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Rowe DG, Dalton JC, Ladowski JM, Soto AL, Rhodin KE, Migaly J, Greenberg JA, Tracy ET. Prior Teaching Experience and Barriers to Effective Resident Teaching: A Cross-Sectional Study. J Surg Res 2024; 301:371-377. [PMID: 39029259 DOI: 10.1016/j.jss.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/16/2024] [Accepted: 06/16/2024] [Indexed: 07/21/2024]
Abstract
INTRODUCTION Resident physicians play an important role in teaching the next generation of health-care providers, yet limited research has explored factors influencing effective teaching, such as preresidency experiences or barriers within residency. This study examines residents' prior teaching experience, its correlation with teaching attitudes, and identifies potential barriers to sustained teaching engagement. METHODS This cross-sectional study surveyed residents across multiple specialties at a single academic center. The survey assessed preresidency teaching experience, perceived barriers, and attitudes toward teaching. Univariate and multivariate analyses identified differences in teaching attitudes based on prior teaching experience and gender. RESULTS Ninety-two residents across 11 specialties participated (52.2% female). Internal Medicine (28.3%) and General Surgery (26.1%) had the highest representation. Two-thirds of respondents (69.6%) had formal teaching experience before residency. After adjustment, prior teaching experience and male gender were associated with feeling prepared to teach medical students (P = 0.014 and P = 0.001). Male gender was also linked to confidence in teaching material on the wards (P = 0.015). Barriers identified included time constraints (73.9%), lack of content clarity (28.3%), and uncertainty about teaching methods (33.7%). CONCLUSIONS Residents with prior teaching experience exhibit higher levels of preparedness, content clarity, and confidence in their teaching abilities, underscoring the importance of teaching experience before residency. This study also identified significant barriers to effective teaching, including time constraints, lack of content clarity, uncertainty about teaching methods, and perceived disinterest from medical students. Addressing these barriers is essential for optimizing medical student education.
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Affiliation(s)
- Dana G Rowe
- Duke University School of Medicine, Durham, North Carolina.
| | | | - Joseph M Ladowski
- Department of Surgery, Duke University Hospital, Durham, North Carolina
| | | | - Kristen E Rhodin
- Department of Surgery, Duke University Hospital, Durham, North Carolina
| | - John Migaly
- Department of Surgery, Duke University Hospital, Durham, North Carolina
| | - Jacob A Greenberg
- Department of Surgery, Duke University Hospital, Durham, North Carolina
| | - Elisabeth T Tracy
- Department of Surgery, Duke University Hospital, Durham, North Carolina
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Chockalingam L, Keniston A, McBeth L, Mutter M. A patient follow-up intervention to improve medical decision making at an internal medicine residency program. Diagnosis (Berl) 2024; 11:142-150. [PMID: 38310520 DOI: 10.1515/dx-2023-0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/11/2024] [Indexed: 02/06/2024]
Abstract
OBJECTIVES Practice-based learning and improvement (PBLI) is an ACGME (Accreditation Council for Graduate Medical Education) core competency. Learning and reflecting on patients through follow-up is one method to help achieve this competency. We therefore designed a study evaluating a structured patient follow-up intervention for senior internal medicine (IM) residents at the University of Colorado Hospital (UCH). METHODS Trainees completed structured reflections after performing chart review of prior patients during protected educational time. Two-month follow-up surveys evaluated the exercise's potential influence on clinical and reflective practices. RESULTS Forty out of 108 (37 %) eligible residents participated in the exercise. Despite 62.5 % of participants lacking specific questions about patient outcomes before chart review, 81.2 % found the exercise at least moderately helpful. 48.4 % of participants believed that the review would change their practice, and 60.9 % felt it reinforced their existing clinical practices. In our qualitative data, residents learned lessons related to challenging clinical decisions, improving transitions of care, the significance of early goals of care conversations, and diagnostic errors/strategies. CONCLUSIONS Our results indicate that IM residents found a structured patient follow-up intervention educational, even when they lacked specific patient outcomes questions. Our results underscore the importance of structured self-reflection in the continuous learning process of trainees and suggest the benefit of dedicated educational time for this process.
