{"id":3437,"date":"2021-07-01T11:30:58","date_gmt":"2021-07-01T15:30:58","guid":{"rendered":"https:\/\/health.uconn.edu\/occupational-environmental\/?page_id=3437"},"modified":"2021-09-03T08:47:55","modified_gmt":"2021-09-03T12:47:55","slug":"diversity-and-inclusion-questionnaire","status":"publish","type":"page","link":"https:\/\/health.uconn.edu\/occupational-environmental\/diversity-and-inclusion-questionnaire\/","title":{"rendered":"Diversity and Inclusion Questionnaire"},"content":{"rendered":"<div id=\"pl-3437\" class=\"panel-layout\">\n<div id=\"pg-3437-0\" class=\"panel-grid panel-no-style\">\n<div id=\"pgc-3437-0-0\" class=\"panel-grid-cell\" data-weight=\"1\">\n<div id=\"panel-3437-0-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"0\" data-style=\"{&quot;background_image_attachment&quot;:false,&quot;background_display&quot;:&quot;tile&quot;,&quot;accordion&quot;:&quot;&quot;}\">\n<div class=\"textwidget\">\n<h3>The Department of Medicine is committed to improving the diversity of its clinical faculty, while simultaneously promoting a culture of inclusivity. Your voluntary participation in this brief survey will assist our effort to attract a more diverse applicant pool for open faculty positions. We appreciate your opinion and value the time taken to complete this brief survey.<\/h3>\n<\/div>\n<div><\/div>\n<\/div>\n<div><\/div>\n<div><script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_17' style='display:none'>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_17'  action='\/occupational-environmental\/wp-json\/wp\/v2\/pages\/3437' data-formid='17' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_17' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_17_15\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_15'><span class='gform-field-label__text'>Email<\/span><\/label><div class='ginput_container'><input name='input_15' id='input_17_15' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_17_15'>This field is for validation purposes and should be left unchanged.<\/div><\/li><li id=\"field_17_1\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>1.\tHave you experienced any challenges regarding your race, sex, and ethnicity when working with faculty, colleagues and other mentors here at UConn?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_17_1'>\n\t\t\t<li class='gchoice gchoice_17_1_0'>\n\t\t\t\t<input name='input_1' type='radio' value='Yes'  id='choice_17_1_0'    \/>\n\t\t\t\t<label for='choice_17_1_0' id='label_17_1_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_1_1'>\n\t\t\t\t<input name='input_1' type='radio' value='No'  id='choice_17_1_1'    \/>\n\t\t\t\t<label for='choice_17_1_1' id='label_17_1_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_17_5\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_5'><span class='gform-field-label__text'>If yes, please describe these challenges.<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_5' id='input_17_5' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_17_2\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>2.\tHave you experienced any challenges accessing appropriate professional academic mentorship and guidance?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_17_2'>\n\t\t\t<li class='gchoice gchoice_17_2_0'>\n\t\t\t\t<input name='input_2' type='radio' value='Yes'  id='choice_17_2_0'    \/>\n\t\t\t\t<label for='choice_17_2_0' id='label_17_2_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_2_1'>\n\t\t\t\t<input name='input_2' type='radio' value='No'  id='choice_17_2_1'    \/>\n\t\t\t\t<label for='choice_17_2_1' id='label_17_2_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_17_6\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_6'><span class='gform-field-label__text'>If yes, please describe these challenges.<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_6' id='input_17_6' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_17_4\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>3.\tHave you experienced any challenges related to trust, organizational expectations, or empathy among mentors, faculty and colleagues?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_17_4'>\n\t\t\t<li class='gchoice gchoice_17_4_0'>\n\t\t\t\t<input name='input_4' type='radio' value='Yes'  id='choice_17_4_0'    \/>\n\t\t\t\t<label for='choice_17_4_0' id='label_17_4_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_4_1'>\n\t\t\t\t<input name='input_4' type='radio' value='No'  id='choice_17_4_1'    \/>\n\t\t\t\t<label for='choice_17_4_1' id='label_17_4_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_17_7\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_7'><span class='gform-field-label__text'>If yes, please describe these challenges.<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_7' id='input_17_7' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_17_8\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>4.\tHas your program directly emphasized the importance of diversity and inclusion for residents\/fellows?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_17_8'>\n\t\t\t<li class='gchoice gchoice_17_8_0'>\n\t\t\t\t<input name='input_8' type='radio' value='Yes'  id='choice_17_8_0'    \/>\n\t\t\t\t<label for='choice_17_8_0' id='label_17_8_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_8_1'>\n\t\t\t\t<input name='input_8' type='radio' value='No'  id='choice_17_8_1'    \/>\n\t\t\t\t<label for='choice_17_8_1' id='label_17_8_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_17_9\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_9'><span class='gform-field-label__text'>If yes, please provide a few examples.<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_9' id='input_17_9' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_17_10\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_10'><span class='gform-field-label__text'>5.\tPlease describe your expectations with respect to the kind of support you need for your career advancement.<\/span><\/label><div class='ginput_container ginput_container_textarea' data-text-counter-max='500' data-text-counter-template='{current} of {max} max characters'><textarea name='input_10' id='input_17_10' class='textarea medium'   maxlength='500'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_17_12\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_12'><span class='gform-field-label__text'>6. How can we improve diversity and inclusion at UConn Health?<\/span><\/label><div class='ginput_container ginput_container_textarea' data-text-counter-max='500' data-text-counter-template='{current} of {max} max characters'><textarea name='input_12' id='input_17_12' class='textarea medium'   maxlength='500'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_17_13\" class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_13'><span class='gform-field-label__text'>7. How likely are you to accept an offer of employment at UConn Health upon your graduation from training?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_17_13' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Very Likely' >Very Likely<\/option><option value='Somewhat Likely' >Somewhat Likely<\/option><option value='Not Sure' >Not Sure<\/option><option value='Unlikely' >Unlikely<\/option><option value='Very Unlikely' >Very Unlikely<\/option><\/select><\/div><\/li><li id=\"field_17_14\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_14'><span class='gform-field-label__text'>8. 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Your voluntary participation in this brief survey will assist our effort to attract a more diverse applicant pool for open faculty positions. We appreciate your opinion and value the time taken to complete this [&hellip;]<\/p>\n","protected":false},"author":210,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-3437","page","type-page","status-publish","hentry"],"acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-11-04 16:30:34","action":"change-status","newStatus":"draft","terms":[],"taxonomy":""},"_links":{"self":[{"href":"https:\/\/health.uconn.edu\/occupational-environmental\/wp-json\/wp\/v2\/pages\/3437","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/health.uconn.edu\/occupational-environmental\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/health.uconn.edu\/occupational-environmental\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/health.uconn.edu\/occupational-environmental\/wp-json\/wp\/v2\/users\/210"}],"replies":[{"embeddable":true,"href":"https:\/\/health.uconn.edu\/occupational-environmental\/wp-json\/wp\/v2\/comments?post=3437"}],"version-history":[{"count":16,"href":"https:\/\/health.uconn.edu\/occupational-environmental\/wp-json\/wp\/v2\/pages\/3437\/revisions"}],"predecessor-version":[{"id":3570,"href":"https:\/\/health.uconn.edu\/occupational-environmental\/wp-json\/wp\/v2\/pages\/3437\/revisions\/3570"}],"wp:attachment":[{"href":"https:\/\/health.uconn.edu\/occupational-environmental\/wp-json\/wp\/v2\/media?parent=3437"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}