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The importance of Diversity, Equity, and Inclusion (DEI) has become increasingly acknowledged within healthcare. Improving DEI leads to more inclusiveness for employees at their workplace which in return can lead to better work engagement, retention, and wellbeing. A recent project on DEI among radiation oncology (RO) professionals, highlighted low levels of inclusion and work engagement in Europe. As a follow-up study, a qualitative study was performed among RO professionals in Europe. Qualitative research methods can be used to explore causal relations as opposed to identifying correlations usually achieved by quantitative studies. The goal of the current qualitative study was to gain a deeper understanding of the underlying mechanisms that explain the low levels of DEI experienced by RO professionals in Europe and propose recommendations to improve DEI within RO departments.

A qualitative research study was conducted that enrolled RO professionals from four selected European countries through an open call within the ESTRO platform. Great Britain, Italy, Poland, and Switzerland were specifically selected based on the high number of respondents who completed the initial survey (1). Differences in DEI scores from the initial survey, geographical location in Europe, and cultural traditions were also taken into consideration to capture the heterogeneity of the community. Respondents who filled in an online survey and met the inclusion criteria were invited for an online semi-structured interview. To learn specifically about low DEI situations, the following inclusion criteria were used: being a RO professional who experienced low DEI levels (answering more than 3 times ‘disagree’ in the survey question) and agreed on publishing data. Interview transcripts were analysed thematically with an abductive approach via concepts in relation to “DEI”, “work engagement”, “organisational culture” and “professional values”.

Twenty-six respondents were interviewed (Table 1). The thematic analysis identified limited engagement at work when the personal values of RO professionals conflicted with dominant organisational values, thereby hampering DEI. Three types of value conflicts were found between personal vs. organisational values: 1) self-development vs. efficiency, 2) togetherness vs. competition, and 3) people-oriented vs. task-oriented values. Situations with low levels of DEI often showed an imbalance between these three doublets of organisational vs. personal values (Figure 1).

This qualitative study showed the importance of power balance in managing conflicting values (personal vs. organisational) within RO departments. To improve DEI and engagement in the workplace, more attention should be paid to personal values as self-development, togetherness, and people-orientation and finding a balance with their organisational values counterpart efficiency, competition, and task-orientation.

1. Gasnier et al (2022), Radiother Oncol., doi:10.1016/j.radonc.2022.04.011