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2024-01-25news-articleNews<p>In an international survey of female healthcare professionals, researchers at Spaulding Rehabilitation Hospital found that a greater sense of workplace "belonging" was quantifiably related to reduced reported likelihood of leaving one's current institution within the next two years.</p>

Sense of Belonging Reduces Likelihood That Female Healthcare Professionals May Leave Their Workplace

January 25,  2024


  • This cross-sectional survey was the first study to assess the multidimensional experience of workplace "belonging" among female healthcare professionals in relation to their likelihood of leaving their institution
  • An increase in the cumulative number of workplace belonging experiences was associated with a significant reduction in the reported likelihood of leaving within the next two years (OR, 0.68; P<0.0001)
  • In a full regression model, the odds of leaving were significantly reduced among participants who endorsed "believing I can thrive professionally" (OR, 0.40; P<0.001) and "having input into work-related policies" (OR, 0.62; P<0.05)
  • When only belonging experiences were considered, "believing I can thrive professionally" was still the top predictor of the reported likelihood of leaving or staying
  • Among underrepresented minorities, the reported likelihood of leaving depended on both years working in the healthcare institution and the experience of workplace belonging

The experience of workplace "belonging" is multidimensional. It includes interpersonal connections with colleagues, feeling supported to do one's best work, feeling valued and appropriately rewarded for work, and believing that one's values align with the organization's mission.

Researchers at Spaulding Rehabilitation recently demonstrated in the Journal of Healthcare Leadership that the experience of workplace belonging across multiple dimensions is a key factor in retaining female healthcare professionals.

The authors are Judith D. Schaechter, PhD, a health equity research scientist in the Department of Physical Medicine and Rehabilitation at Spaulding, Richard Goldstein, PhD, a lecturer in that Department, Ross D. Zafonte, DO, president of Spaulding Rehabilitation and the Earle P. and Ida S. Charlton professor and chair of the Harvard Medical School Department of Physical Medicine and Rehabilitation, and Julie K. Silver, MD, associate professor of physical medicine and rehabilitation at Spaulding.


The researchers offered a brief online survey to 856 attendees of a course on women's leadership skills in healthcare, held virtually from November 3 to 5, 2022. From a list of 10 items, respondents were asked to select all aspects of belonging they were experiencing in their current workplace:

  • Feeling valued by my colleagues
  • Feeling valued by my supervisor(s)
  • Feeling psychologically safe
  • Believing that I am being treated equitably
  • Having input into work-related policies
  • Feeling empowered to contribute to the success of my workplace
  • Seeing diversity and inclusion
  • Believing I can thrive professionally
  • Believing that my professional advancement is supported
  • Believing that my personal values are consistent with the values of my workplace

The final choice was, "I am not experiencing any aspect of belonging listed above."

The survey also asked participants how likely they were to leave their current institution within two years, using a five-point Likert scale.

366 course attendees (43%) responded to the survey. 361 identified as female, one as nonbinary, and four did not report their gender. 92% reported working in the U.S., and 63% said their primary role is as clinicians. 41% did not identify as "White or European American," as "heterosexual/straight," and/or as either "woman" or "man" and were thus classified as underrepresented minorities (URM).

Belonging Factors

"Feeling valued by my colleagues" was the aspect of belonging reported most frequently (70% of cohort). The least frequent was "Believing that I am being treated equitably" (31% of cohort).

Likelihood of Leaving

61% of respondents reported at least a slight likelihood of leaving their institution within two years. URM respondents reported a lower likelihood of leaving than non-URM respondents when employed in their current workplace for <1 year or >20 years, after adjustment for the cumulative experience of belonging.

Regression Analyses

The cumulative experience of workplace belonging was significantly associated with the reported likelihood of leaving (OR, 0.68; P<0.0001). Said another way, for each unit increase in the number of belonging factors experienced (e.g., from one to two), there was a 32% decrease in the odds of reporting a higher category of attrition risk (e.g., lower odds of being "extremely likely" to leave vs. "very likely" to leave).

In a model that considered belonging factors, URM status, years of working in the current workplace, and interactions between the latter two covariates, the odds of leaving were significantly reduced among participants who endorsed "believing I can thrive professionally" (OR, 0.40, P<0.001) and "having input into work-related policies" (OR, 0.62; P< 0.05).

When predictors of leaving were ranked only by belonging factors, "believing I can thrive professionally," "having input into work-related policies," and "feeling psychologically safe" were the first, second, and third most important. Psychological safety in the workplace has been defined as the belief that one can express personal ideas and concerns, ask questions and admit mistakes without fear of negative consequences.

Laying the Groundwork

It will be worthwhile to test whether interventions that strengthen workplace belonging, with an emphasis on empowering professional thriving and improving open communication, improve retention of women in healthcare organizations.

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