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Affiliation(s)
- Leela Chockalingam
- Department of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Angela Keniston
- Department of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Lauren McBeth
- Department of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Marina Mutter
- Department of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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Klein R, Snyder ED, Koch J, Volerman A, Alba-Nguyen S, Julian KA, Thompson V, Ufere NN, Burnett-Bowie SAM, Kumar A, White BAA, Park YS, Palamara K. Exploring gender and thematic differences in qualitative assessments of internal medicine resident performance. BMC MEDICAL EDUCATION 2023; 23:932. [PMID: 38066551 PMCID: PMC10709833 DOI: 10.1186/s12909-023-04917-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Evidence suggests gender disparities in medical education assessment, including differences in ratings of competency and narrative comments provided in resident performance assessments. This study explores how gender manifests within the content of qualitative assessments (i.e., narrative comments or performance feedback) of resident performance. METHODS Qualitative content analysis was used to explore gender-based differences in narrative comments included in faculty assessments of resident performance during inpatient medicine rotations at six Internal Medicine residency programs, 2016-2017. A blinded, multi-analyst approach was employed to identify themes across comments. Patterns in themes with resident gender and post-graduate year (PGY) were explored, focusing on PGY2 and PGY3 when residents are serving in the team leader role. RESULTS Data included 3,383 evaluations with narrative comments of 385 men (55.2%) and 313 women residents (44.8%). There were thematic differences in narrative comments received by men and women residents and how these themes manifested within comments changed with training time. Compared to men, comments about women had a persistent relationship-orientation and emphasized confidence over training including as interns and in PGY2 and PGY3, when serving as team leader. The relationship-orientation was characterized not only by the residents' communal attributes but also their interpersonal and communication skills, including efforts supporting others and establishing the tone for the team. Comments about women residents often highlighted confidence, including recommendations around behaviors that convey confidence in decision-making and team leadership. DISCUSSION There were gender-based thematic differences in qualitative assessments. Comments about women resident team leaders highlight relationship building skills and urge confidence and actions that convey confidence as team leader. Persistent attention to communal skills suggests gendered expectations for women resident team leaders and a lost opportunity for well-rounded feedback to the disadvantage of women residents. These findings may inform interventions to promote equitable assessment, such as providing feedback across the competencies.
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Affiliation(s)
- Robin Klein
- Emory University School of Medicine, Atlanta, GA, USA.
| | - Erin D Snyder
- Department of Medicine, Division of General Internal Medicine, University of Alabama Birmingham School of Medicine, Birmingham, AL, USA
| | - Jennifer Koch
- Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Anna Volerman
- Departments of Medicine and Pediatrics, University of Chicago, Chicago, IL, USA
| | - Sarah Alba-Nguyen
- Department of Medicine, Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Katherine A Julian
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Vanessa Thompson
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Nneka N Ufere
- Department of Medicine, Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Anshul Kumar
- Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA
| | | | - Yoon Soo Park
- Department of Medical Education, University of Illinois, Chicago, IL, USA
| | - Kerri Palamara
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
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Fiorellino O, Newman CJ. Physicians' Self-Perceived Competence on Breaking Bad News to Parents of Children with Neurodisabilities. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1854. [PMID: 38136056 PMCID: PMC10741853 DOI: 10.3390/children10121854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023]
Abstract
Delivering difficult news to parents of children with neurodisabilities, often involving new diagnoses, prognosis changes, or declines in function or health, presents a complex task. Our aim was to assess physicians' self-perceived competence in breaking bad news (BBN) within this context. An online survey was administered to neuropediatricians and developmental and rehabilitation pediatricians in Switzerland. Among 247 invited physicians, 62 (25.1%) responded (age of 51 ± 11 years; M/F ratio of 2:3). They rated their BBN competence at 7.5 ± 1.6 out of 10. Factors significantly associated with self-perceived competence in uni- and multivariate analyses included years of professional experience (≤10 years: 6.2 ± 1.8; >10 years: 8.2 ± 0.8), and region of pregraduate training (Switzerland: 7.3 ± 1.6; European Union: 8.3 ± 0.9). The respondents highlighted the positive roles of professional and personal experience, quality relationships with families, and empathy in BBN. In summary, physicians generally expressed a sense of competence in delivering difficult news to parents of children with neurodisabilities. They underscored the significance of life experiences and certain individual qualities in their effectiveness. These findings provide valuable insights into enhancing professional training and support in this crucial yet underexplored aspect of medical practice.
