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Gisselbaek M, Marsh B, Soriano L, Jackman S, Seidel L, Albert A, Matot I, Coppens S, Narouze S, Barreto Chang OL, Saxena S. Gender and Race/Ethnicity dynamics in anesthesiology mentorship: results of a European survey. BMC Anesthesiol 2024; 24:311. [PMID: 39242999 PMCID: PMC11378607 DOI: 10.1186/s12871-024-02692-6] [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: 04/12/2024] [Accepted: 08/23/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Mentorship is crucial to career advancement, medical education, and psychosocial support, especially for women and minorities. Although anesthesia mentoring programs have shown promise, there are no survey data regarding mentor-mentee relationship dynamics. This study aimed to explore the dynamics of the anesthesia mentor/mentee relationship. METHODS A open cross-sectional web-based survey was distributed by the European Society of Anesthesiology and Intensive Care and European Society of Regional Anesthesia to European anesthesiologists. Participation was anonymous and consent was obtained. The study evaluated responses relating to preferences, facilitators, and barriers to mentorship relationships along with sociodemographic information. RESULTS In total, 543 anesthesiologists responded to the survey, and 406 (111 mentees, 49 mentors, 193 both, 53 neither) responded to questions regarding mentorship. 184 anesthesiologists identified as woman and 22 as other genders (non-binary, transgender, gender-fluid, and self-described gender). Moreover, 250 anesthesiologists identified as white. Both mentors and mentees indicated that personal compatibility was the most important factor for successful mentorship. Barriers to mentorship included time consumption and perceived lack of interest from the mentor and mentee. Both mentors and mentees benefited from this relationship. The former reported feeling helpful, and the latter supported the development of clinical skills. The mentors indicated that their participation was important for protecting against burnout/exhaustion and impostor syndrome. Participants reported a preference for mentorship programs organized at the departmental level, offered at the start of the anesthesiology education curricula. Women were more likely to feel a 'lack of interest' in mentoring them as a barrier (OR = 2.49, P = 0.033). Gender was a barrier for mentors of other genders (OR = 23.9, P = 0.0027) and ethnicity (OR = 48.0, P = 0.0023). White mentees found gender (OR = 0.14, P = 0.021) and ethnicity (OR = 0.11, P = 0.048) to be less important barriers to successful mentorship relationship. CONCLUSION When possible, programs should prioritize matching mentors and mentees based on personal compatibility and experience in the mentee's area of interest. Addressing the perceived lack of interest in mentoring is essential for promoting diversity, equality, and inclusion within anesthesiology, as well as and uplifting women and minorities. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT05968339, First posted (01/08/2023).
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Affiliation(s)
- Mia Gisselbaek
- Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology, Intensive care, and Emergency medicine, Geneva University Hospitals, Geneva, Switzerland.
| | - Becki Marsh
- Department of Anaesthetics and Critical Care, Royal Cornwall Hospital, Truro, Cornwall, UK
| | - Laura Soriano
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
| | - Sophie Jackman
- Department of Acute Medicine, Peterborough City Hospital, North West Anglia NHS Foundation Trust, Peterborough, UK
| | - Laurence Seidel
- B-STAT, Biostatistics and Research Method Center of ULiège and CHU of Liège, Liege, Belgium
| | - Adelin Albert
- Department of Public Health sciences, ULiège, Liege, Belgium
| | - Idit Matot
- Department of Anesthesiology, Intensive Care and Pain, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Steve Coppens
- Department of Anesthesiology, University Hospitals of Leuven, Leuven, Belgium
- Biomedical Sciences Group, Department of Cardiovascular Sciences, University of Leuven, KU Leuven, Leuven, B-3000, Belgium
| | - Samer Narouze
- Division of Pain Management , University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Odmara L Barreto Chang
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
| | - Sarah Saxena
- Université Libre de Bruxelles, Brussels, Belgium
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Lorello GR, Flexman AM. A matter of life and death: physician gender and patient outcomes after surgery. Br J Anaesth 2024; 133:479-482. [PMID: 38965014 DOI: 10.1016/j.bja.2024.06.002] [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: 05/04/2024] [Revised: 05/31/2024] [Accepted: 06/04/2024] [Indexed: 07/06/2024] Open
Abstract
Accumulating evidence supports an effect of physician gender (or sex, a surrogate used in many studies) on important patient outcomes such as death, complications, and hospital length of stay. Recent studies suggest that these effects result from the gender diversity of the team rather than individual physician gender. Here, we reflect on the potential mechanisms of an effect of physician gender on patient outcomes.
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Affiliation(s)
- Gianni R Lorello
- Department of Anesthesia and Pain Management, University Health Network, Toronto Western Hospital, Toronto, ON, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada; The Wilson Centre, Toronto, ON, Canada; Women's College Research Institute, Toronto, ON, Canada
| | - Alana M Flexman
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada; Department of Anesthesia, Providence Health Care, St. Paul's Hospital, Vancouver, BC, Canada; Centre for Advancing Health Outcomes, St. Paul's Hospital, Vancouver, BC, Canada.
