Open call: interested in working on diversity, inclusion, mentorship and sponsorship topics for AO?

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* 1. Please complete your contact information:

Name

Institution/university

Address

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Should I not be offered a position at this time, I agree to be contacted in the future for any AO Access related engagement opportunity.

Yes

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* 3. To which AO clinical division/unit/institute do you belong?

Other (please specify)

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* 4. In which AO geographical region do you reside?

Other (please specify)

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* 5. How do you define your ethnicity?

Black

Native American/Indigenous People/First Nations or Alaska Native

Hispanic/Latin American

Eastern Asian

Pacific Islander

Middle Eastern

White/Caucasian

Southern Asian

Central Asian

North African

Bi- or multiracial

Prefer not to answer

Prefer to self describe

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* 6. What best describes your gender?

Woman

Man

Non-binary

I do not wish to disclose

Prefer to self-describe

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* 7. Which of the following identified focus areas are you interested in potentially collaborating (please choose a maximum of two):

1. Faculty and leader development: Integrate education on diversity & inclusion, unconscious bias, mentorship and sponsorship into faculty development programs

2. Officer & faculty selection processes: Change officer & faculty selection processes to ensure groups are diverse

3. Mentorship & sponsorship: Assess value and impact of existing sponsorship & mentor/mentee relationships in the AO

4. AO staff selection & development: Become recognized and certified as inclusive and diverse organization and change internal processes, policies and documentation to create diverse and inclusive environment

5. Communications: Create and implement communications plan(s) on initiative: Assess and adapt communication style and appearance (non-agentic language, inclusive visuals – to be applied to internal and external communications). Use of Social Media for diversity & inclusion, mentorship & sponsorship purposes.

6. Outreach: Implement outreach programs to junior stakeholders and groups not yet part of the AO and set up outreach programs to children to encourage them to engage in orthopedic surgery professions

7. Collaborations & partnerships: Establish partnerships and collaboration with organizations with similar initiatives/projects

Other (please specify)

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* 8. What is your self-assessed expertise and/or experience with diversity and inclusion?

None

Low

Medium

High

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* 9. What is your self-assessed expertise and/or experience with mentorship/sponsorship?

None

Low

Medium

High

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* 10. List any recent (within the last 5 years) examples of diversity/inclusion and/or mentorship/sponsorship activities in which you have been involved:

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* 11. Describe your motivation to working on diversity/inclusion and/or mentorship/sponsorship projects:

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* 12. Are you currently enrolled and/or have you completed the AO Access ‘Interrupting your unconscious biases’ online learning module?

Yes