the number of full-time underrepresented minority students over the past five years. / / / / / / /
MISCELLANEOUS QUESTIONS
38. Please tell us how you first heard about the INSIGHT Into Diversity HEED Award?
/ Past award recipient or applicant/ Colleague
/ Search engine
/ Conference
/ INSIGHT Into Diversity newsletter
/ INSIGHT Into Diversity magazine
/ Other: ______
39. Why did you apply for the Health Professions HEED Award?
40. Do you have any feedback you would like to submit regarding the Health Professions HEED Award or this application?
OTHER APPLICATION INFORMATION The deadline to submit your Health Professions HEED Award application is July 15, 2016. If your school is selected as an INSIGHT Into Diversity Health Professions HEED Award recipient, you will be notified by Sept. 15, 2016. Each HEED Award recipient will receive a 2016 Health Professions HEED Award certificate and the 2016 Health Professions HEED Award logo. All Health Professions HEED Award recipients will be officially announced and featured in the December 2016 issue of INSIGHT Into Diversity magazine. If you would like to submit additional information to accompany this application, please email it to by the application deadline. Please make sure you print a copy of your completed application for your records. Thank you for applying for the 2016 INSIGHT Into Diversity Health Professions HEED Award!
You hereby certify as a representative of your school that the information submitted in this application is accurate and correct to the best of your ability.
Your name /Your title /
Your phone number /
Your email address /
CONTACT INFORMATION
Please provide contact information for your chief diversity officer or dean (or the person we should contact if your school is selected as a Health Professions HEED Award recipient).
Name (include credentials — e.g., PhD, JD) /Title /
Mailing address 1 (No P.O. boxes, please) /
Mailing address 2 /
City /
State /
Zip code /
Phone number /
Email address /
Please provide contact information for your director of marketing.
Name /Title /
Phone number /
Email address /
Please provide contact information for your director of public relations (if different from above).
Name /Title /
Phone number /
Email address /