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3
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Carter JC, Purcell N, Stewart CH, Pearce GC, Balkin M, Allen KJ. Still a 'boys' club': a qualitative analysis of how gender affects a career in anaesthesia in Australia and Aotearoa New Zealand. Anaesthesia 2024; 79:694-705. [PMID: 38629288 DOI: 10.1111/anae.16281] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 06/09/2024]
Abstract
Gender inequity remains an issue in anaesthesia despite increasing numbers of women training and achieving fellowship in the speciality. Women are under-represented in all areas of anaesthetic research, academia and leadership. The Gender Equity Subcommittee of the Australian and New Zealand College of Anaesthetists recently conducted a survey asking "Does gender still matter in the pursuit of a career in anaesthesia in 2022?". The survey was distributed to a randomly selected sample of 1225 anaesthetic consultants and completed by 470 respondents (38% response rate) with 793 free-text comments provided. Three overarching themes were identified: gender effects on the career and family interface; women do not fit the mould; and gender equity changes the status quo. Women respondents described a need to make a choice between career and family, which was not described by men, as well as stigmatisation of part-time work, a lack of access to challenging work and negative impacts of parental leave. Women respondents also described a sense of marginalisation within anaesthesia due to a 'boys' club' mentality, a lack of professional respect and insufficient structural supports for women in leadership. This was compounded for women from ethnically and culturally diverse backgrounds. A need for specific strategies to support anaesthetic careers for women was described as well as normalisation of flexibility in workplaces, combined with a broadening of our definition of success to allow people of all genders to experience fulfilment both at home and at work. This study is the first published qualitative data on factors affecting gender equity for anaesthetists in Australia and Aotearoa New Zealand. It highlights the need for further exploration, as well providing a foundation for changes in attitude and structural changes towards advancing gender equity.
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Affiliation(s)
- J C Carter
- Department of Anaesthesia, Austin Health, Melbourne, Australia
- Department of Anaesthesia, Mercy Hospital for Women, Melbourne, Australia
| | - N Purcell
- Department of Anaesthesia, Royal Prince Alfred Hospital, Sydney, Australia
| | - C H Stewart
- Department of Perioperative Medicine and Anaesthesia, Westmead Hospital, Sydney, Australia
| | - G C Pearce
- Department of Anaesthesia and Perioperative Medicine, Te Whatu Ora Waitemata, Auckland, Aotearoa, New Zealand
| | - M Balkin
- Department of Anaesthesia and Pain Medicine, Alfred Health, Melbourne, Australia
| | - K J Allen
- Department of Anaesthesia and Pain Medicine, Royal Melbourne Hospital, Melbourne, Australia
- Department of Critical Care, University of Melbourne, Australia
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Ki BK, Onajin-Obembe B, Adekola O, Baele PL, Binam F, Daddy H, Diouf E, Fanou L, Gathuya ZN, Igaga EN, Jeque E, Mawandza P, Nabukenya MT, Nabulindo SM, Nicole Rakotoarison RC, Robert AR, Schwalbach T, Uwambazimana JD, Vilasco B, Zomahoun L. Women Anesthesiologists in Sub-Saharan Africa in the Pre-COVID Era: A Multinational Demographic Study. Anesth Analg 2024; 139:4-14. [PMID: 38300845 PMCID: PMC11155285 DOI: 10.1213/ane.0000000000006868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND Gender imbalance and poor representation of women complicate the anesthesiology workforce crisis in sub-Saharan Africa (SSA). This study was performed to obtain a better understanding of gender disparity among medical graduates and anesthesiologists in SSA. METHODS Using a quantitative, participatory, insider research study, led by female anesthesiologists as the national coordinators in SSA, we collected data from academic or national health authorities and agencies. National coordinators were nominees of anesthesiology societies that responded to our email invitations. Data gathered from 13 countries included information on medical graduates, anesthesiologists graduating between 1998 and 2021, and number of anesthesiologists licensed to practice in 2018. We compared data between Francophone and Anglophone countries, and between countries in East Africa and West Africa/Central Africa. We calculated anesthesiology workforce densities and compared representation of women among graduating anesthesiologists and medical graduates.Data analysis was performed using linear regression. We used F-tests on regression slopes to assess the trends in representation of women over the years and the differences between the slopes. A value of P < .050 was considered statistically significant. RESULTS Over a 20-year period, the representation of female medical graduates in SSA increased from 29% (1998) to 41% (2017), whereas representation of female anesthesiologists was inconsistent, with an average of 25%, and lagged behind. Growth and gender disparity patterns were different between West Africa/Central Africa and East Africa. Representation of female anesthesiologists was higher in East Africa (39.4%) than West Africa/Central Africa (19.7%); and the representation of female medical graduates in East Africa (42.5%) was also higher that West Africa/Central Africa (33.1%). CONCLUSIONS On average, in SSA, female medical graduates (36.9%), female anesthesiologists (24.9%), and female anesthesiology residents projected to graduate between 2018 and 2022 (25.2%) were underrepresented when compared to their male counterparts. Women were underrepresented in SSA, despite evidence that their representation in medicine and anesthesiology in East African countries was rising.
