{"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 type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\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_1\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_17_1\" ><label class='gfield_label gform-field-label' >1.\tHave you experienced any challenges regarding your race, sex, and ethnicity when working with faculty, colleagues and other mentors here at UConn?<\/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\"  data-js-reload=\"field_17_5\" ><label class='gfield_label gform-field-label' for='input_17_5'>If yes, please describe these challenges.<\/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\"  data-js-reload=\"field_17_2\" ><label class='gfield_label gform-field-label' >2.\tHave you experienced any challenges accessing appropriate professional academic mentorship and guidance?<\/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\"  data-js-reload=\"field_17_6\" ><label class='gfield_label gform-field-label' for='input_17_6'>If yes, please describe these challenges.<\/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\"  data-js-reload=\"field_17_4\" ><label class='gfield_label gform-field-label' >3.\tHave you experienced any challenges related to trust, organizational expectations, or empathy among mentors, faculty and colleagues?<\/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\"  data-js-reload=\"field_17_7\" ><label class='gfield_label gform-field-label' for='input_17_7'>If yes, please describe these challenges.<\/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\"  data-js-reload=\"field_17_8\" ><label class='gfield_label gform-field-label' >4.\tHas your program directly emphasized the importance of diversity and inclusion for residents\/fellows?<\/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\"  data-js-reload=\"field_17_9\" ><label class='gfield_label gform-field-label' for='input_17_9'>If yes, please provide a few examples.<\/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\"  data-js-reload=\"field_17_10\" ><label class='gfield_label gform-field-label' for='input_17_10'>5.\tPlease describe your expectations with respect to the kind of support you need for your career advancement.<\/label><div class='ginput_container ginput_container_textarea'><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\"  data-js-reload=\"field_17_12\" ><label class='gfield_label gform-field-label' for='input_17_12'>6. How can we improve diversity and inclusion at UConn Health?<\/label><div class='ginput_container ginput_container_textarea'><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\"  data-js-reload=\"field_17_13\" ><label class='gfield_label gform-field-label' for='input_17_13'>7. How likely are you to accept an offer of employment at UConn Health upon your graduation from training?<\/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\"  data-js-reload=\"field_17_14\" ><label class='gfield_label gform-field-label' for='input_17_14'>8. 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