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Menchetti I, Eagles D, Ghanem D, Leppard J, Fournier K, Cheung WJ. Gender differences in emergency medicine resident assessment: A scoping review. AEM EDUCATION AND TRAINING 2022; 6:e10808. [PMID: 36189450 PMCID: PMC9513437 DOI: 10.1002/aet2.10808] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 05/26/2023]
Abstract
Background Growing literature within postgraduate medical education demonstrates that female resident physicians experience gender bias throughout their training and future careers. This scoping review aims to describe the current body of literature on gender differences in emergency medicine (EM) resident assessment. Methods We conducted a scoping review which adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. We included research involving resident physicians or fellows in EM (population and context), which focused on the impact of gender on assessments (concept). We searched seven databases from the databases' inception to April 4, 2022. Two reviewers independently screened citations, completed full-text review, and abstracted data. A third reviewer resolved any discrepancies. Results A total of 667 unique citations were identified; 10 studies were included, and all were conducted within the United States. Four studies reported differences in EM resident assessments attributable to gender within workplace-based assessments (qualitative comments and quantitative scores) by both attending physicians and nonphysicians. Six studies investigating clinical competency committee scores, procedural scores, and simulation-based assessments did not report any significant differences attributable to gender. Conclusions This scoping review found that gender bias exists within EM resident assessment most notably at the level of narrative comments typically received via workplace-based assessments. As female EM residents receive higher rates of negative or critical comments and discordant feedback documented on assessment, these findings raise concern about added barriers female EM residents may face while progressing through residency and the impact on their clinical and professional development.
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Affiliation(s)
| | - Debra Eagles
- Department of Emergency MedicineUniversity of OttawaOttawaOntarioCanada
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
| | - Dana Ghanem
- Faculty of MedicineUniversity of OttawaOttawaOntarioCanada
| | - Jennifer Leppard
- Department of Emergency MedicineUniversity of OttawaOttawaOntarioCanada
| | - Karine Fournier
- Health Sciences LibraryUniversity of OttawaOttawaOntarioCanada
| | - Warren J. Cheung
- Department of Emergency MedicineUniversity of OttawaOttawaOntarioCanada
- Royal College of Physicians and Surgeons of CanadaOttawaOntarioCanada
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Stavely T, Salhi BA, Lall MD, Zeidan A. "I just assume they don't know that I'm the doctor": Gender bias and professional identity development of women residents. AEM EDUCATION AND TRAINING 2022; 6:e10735. [PMID: 35368505 PMCID: PMC8939042 DOI: 10.1002/aet2.10735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The increasing entry of women into medicine, a traditionally male-gendered institution, has revealed much about the gendered politics of medical practice. Women are required to negotiate conflicting gender-normative roles and expectations as they develop their professional identities. Relatively little is known with regard to the study of gender identity and professional development in emergency medicine (EM), with even fewer studies specifically examining women EM residents. METHODS This was a qualitative, semistructured interview study conducted at the Emory University Emergency Medicine Residency. Women residents in their first, second, and third years of training were recruited for participation through residency listservs. Interviews were completed using a virtual platform until thematic saturation was reached. Interviews were recorded, professionally transcribed, and coded by two study investigators. The study team met throughout the process to identify codes and themes from the interviews. RESULTS A total of 11 interviews were completed. Participants self-identified as Black (five), White (two), biracial (two). and South Asian (two) and represented all levels of training. Participants identified challenges to providing clinical care and conveying their competency related to their gender and role as physicians in training. Common challenges included role confusion and questioning of their decisions by both patients and colleagues. They identified other aspects of their identity as facilitators for care delivery, specifically race as a facilitator when caring for race-concordant patients. Participants described strategies developed to navigate gender-specific challenges including routinely providing justification for their clinical decisions. Participants also described a need for interventions at the departmental and institutional levels to improve allyship and bystander behaviors. CONCLUSION Women residents actively negotiate tensions between their gender and role as physicians and develop multifaceted strategies to address challenges in care delivery. Because residency training is a challenging yet formative time in developing one's professional identity, it is important to consider interventions that support women residents and the unique challenges they face.
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Affiliation(s)
- Taylor Stavely
- Department of Emergency MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Bisan A. Salhi
- Department of Emergency MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Michelle D. Lall
- Department of Emergency MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Amy Zeidan
- Department of Emergency MedicineEmory University School of MedicineAtlantaGeorgiaUSA
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McIlveen-Brown E, Morris J, Lim R, Johnson K, Byrne A, Bischoff T, Hurley K, Mann M, Menchetti I, Pardhan A, Pham C, Sheppard G, Zia A, Chan TM. Priority strategies to improve gender equity in Canadian emergency medicine: proceedings from the CAEP 2021 Academic Symposium on leadership. CAN J EMERG MED 2022; 24:151-160. [PMID: 35034336 DOI: 10.1007/s43678-021-00245-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 11/24/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Gender inequities are deeply rooted in our society and have significant negative consequences. Female physicians experience numerous gender-related inequities (e.g., microaggressions, harassment, violence). These inequities have far-reaching consequences on health, well-being and career longevity and may result in the devaluing of various strengths that female emergency physicians bring to the table. This, in turn, has an impact on patient healthcare experience and outcomes. During the 2021 Canadian Association of Emergency Physicians (CAEP) Academic Symposium, a national collaborative sought to understand gender inequities in emergency medicine in Canada. METHODS We used a multistep stakeholder-engagement-based approach (harnessing both quantitative and qualitative methods) to identify and prioritize problems with gender equity in emergency medicine in Canada. Based on expert consultation and literature review, we developed recommendations to effect change for the higher priority problems. We then conducted a nationwide consultation with the Canadian emergency medicine community via online engagement and the CAEP Academic Symposium to ensure that these priority problems and solutions were appropriate for the Canadian context. CONCLUSION Via the above process, 15 recommendations were developed to address five unique problem areas. There is a dearth of research in this important area and we hope this preliminary work will serve as a starting point to fuel further research. To facilitate these scholarly endeavors, we have appended additional documents identifying other key problems with gender equity in emergency medicine in Canada as well as proposed next steps for future research.
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Affiliation(s)
- Emma McIlveen-Brown
- Discipline of Emergency Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B3V6, Canada.
| | - Judy Morris
- Department of Family and Emergency Medicine, Université de Montréal, Montreal, QC, Canada
| | | | - Kirsten Johnson
- Department of Emergency Medicine, McGill University, Montreal, QC, Canada
| | | | - Taylor Bischoff
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Miriam Mann
- Stratford General Hospital, Western University, London, ON, Canada
| | - Isabella Menchetti
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Alim Pardhan
- Division of Emergency Medicine, Departments of Medicine and Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Chau Pham
- Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Gillian Sheppard
- Discipline of Emergency Medicine, Memorial University, St. John's, NL, Canada
| | - Ayesha Zia
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Teresa M Chan
- Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada
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