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Affiliation(s)
- Bertille K. Ki
- From the Service d’Anesthésie-Réanimation, CHU Pédiatrique Charles de Gaulle, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Bisola Onajin-Obembe
- Department of Anaesthesiology, Faculty of Clinical Sciences, College of Health Sciences, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Oyebola Adekola
- Department of Anaesthesia, College of Medicine University of Lagos, Lagos, Nigeria
| | - Philippe L. Baele
- Department of Anesthesiology, Faculty of Medicine, Catholic University of Louvain (UCLouvain), Ottignies-Louvain-la-Neuve, Belgium
| | - Fidele Binam
- Department of Anaesthesia, Yaoundé Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon
| | - Hadjara Daddy
- Faculté des sciences de la santé, Université Abdou Moumouni, Niamey, Niger
| | - Elizabeth Diouf
- Service d’Anesthésie-Réanimation, Faculté de Médecine, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Lionelle Fanou
- Hôpital d’instruction des armées, Centre hospitalier universitaire de Cotonou, Université d’Abomey-Calavi, Abomey-Calavi, Benin
| | | | - Elizabeth N. Igaga
- Uganda Heart Institute, Department of Anaesthesia and Critical care, Division of Cardiac Anaesthesia, Kampala, Uganda
| | - Emilia Jeque
- Faculdade de Medicina da Universidade Eduardo Mondlane, Maputo, Moçambique
| | - Peggy Mawandza
- Faculté des Sciences de la Santé - Université Marien Ngouabi, Brazzaville, Congo
| | - Mary T. Nabukenya
- Uganda Heart Institute, Department of Anaesthesia and Critical care, Division of Cardiac Anaesthesia, Kampala, Uganda
| | | | | | - Annie R. Robert
- Department of Epidemiology & Biostatistics, IREC EPID UCLouvain, Brussels, Belgium
| | - Teresa Schwalbach
- Faculdade de Medicina da Universidade Eduardo Mondlane, Maputo, Moçambique
| | - Jeanne D’Arc Uwambazimana
- Department of Anaesthesia, College of Medicine and Health Sciences, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
| | - Brigitte Vilasco
- Unité de Formation et de Recherche en Sciences Médicales, Université Félix Houphouët-Boigny d’Abidjan, Cocody, Côte D’ivoire
| | - Lidwine Zomahoun
- Faculté des Sciences de la Santé, CHU Mère-Enfant Lagune, Université d’Abomey-Calavi, Cotonou, Benin
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5
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Ege E, Koyyalagunta L, Javed S. Not a match: Why women are not choosing pain medicine. Pain Pract 2024. [PMID: 38828916 DOI: 10.1111/papr.13381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/30/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Despite a long history of disparities in medicine, women have made significant progress toward gender equity in medical schools, training programs, and many fields in recent years. However, pain medicine has remained behind most specialties in female recruitment and representation. METHODS We reviewed the latest demographic data on practicing physicians, trainees, and applicants with the aim of analyzing gender trends and identifying potential factors contributing to the shortage of women in our specialty. RESULTS Based on data from the past 10 years, the percentages of women among pain physicians, fellows, and applicants have remained stagnant, in contrast to the increases seen not only in the general medical workforce but also in other interventional specialties. CONCLUSIONS Given these trends, it is likely that persistent gender disparities and biases play a role in preventing women from pursuing careers in pain, and unlikely that the current trajectory will change unless we take steps to address these and other relevant factors.
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Affiliation(s)
- Eliana Ege
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
| | | | - Saba Javed
- Department of Pain Medicine, MD Anderson Cancer Center, Houston, Texas, USA
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Hallet J, Sutradhar R, Flexman A, McIsaac DI, Carrier FM, Turgeon AF, McCartney C, Chan WC, Coburn N, Eskander A, Jerath A, Perez d’Empaire P, Lorello G. Association between anaesthesia-surgery team sex diversity and major morbidity. Br J Surg 2024; 111:znae097. [PMID: 38747328 PMCID: PMC11094651 DOI: 10.1093/bjs/znae097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/12/2024] [Accepted: 03/25/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Team diversity is recognized not only as an equity issue but also a catalyst for improved performance through diversity in knowledge and practices. However, team diversity data in healthcare are limited and it is not known whether it may affect outcomes in surgery. This study examined the association between anaesthesia-surgery team sex diversity and postoperative outcomes. METHODS This was a population-based retrospective cohort study of adults undergoing major inpatient procedures between 2009 and 2019. The exposure was the hospital percentage of female anaesthetists and surgeons in the year of surgery. The outcome was 90-day major morbidity. Restricted cubic splines were used to identify a clinically meaningful dichotomization of team sex diversity, with over 35% female anaesthetists and surgeons representing higher diversity. The association with outcomes was examined using multivariable logistic regression. RESULTS Of 709 899 index operations performed at 88 hospitals, 90-day major morbidity occurred in 14.4%. The median proportion of female anaesthetists and surgeons was 28 (interquartile range 25-31)% per hospital per year. Care in hospitals with higher sex diversity (over 35% female) was associated with reduced odds of 90-day major morbidity (OR 0.97, 95% c.i. 0.95 to 0.99; P = 0.02) after adjustment. The magnitude of this association was greater for patients treated by female anaesthetists (OR 0.92, 0.88 to 0.97; P = 0.002) and female surgeons (OR 0.83, 0.76 to 0.90; P < 0.001). CONCLUSION Care in hospitals with greater anaesthesia-surgery team sex diversity was associated with better postoperative outcomes. Care in a hospital reaching a critical mass with over 35% female anaesthetists and surgeons, representing higher team sex-diversity, was associated with a 3% lower odds of 90-day major morbidity.
