Progress and persistent gaps in organizational climate in SAGES: a 2017-2023 survey comparison.

INTRODUCTION: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long prioritized fostering a diverse, equitable, and inclusive professional environment. In 2017, SAGES conducted its first organizational climate survey to assess members' experiences with inclusivity, mentorship, bias, and overall satisfaction. Overall results showed a positive climate; however, several key issues were identified. A follow-up survey in 2023 was conducted to evaluate the impact of improvement initiatives and identify ongoing areas for development. METHODS: This cross-sectional study utilized a validated climate survey instrument, adapted from the ADVANCE University of Michigan tool, to assess SAGES' organizational climate in 2023. Domains included overall society experience, mentorship, leadership opportunities, inclusivity, and experiences with bias or discrimination, rated on scale from 0 to 10, with 10 being completely agree. Responses were collected from SAGES committee members via an anonymous online survey. Data were analyzed using descriptive statistics and compared with 2017 results. Subgroup analyses examined differences by gender, race/ethnicity, sexual orientation, and practice type. Statistical tests included chi-squared, Wilcoxon rank-sum, one-way ANOVA, and Kruskall-Wallis as appropriate. Thematic analysis was performed on qualitative free-text responses. RESULTS: Survey response rate was 29.8% (223/747). Between 2017 and 2023, there were overall trends toward improved satisfaction with SAGES membership on a 10-point Likert scale (7.5 ± 2.1 vs. 9.0 ± 1.3, p < 0.01), improved transparency for leadership and advancement (6.6 ± 2.5 vs. 7.8 ± 2.5, p < 0.01), reduced discrimination based on gender (7.9 ± 2.5 vs. 8.3 ± 2.4, p = 0.03) and race/ethnicity (7.8 ± 2.6 vs. 8.5 ± 2.4, p < 0.01). Subgroup analysis revealed persistent gaps in experiences based on gender and race/ethnicity. Females still reported slightly less positive perception overall compared to their male counterparts (1.7 ± 2.5 vs. 1.1 ± 2.3, p < 0.01) and were also more likely to desire gender-congruent mentors (6.1 ± 2.6 vs. 5.3 ± 2.9, p < 0.01). Racial and ethnic minorities reported higher levels of scrutiny than non-minorities (1.9 ± 2.5 vs. 1.2 ± 1.7, p = 0.02). CONCLUSION: Longitudinal comparison of the 2017 and 2023 SAGES Climate Surveys demonstrates improvements in members' perceptions of inclusion, satisfaction, and equity. Despite these gains and overall positive perception of culture, differences in how members perceive culture remain. This underscores the need for ongoing, deliberate strategies to foster an environment of belonging. Regular climate assessments remain essential to guide continued progress and accountability.