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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. Analysis of narrative assessments of internal medicine resident performance: are there differences associated with gender or race and ethnicity? BMC MEDICAL EDUCATION 2024; 24:72. [PMID: 38233807 PMCID: PMC10795394 DOI: 10.1186/s12909-023-04970-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 12/13/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Equitable assessment is critical in competency-based medical education. This study explores differences in key characteristics of qualitative assessments (i.e., narrative comments or assessment feedback) of internal medicine postgraduate resident performance associated with gender and race and ethnicity. METHODS Analysis of narrative comments included in faculty assessments of resident performance from six internal medicine residency programs was conducted. Content analysis was used to assess two key characteristics of comments- valence (overall positive or negative orientation) and specificity (detailed nature and actionability of comment) - via a blinded, multi-analyst approach. Differences in comment valence and specificity with gender and race and ethnicity were assessed using multilevel regression, controlling for multiple covariates including quantitative competency ratings. RESULTS Data included 3,383 evaluations with narrative comments by 597 faculty of 698 residents, including 45% of comments about women residents and 13.2% about residents who identified with race and ethnicities underrepresented in medicine. Most comments were moderately specific and positive. Comments about women residents were more positive (estimate 0.06, p 0.045) but less specific (estimate - 0.07, p 0.002) compared to men. Women residents were more likely to receive non-specific, weakly specific or no comments (adjusted OR 1.29, p 0.012) and less likely to receive highly specific comments (adjusted OR 0.71, p 0.003) or comments with specific examples of things done well or areas for growth (adjusted OR 0.74, p 0.003) than men. Gendered differences in comment specificity and valence were most notable early in training. Comment specificity and valence did not differ with resident race and ethnicity (specificity: estimate 0.03, p 0.32; valence: estimate - 0.05, p 0.26) or faculty gender (specificity: estimate 0.06, p 0.15; valence: estimate 0.02 p 0.54). CONCLUSION There were significant differences in the specificity and valence of qualitative assessments associated with resident gender with women receiving more praising but less specific and actionable comments. This suggests a lost opportunity for well-rounded assessment feedback to the disadvantage of women.
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Affiliation(s)
- Robin Klein
- Department of Medicine, Division of General Internal Medicine, Emory University School of Medicine, 80 Jesse Hill Jr Dr SE, Atlanta, GA, 30303, 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, CA, USA
| | - Katherine A Julian
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA, USA
| | - Vanessa Thompson
- Department of Medicine, Division of General Internal Medicine, University of California, 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
| | - Bobbie Ann A White
- Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA
| | - Yoon Soo Park
- Department of Medical Education, University of Illinois Chicago, Chicago, IL, USA
| | - Kerri Palamara
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
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Bao G, Yang P, Yi J, Peng S, Liang J, Li Y, Guo D, Li H, Ma K, Yang Z. Full-sized realistic 3D printed models of liver and tumour anatomy: a useful tool for the clinical medicine education of beginning trainees. BMC MEDICAL EDUCATION 2023; 23:574. [PMID: 37582729 PMCID: PMC10428657 DOI: 10.1186/s12909-023-04535-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 07/24/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Simulation-based medical education (SBME) and three-dimensional printed (3DP) models are increasingly used in continuing medical education and clinical training. However, our understanding of their role and value in improving trainees' understanding of the anatomical and surgical procedures associated with liver surgery remains limited. Furthermore, gender bias is also a potential factor in the evaluation of medical education. Therefore, the aim of this study was to evaluate the educational benefits trainees receive from the use of novel 3DP liver models while considering trainees' experience and gender. METHODS Full-sized 3DP liver models were developed and printed using transparent material based on anonymous CT scans. We used printed 3D models and conventional 2D CT scans of the liver to investigate thirty trainees with various levels of experience and different genders in the context of both small group teaching and formative assessment. We adopted a mixed methods approach involving both questionnaires and focus groups to collect the views of different trainees and monitors to assess trainees' educational benefits and perceptions after progressing through different training programs. We used Objective Structured Clinical Examination (OSCE) and Likert scales to support thematic analysis of the responses to the questionnaires by trainees and monitors, respectively. Descriptive analyses were conducted using SPSS statistical software version 21.0. RESULTS Overall, a 3DP model of the liver is of great significance for improving trainees' understanding of surgical procedures and cooperation during operation. After viewing the personalized full-sized 3DP liver model, all trainees at the various levels exhibited significant improvements in their understanding of the key points of surgery (p < 0.05), especially regarding the planned surgical procedure and key details of the surgical procedures. More importantly, the trainees exhibited higher levels of satisfaction and self-confidence during the operation regardless of gender. However, with regard to gender, the results showed that the improvement of male trainees after training with the 3DP liver model was more significant than that of female trainees in understanding and cooperation during the surgical procedure, while no such trend was found with regard to their understanding of the base knowledge. CONCLUSION Trainees and monitors agreed that the use of 3DP liver models was acceptable. The improvement of the learning effect for practical skills and theoretical understanding after training with the 3DP liver models was significant. This study also indicated that training with personalized 3DP liver models can improve all trainees' presurgical understanding of liver tumours and surgery and males show more advantage in understanding and cooperation during the surgical procedure as compared to females. Full-sized realistic 3DP models of the liver are an effective auxiliary teaching tool for SBME teaching in Chinese continuing medical education.
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Affiliation(s)
- Guoqiang Bao
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Ping Yang
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Jiangpu Yi
- 3D Printing Research Center of Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, China
| | - Shujia Peng
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Jiahe Liang
- 3D Printing Research Center of Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, China
| | - Yajie Li
- Xi 'an Ma Ke Medical Technology Ltd, Room 21516, Block C, Chaoyang International Plaza, Xi'an, Shaanxi, China
| | - Dian Guo
- Xi 'an Ma Ke Medical Technology Ltd, Room 21516, Block C, Chaoyang International Plaza, Xi'an, Shaanxi, China
| | - Haoran Li
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Kejun Ma
- Xi 'an Ma Ke Medical Technology Ltd, Room 21516, Block C, Chaoyang International Plaza, Xi'an, Shaanxi, China
| | - Zhenyu Yang
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710038, China.
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Piquette D, Spring J. Gender Disparity in Procedural Training: A Persistent Problem in Need of Early Interventions. ATS Sch 2023; 4:109-112. [PMID: 37538070 PMCID: PMC10394592 DOI: 10.34197/ats-scholar.2023-0041ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Affiliation(s)
- Dominique Piquette
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada; and
| | - Jenna Spring
- University of Toronto, Toronto, Ontario, Canada; and
- Mount Sinai Hospital, Toronto, Ontario, Canada
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