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Affiliation(s)
- Julie Hallet
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Cancer Program, ICES, Toronto, Ontario, Canada
| | - Rinku Sutradhar
- Cancer Program, ICES, Toronto, Ontario, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Alana Flexman
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Anesthesiology, St Paul’s Hospital/Providence Health Care, Vancouver, British Columbia, Canada
| | - Daniel I McIsaac
- Departments of Anesthesiology and Pain Medicine, University of Ottawa and Ottawa Hospital, Ottawa, Ontario, Canada
| | - François M Carrier
- Carrefour de l’innovation et santé des populations, Centre de recherche du CHUM, and Department of Anesthesiology and Division of Critical Care, Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Department of Anesthesiology and Pain Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Alexis F Turgeon
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Québec City, Québec, Canada
- Population Health and Optimal Health Practices Research Unit, Trauma–Emergency–Critical Care Medicine, CHU de Québec–Université Laval Research Centre, Université Laval, Québec City, Québec, Canada
| | - Colin McCartney
- Department of Anesthesiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Wing C Chan
- Cancer Program, ICES, Toronto, Ontario, Canada
| | - Natalie Coburn
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Cancer Program, ICES, Toronto, Ontario, Canada
| | - Antoine Eskander
- Division of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Cancer Program, ICES, Toronto, Ontario, Canada
- Department of Otolaryngology Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Angela Jerath
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Cancer Program, ICES, Toronto, Ontario, Canada
- Department of Anesthesiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Pablo Perez d’Empaire
- Department of Anesthesiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Gianni Lorello
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesiology and Wilson Centre, University Health Network, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
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Berger-Estilita J, Fritsche L, El-Boghdadly K, Dias CC, Zdravkovic M. European anesthesiologists' experiences with gender-based mistreatment in the workplace: a secondary multilevel regression analysis. Korean J Anesthesiol 2024; 77:46-57. [PMID: 38087649 PMCID: PMC10834715 DOI: 10.4097/kja.23392] [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: 05/17/2023] [Revised: 12/02/2023] [Accepted: 12/13/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Workplace gender-based mistreatment (GBM) refers to negative or harmful behaviors directed towards employees. In healthcare settings, this can lead to job dissatisfaction and underperformance and potentially compromise patient outcomes. The aim of this study was to examine workplace GBM among European anesthesiologists and produce the first European Gender-based Mistreatment Rank in Anesthesiology. METHODS We conducted a secondary analysis from a worldwide cross-sectional survey database consisting of a 46-item questionnaire exploring, among other outcomes, gender bias attributable to workplace attitudes. The survey completion rate was 80.8%. All respondents were selected from European countries. Associations between mistreatment and the remaining variables were analyzed using univariate and multivariate logistic regression analyses. A generalized linear mixed model was then used to quantify the impact of mistreatment in each European country. Statistical significance was set at P < 0.05. RESULTS This study included 5,795 respondents from 43 European countries. The independent predictors of GBM were as follows: female gender, younger age, perceiving gender as a disadvantage for leadership, and perceiving gender as a disadvantage for research. The full model was statistically significant, indicating an ability to distinguish between those who experienced GBM and those who did not (P < 0.001). Thus, 26 European countries were ranked based on the prevalence of mistreatment, with Italy showing the best performance (lowest prevalence). CONCLUSIONS The aim of our study was to provide preliminary insight into GBM in anesthesiology in Europe, function as a key benchmark for gender equity, and chart the evolution of disparities over time.
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Affiliation(s)
- Joana Berger-Estilita
- Institute of Anesthesiology and Intensive Care, Salemspital, Hirslanden Medical Group, Bern, Switzerland
- Institute for Medical Education, University of Bern, Bern, Switzerland
- CINTESIS@RISE, Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Kariem El-Boghdadly
- Department of Anesthesia, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Claudia Camila Dias
- CINTESIS@RISE, Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
- Knowledge Management Unit and Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto (FMUP), Alameda Prof. Hernâni Monteiro, Porto, Portugal
| | - Marko Zdravkovic
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Anesthesiology, Intensive Care and Pain Management, University Medical Center Maribor, Maribor, Slovenia
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Gisselbaek M, Hontoir S, Pesonen AE, Seidel L, Geniets B, Steen E, Barreto Chang OL, Saxena S. Impostor syndrome in anaesthesiology primarily affects female and junior physicians ☆. Br J Anaesth 2024; 132:407-409. [PMID: 37884406 DOI: 10.1016/j.bja.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/28/2023] Open
Affiliation(s)
- Mia Gisselbaek
- Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology, Intensive Care, and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Sonia Hontoir
- Department of Anaesthesiology UZ Brussel, Brussels, Belgium
| | | | - Laurence Seidel
- B-STAT, Biostatistics and Research Method Center of ULiège and CHU of Liège, Liege, Belgium
| | | | - Evi Steen
- Department of Anaesthesiology-Critical Care, Az Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Odmara L Barreto Chang
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
| | - Sarah Saxena
- Department of Anaesthesiology-Critical Care, Az Sint-Jan Brugge-Oostende AV, Bruges, Belgium.
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Wising J, Ström M, Hallgren J, Rambaree K. Certified Registered Nurse Anaesthetists' and Critical Care Registered Nurses' perception of knowledge/power in teamwork with Anaesthesiologists in Sweden: a mixed-method study. BMC Nurs 2024; 23:7. [PMID: 38163862 PMCID: PMC10759417 DOI: 10.1186/s12912-023-01677-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024] Open
Abstract
Efficient teamwork is crucial to provide optimal health care. This paper focuses on teamwork between Anaesthesiologists (ANES), Certified Registered Nurse Anaesthetists' (CRNA) and Critical Care Registered Nurses (CCRN) working in challenging environments such as the intensive care unit (ICU) and the operating room (OR). Conflicts are common between physicians and nurses, negatively impacting teamwork. Social hierarchies based on professional status and power inequalities between nurses and physicians plays a vital role in influencing teamwork. Foucault was a famous thinker especially known for his reasoning regarding power/knowledge. A Foucauldian perspective was therefore incorporated into this paper and the overall aim was to explore CCRN/CRNA perception of knowledge/power in teamwork with ANES.Methods A mixed-method approach was applied in this study. Data was collected using a web-based questionnaire containing both closed-end and open-ended questions. A total of 289 CCRNs and CRNAs completed the questionnaire. Data analysis was then conducted through five stages as outlined by Onwuebugzie and Teddlie; analysing quantitative data in SPSS 27.0 and qualitative data with a directed content analysis, finally merging data together in ATLAS.ti v.23.Results The result reveals a dissonance between quantitative and qualitative data; quantitative data indicates a well-functioning interdisciplinary teamwork between CCRN/CRNA and ANES - qualitative data highlights that there are several barriers and inequalities between the two groups. Medicine was perceived as superior to nursing, which was reinforced by both social and organisational structures at the ICU and OR.Conclusion Unconscious rules underlying current power structures in the ICU and OR works in favour of the ANES and biomedical paradigm, supporting medical knowledge. To achieve a more equal power distribution between CCRN/CRNAs and ANES, the structural hierarchies between nursing and medicine needs to be addressed. A more equal power balance between the two disciplines can improve teamwork and thereby reduce patient mortality and improve patient outcomes.