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Affiliation(s)
- Ophélie Fiorellino
- Faculty of Science and Medicine, Medicine Section, University of Fribourg, 1700 Fribourg, Switzerland;
| | - Christopher John Newman
- Pediatric Neurology and Neurorehabilitation Unit, Woman Mother Child Department, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
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Kilic O, Riecher-Rössler A, Galderisi S, Gorwood P, Frangou S, Pinto da Costa M. The role of gender as a barrier to the professional development of psychiatrists. Eur Psychiatry 2023; 66:e89. [PMID: 37848403 PMCID: PMC10755565 DOI: 10.1192/j.eurpsy.2023.2462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Despite efforts toward greater gender equality in clinical and academic psychiatry in recent years, more information is needed about the challenges in professional development within psychiatry, and how these may vary with gender. METHODS A cross-sectional 27-item online survey was conducted with psychiatrists and psychiatric trainee members of the European Psychiatric Association. RESULTS A total of 561 psychiatrists and psychiatric trainees from 35 European countries participated representing a response rate of 52.8% for women and 17.7% for men from a total sample of 1,580. The specific challenges that women face in their professional development fall into two categories. One comprised women's negative attitudes concerning their abilities in self-promotion and networking. The other identified environmental barriers related to lack of opportunity and support and gender discrimination. Compared to men, women reported higher rates of gender discrimination in terms of professional advancement. Women were less likely to agree that their institutions had regular activities promoting inclusion, diversity, and training to address implicit gender bias. Working in high-income countries compared to middle-income countries relates to reporting institutional support for career progression. CONCLUSIONS These findings are an open call to hospital leaders, deans of medical schools, and department chairs to increase efforts to eradicate bias against women and create safer, inclusive, and respectful environments for all psychiatrists, a special call to women psychiatrists to be aware of inner tendencies to avoid self-promotion and networking and to think positively and confidently about themselves and their abilities.
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Affiliation(s)
- Ozge Kilic
- Department of Psychiatry, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey
| | | | - Silvana Galderisi
- Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Philip Gorwood
- Université Paris Cité, GHU Paris Psychiatrie et Neurosciences, CMME, Hôpital Sainte-Anne, Paris, France
- Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Mariana Pinto da Costa
- South London & Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology & Neuroscience, King’s College of London, London, UK
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
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Does writing style affect gender differences in the research performance of articles?: An empirical study of BERT-based textual sentiment analysis. Scientometrics 2023; 128:2105-2143. [PMID: 37095862 PMCID: PMC9991882 DOI: 10.1007/s11192-023-04666-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/16/2023] [Indexed: 03/10/2023]
Abstract
“Achieve gender equality and empower all women and girls” is essential to reduce gender disparity and improve the status of women. But it remains a challenge to narrow gender differences and improve gender equality in academic research. In this paper, we propose that the impact of articles is lower and writing style of articles is less positive when the article’s first author is female relative to male first authors, and writing style mediates this relationship. Focusing on the positive writing style, we attempt to contribute and explain the research on gender differences in research performance. We use BERT-based textual sentiment analysis to analyse 87 years of 9820 articles published in the top four marketing journals and prove our hypotheses. We also consider a set of control variables and conduct a set of robustness checks to ensure the robustness of our findings. We discuss the theoretical and managerial implications of our findings for researchers.
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Karani R, Teherani A. Equity and Justice in Health Professions Education: Delivering on SGIM's Vision and Commitment. J Gen Intern Med 2022; 37:2142-2143. [PMID: 35614170 PMCID: PMC9132564 DOI: 10.1007/s11606-022-07664-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Reena Karani
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Arianne Teherani
- University of California San Francisco School of Medicine, San Francisco, CA, USA
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