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Affiliation(s)
- Jenny Wising
- School of Health Sciences, University of Skövde, Skövde, Sweden.
| | - Madelene Ström
- Region Västra Götaland, Skaraborgs Hospital Skövde, Dept of Anesthesia, Skövde, Sweden
| | - Jenny Hallgren
- School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Komalsingh Rambaree
- Department of Social Work and Criminology, University of Gävle, Gävle, Sweden
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Staub M, Han B, Lee Hill A, Thomson E, Martin JL, Hoffmann R, Osborn TM, McCormick M, Ogden MA, Chilson K, Eckhouse SR. Does gender affect experiences in the operating room for surgeons and anesthesiologists at a large academic center? Am J Surg 2024; 227:63-71. [PMID: 37821294 DOI: 10.1016/j.amjsurg.2023.09.033] [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: 06/30/2023] [Revised: 09/12/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Although the number of women medical trainees has increased in recent years, they remain a minority of the academic workforce. Gender-based implicit biases may lead to deleterious effects on surgical workforce retention and productivity. METHODS All 440 attending surgeons and anesthesiologists employed at our institution were invited to complete a survey regarding perceptions of the perioperative work environment and resources. Odds ratios for dichotomous variables were calculated using logistic regressions, and for trichotomous variables, polytomous regressions. RESULTS 243 participants (55.2%) provided complete survey responses. Relative to men, women faculty reported a greater need to prove themselves to staff; less respect and fewer resources and opportunities; more frequent assumptions about their capabilities; and a greater need to adjust their demeanor to connect with their team (p < 0.05). CONCLUSION Perceived gender bias remains present in the perioperative environment. We need greater efforts to address barriers and create an equitable work environment.
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Affiliation(s)
- Melinda Staub
- Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA.
| | - Britta Han
- Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - Angela Lee Hill
- Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - Emily Thomson
- Perioperative Services, Barnes Jewish Hospital, Saint Louis, MO, USA
| | - Jackie L Martin
- Perioperative Services, Barnes Jewish Hospital, Saint Louis, MO, USA
| | | | - Tiffany M Osborn
- Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - Molly McCormick
- Department of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - M Allison Ogden
- Department of Otolaryngology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Kelly Chilson
- Department of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Shaina R Eckhouse
- Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA
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11
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Diallo MS, Wright CC, Coombs AAT, Vetter TR. Assuring the Groundwork for Success: Mentorship, Sponsorship, and Allyship for Practicing Anesthesiologists. Anesth Analg 2023; 137:754-762. [PMID: 37712466 DOI: 10.1213/ane.0000000000006646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
The challenges facing the health care industry in the post-coronavirus disease 2019 (COVID-19) pandemic world are numerous, jeopardizing wellness, and performance. Maintaining engagement and fulfillment of anesthesiologists in their work is now a critical issue in various practice settings: academic, private practice, and corporate medicine. In this article, we offer insights on how mentorship, sponsorship, and allyship are important in the advancement of the anesthesiology workforce including women and underrepresented minorities inclusive of race, gender, and disability. Mentorship, sponsorship, and allyship require a framework that intentionally addresses the programmatic structures needed to optimize the environment for increasing women, underrepresented minorities, and other diverse groups. These 3 distinct yet interrelated concepts are defined with a discussion on the value of implementation. In addition, the concept of "belonging" and its importance in enhancing the culture in anesthesiology is explored. We believe that part of the solution to wellness, recruitment and retention and improved job satisfaction of clinicians is having an environment where mentorship, sponsorship, and allyship are foundational.
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Affiliation(s)
- Mofya S Diallo
- From the Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Keck School of Medicine at the University of Southern California, Los Angeles, California
| | - Crystal C Wright
- Division of Anesthesiology and Critical Care, Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Thomas R Vetter
- Department of Surgery and Perioperative Care, Dell Medical School at The University of Texas at Austin, Austin, Texas
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12
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Tayeb BO, Shubbak FA, Doais KS, Yamani AN, Dhaifallah DG, Alsayed EF, Addas MJ, Boker AM. Uses of simulation-based education for anesthesiology training, certification and recertification: A scoping review. J Taibah Univ Med Sci 2023; 18:1118-1123. [PMID: 37881638 PMCID: PMC10594003 DOI: 10.1016/j.jtumed.2023.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/03/2023] [Accepted: 03/30/2023] [Indexed: 10/27/2023] Open
Abstract
Objectives To conduct a comprehensive scoping review focusing on published anesthesiology-specific training based on simulation to assess up-to-date uses of simulation-based education in anesthesiology training. Our goal was to establish a solid ground for building standardized and accredited curricula for simulation-based education in the specialty of anesthesia in the near future. Methods We searched the PubMed, CINAHL and EMBASE databases on May 10, 2021 for relevant articles. We followed the five-stage scoping review methodology: identifying a research question, identifying relevant studies, study selection, charting the data, and synthesis of results. Results Our initial electronic search identified 5609 potential articles. After abstract screening and removing duplicates, 636 articles were evaluated in full text for inclusion or exclusion. Based on this strategy, 283 articles were included in this review. We mapped the current practice of simulation in training and certification across different anesthesiology subspecialties. Conclusions Significant effort has been placed into the use of simulation for training, certification, and recertification in anesthesiology. Future effort to develop simulation-based training that can be generalized to trainees in this specialty, similar to other fields such as aviation and space sciences, will enhance the standardization of training and hence patient safety.
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Affiliation(s)
- Baraa O. Tayeb
- Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
- Anesthesiology Services Section, Department of Anesthesia and Critical Care, King Abdulaziz University Hospital, Jeddah, KSA
- Clinical Skills and Simulation Centre, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
| | - Firas A. Shubbak
- Anesthesiology and Perioperative Medicine Administration Department, Faculty of Medicine, King Fahad Medical City, Riyadh, KSA
| | - Khaled S. Doais
- Anesthesiology and Perioperative Medicine Administration Department, Faculty of Medicine, King Fahad Medical City, Riyadh, KSA
| | - Ahad N. Yamani
- Department of Surgery, Anesthesiology Section, Faculty of Medicine, King Abdulaziz University, Rabigh, KSA
| | - Daniah G. Dhaifallah
- Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
- Anesthesiology Services Section, Department of Anesthesia and Critical Care, King Abdulaziz University Hospital, Jeddah, KSA
| | - Eyad F. Alsayed
- Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
- Anesthesiology Services Section, Department of Anesthesia and Critical Care, King Abdulaziz University Hospital, Jeddah, KSA
| | - Malik J. Addas
- Internship Department, King Abdulaziz University Hospital, Jeddah, KSA
| | - Abdulaziz M. Boker
- Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
- Anesthesiology Services Section, Department of Anesthesia and Critical Care, King Abdulaziz University Hospital, Jeddah, KSA
- Clinical Skills and Simulation Centre, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
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Barclay AB, Moran K, Tumin D, Nichols KR. Pro-Con Debate: Consideration of Race, Ethnicity, and Gender Is Detrimental to Successful Mentorship. Anesth Analg 2023; 137:747-753. [PMID: 37712465 DOI: 10.1213/ane.0000000000006502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Anesthesiology remains a specialty with low representation of women or members of racial and ethnic groups considered underrepresented in medicine (UiM). In the United States, women account for 33% of anesthesiology residents, while physicians identifying as Black, African American, Latinx, American Indian, or Alaska Native account for approximately 10%. Underrepresentation of these groups is even more pronounced in academic anesthesiology, especially at the senior ranks and roles, such as department chairs. Leaders in the field have recently shared recommendations for how individual departments, medical schools, hospitals, and professional organizations can create and support a more diverse anesthesiology workforce. These commentaries have often stressed the importance of mentorship for supporting women and physicians from UiM groups, including mentorship of trainees and practicing anesthesiologists seeking to advance their careers. While the value of mentorship is undisputed, it remains a matter of controversy whether race, ethnicity, or gender should be explicitly considered by mentoring programs and individual mentors. In this article, we discuss whether and how race, ethnicity, and gender should be considered in the setting of mentorship programs and the formation of individual mentoring relationships, as well as some of the potential consequences that lie therein.
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Affiliation(s)
- Alicia B Barclay
- From the Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, Ohio
| | - Kenneth Moran
- From the Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, Ohio
| | - Dmitry Tumin
- Departments of Pediatrics
- Academic Affairs, Brody School of Medicine at East Carolina University, Greenville, North Carolina
| | - Kimberley R Nichols
- Department of Anesthesiology
- Office of Medical Student Education, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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14
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Soussi S, Mehta S, Lorello GR. Equity, diversity, and inclusion in anaesthesia and critical care medicine: consider the various aspects of diversity. Br J Anaesth 2023; 131:e135-e136. [PMID: 37567809 DOI: 10.1016/j.bja.2023.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/06/2023] [Accepted: 07/15/2023] [Indexed: 08/13/2023] Open
Affiliation(s)
- Sabri Soussi
- Department of Anaesthesia and Pain Management, University Health Network - Toronto Western Hospital, University of Toronto, Toronto, ON, Canada; Department of Anaesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
| | - Sangeeta Mehta
- Department of Medicine, Sinai Health, Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Gianni R Lorello
- Department of Anaesthesia and Pain Management, University Health Network - Toronto Western Hospital, University of Toronto, Toronto, ON, Canada; Department of Anaesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; The Wilson Centre, Toronto General Hospital, University of Toronto, Toronto, ON, Canada
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15
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Matava CT, Alam F, Kealey A, Bahrey LA, McCreath GA, Walsh CM. The influence of resident and faculty gender on assessments in anesthesia competency-based medical education. Can J Anaesth 2023; 70:978-987. [PMID: 37165126 PMCID: PMC10171726 DOI: 10.1007/s12630-023-02454-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 05/12/2023] Open
Abstract
PURPOSE Competency-based medical education (CBME) relies on frequent workplace-based assessments of trainees, providing opportunities for conscious and implicit biases to reflect in these assessments. We aimed to examine the influence of resident and faculty gender on performance ratings of residents within a CBME system. METHODS This retrospective cohort study took place from August 2017 to January 2021 using resident assessment data from two workplace-based assessments: the Anesthesia Clinical Encounter Assessment (ACEA) and Entrustable Professional Activities (EPAs). Self-reported gender data were also extracted. The primary outcome-gender-based differences in entrustment ratings of residents on the ACEA and EPAs-was evaluated using mixed-effects logistic regression, with differences reported through odds ratios and confidence intervals (α = 0.01). Gender-based differences in the receipt of free-text comments on the ACEA and EPAs were also explored. RESULTS In total, 14,376 ACEA and 4,467 EPA assessments were analyzed. There were no significant differences in entrustment ratings on either assessment tool between men and women residents. Regardless of whether assessments were completed by men or women faculty, entrustment rates between men and women residents were not significantly different for any postgraduate year level. Additionally, men and women residents received strengths-related and actions-related comments on both assessments at comparable frequencies, irrespective of faculty gender. CONCLUSION We found no gender-based differences in entrustment ratings for both the ACEA and EPAs, which suggests an absence of resident gender bias within this CBME system. Given considerable heterogeneity in rater leniency, future work would be strengthened by using rater leniency-adjusted scores rather than raw scores.
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Affiliation(s)
- Clyde T Matava
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, 555 University Ave., Toronto, ON, M5G 1X8, Canada.
- Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- SickKids Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.
| | - Fahad Alam
- Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Alayne Kealey
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, 555 University Ave., Toronto, ON, M5G 1X8, Canada
- Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lisa A Bahrey
- Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia, University Health Network-Toronto General Hospital, Toronto, ON, Canada
| | - Graham A McCreath
- SickKids Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Catharine M Walsh
- SickKids Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- The Wilson Centre, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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16
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Mottiar M, Burchell D, MacCormick H. Equity, Diversity, and Inclusion in anesthesiology: a primer. Can J Anaesth 2023; 70:1075-1089. [PMID: 37341898 DOI: 10.1007/s12630-023-02504-4] [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: 04/01/2022] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 06/22/2023] Open
Abstract
PURPOSE This continuing professional development module aims to elucidate the current demographics of anesthesiology in Canada and the experience of anesthesiologists from equity-seeking groups. This module will also identify and describe factors impacting the health care experience of patients from equity-seeking groups who receive perioperative, pain, and obstetric care. PRINCIPAL FINDINGS In recent years, discrimination based on sex, gender, race, ethnicity, sexual orientation, ability, other demographic factors, and the intersection of these identities have gained greater attention not only in our society at large but also within medicine and anesthesiology. The stark consequences of this discrimination for both anesthesiologists and patients from equity-seeking groups have become clearer in recent years, although the full scope of the problem is not fully understood. Data regarding the demographics of the national anesthesia workforce are lacking. Literature describing patient perspectives of various equity-seeking groups is also sparse, although increasing. Health disparities impacting people who are racialized, women, LGBTQIA+, and/or living with disability are also present in the perioperative context. CONCLUSION Discrimination and inequity persist in the Canadian health care system. It is incumbent upon us to actively work against these inequities every day to create a kinder and more just health care system in Canada.
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Affiliation(s)
- Miriam Mottiar
- Department of Anesthesiology & Pain Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada.
- Division of Palliative Medicine, Department of Medicine, University of Ottawa, The Ottawa Hospital, 501 Smyth Rd, Room 1401, Ottawa, ON, K1H 8L6, Canada.
| | - Drew Burchell
- Women's & Obstetric Anesthesia, IWK Health Centre, Halifax, NS, Canada
- Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
| | - Hilary MacCormick
- Women's & Obstetric Anesthesia, IWK Health Centre, Halifax, NS, Canada
- Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
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17
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Raza D, Khan FA. Professional barriers experienced by South Asian women in academic anesthesia. Can J Anaesth 2023; 70:972-974. [PMID: 37188834 PMCID: PMC10184962 DOI: 10.1007/s12630-023-02452-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 07/26/2022] [Accepted: 08/23/2022] [Indexed: 05/17/2023] Open
Affiliation(s)
- Durriya Raza
- Department of Anaesthesiology, Faculty of Health Sciences, Medical College, Aga Khan University, Stadium Road, P.O. Box 35000, Karachi, 74800, Pakistan
| | - Fauzia A Khan
- Department of Anaesthesiology, Faculty of Health Sciences, Medical College, Aga Khan University, Stadium Road, P.O. Box 35000, Karachi, 74800, Pakistan
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18
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Hoyler MM, Pryor KO, Gotian R, Brumberger ED, Chan JM. Resident Physicians as Clinical Educators in Anesthesiology: A Narrative Review. Anesth Analg 2023; 136:270-281. [PMID: 36638511 DOI: 10.1213/ane.0000000000006243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The importance of resident physicians as clinical educators is widely acknowledged in many clinical specialties and by national accreditation organizations for medical education. Within anesthesiology training programs, there is growing attention to the role of trainees as clinical educators. This narrative review describes the theoretical and demonstrated benefits of clinical teaching by residents in anesthesiology and other medical fields, summarizes current efforts to support and promote residents as educators, and suggests ways in which anesthesiology training programs can further assess and develop the role of residents as clinical educators.
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Affiliation(s)
- Marguerite M Hoyler
- From the Department of Anesthesiology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York
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Authorship by gender in anesthesiology journals: a retrospective cross-sectional study for Japan. J Anesth 2023; 37:364-370. [PMID: 36688988 PMCID: PMC9868495 DOI: 10.1007/s00540-023-03165-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/10/2023] [Indexed: 01/24/2023]
Abstract
PURPOSE Although it is important to recognize gender disparities in publishing to achieve gender diversity, women's authorship in Japan remains unclear. Therefore, this study aimed to investigate the percentage and analyze the trends of articles authored and published in anesthesiology journals by Japanese female authors. METHODS The genders of the first and last authors affiliated with Japanese institutions were surveyed in the Journal of Anesthesia (JA) (1990, 1995, and 2000-2022) and 11 international anesthesiology journals (2010-2022). RESULTS We included 845 and 819 original research articles from JA in the analyses of the first and last authors, respectively. The proportion of female first authors significantly increased from 41 (11.7%) out of 351 before 2009 to 119 (24.1%) out of 494 after 2010 (p < 0.001). The proportion of female last authors was 11 (3.3%) out of 335 before 2009 and 22 (4.5%) out of 484 after 2010, respectively, with no significant difference (p = 0.470). We included 624 and 572 original research articles from international anesthesiology journals in the analyses of first and last authors, respectively. Among these, there were 134 (21.5%) and 23 (4.0%) female first and last authors, respectively. These proportions in international anesthesiology journals did not significantly differ from those in JA (p = 0.334, p = 0.789, respectively). CONCLUSION The percentage of female first authors has increased, commensurate with the percentage of female anesthesiologists. However, the percentage of female last authors has not increased and remains low in Japan.
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Keim AA, Pelkey MN, Broadfoot JE, Folley TA, Kraus MB, Maloney JA, Strand NH, Misra L. Women Authorship Trends in the Highest-Impact Anesthesiology Journals from 2005 to 2021. J Womens Health (Larchmt) 2023; 32:592-597. [PMID: 36637854 DOI: 10.1089/jwh.2022.0532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background: Although women and men have matriculated into medical schools in similar proportions since the 1980s, recent data indicate that anesthesiology is lagging in gender equity, especially in academic leadership roles.1,2 As promotion in academic medicine is strongly influenced by publications, understanding whether a lack of women authorship is contributing to this gender gap is crucial.3,4 This article aims to assess how woman authorship trends have changed in the last 16 years, including during the COVID-19 pandemic. Methods: The five highest impact journals in anesthesia were identified as Journal of Clinical Anesthesia, British Journal of Anaesthesia, Anesthesiology, PAIN, and Regional Anesthesia & Pain Medicine. Number of total authors, including women, men, and unknown gender authors as well as incidence of woman first and/or last author, was documented from articles published in 2005, 2010, 2015, 2020, and 2021. Results: This analysis shows that women are gaining representation in anesthesia publications. Overall, there was a statistically significant increase in the total number of women authors and women first and last authorship. However, as of 2021, women still only represented ∼40% of total and first authors and ∼24% of last authors. In addition, increase in first/last woman authorship was not present in all journals when stratified. Conclusion: These journal differences may suggest the editorial evaluation process as a potential source of gender bias. There was a statistically significant relationship between women senior authors and articles with 50% or more women authors, indicating that woman mentorship is contributing to closing equity gap. These data present a starting point for further investigations into gender disparities within anesthesia to continue the forward progression for women in academic medicine.
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Affiliation(s)
- Audrey A Keim
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA
| | - Melissa N Pelkey
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA
| | - Jourdan E Broadfoot
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Tarrah A Folley
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Molly B Kraus
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Jillian A Maloney
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Natalie H Strand
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Lopa Misra
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA
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Deutsch N, Yanofsky SD, Markowitz SD, Tackett S, Berenstain LK, Schwartz LI, Flick R, Heitmiller E, Fiadjoe J, Lee HH, Honkanen A, Malviya S, Lee JK, Schwartz JM. Evaluating the Women's Empowerment and Leadership Initiative: Supporting mentorship, career satisfaction, and well-being among pediatric anesthesiologists. Paediatr Anaesth 2023; 33:6-16. [PMID: 36331372 DOI: 10.1111/pan.14596] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 09/29/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
The Society for Pediatric Anesthesia launched the Women's Empowerment and Leadership Initiative (WELI) in 2018 to empower highly productive women pediatric anesthesiologists to achieve equity, promotion, and leadership. WELI is focused on six career development domains: promotion and leadership, networking, conceptualization and completion of projects, mentoring, career satisfaction, and sense of well-being. We sought feedback about whether WELI supported members' career development by surveys emailed in November 2020 (baseline), May 2021 (6 months), and January 2022 (14 months). Program feedback was quantitatively evaluated by the Likert scale questions and qualitatively evaluated by extracting themes from free-text question responses. The response rates were 60.5% (92 of 152) for the baseline, 51% (82 of 161) for the 6-month, and 52% (96 of 185) for the 14-month surveys. Five main themes were identified from the free-text responses in the 6- and 14-month surveys. Members reported that WELI helped them create meaningful connections through networking, obtain new career opportunities, find tools and projects that supported their career advancement and promotion, build the confidence to try new things beyond their comfort zone, and achieve better work-life integration. Frustration with the inability to connect in-person during the coronavirus-19 pandemic was highlighted. Advisors further stated that WELI helped them improve their mentorship skills and gave them insight into early career faculty issues. Relative to the baseline survey, protégés reported greater contributions from WELI at 6 months in helping them clarify their priorities, increase their sense of achievement, and get promoted. These benefits persisted through 14 months. Advisors reported a steady increase in forming new meaningful relationships and finding new collaborators through WELI over time. All the members reported that their self-rated mentoring abilities improved at 6 months with sustained improvement at 14 months. Thus, programs such as WELI can assist women anesthesiologists and foster gender equity in career development, promotion, and leadership.
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Affiliation(s)
- Nina Deutsch
- Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Samuel D Yanofsky
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Scott D Markowitz
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sean Tackett
- Department of Medicine, Biostatistics, Epidemiology, and Data Management Core, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Laura K Berenstain
- Department of Clinical Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Lawrence I Schwartz
- Department of Anesthesiology, Children's Hospital Colorado, University of Colorado, Aurora, Colorado, USA
| | - Randall Flick
- Departments of Anesthesiology and Perioperative Medicine and Pediatrics and Adolescent Medicine, Mayo Clinic Children's Center, Mayo Clinic, Rochester, Minnesota, USA
| | - Eugenie Heitmiller
- Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - John Fiadjoe
- Deparment of Anesthesiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Helen H Lee
- Department of Anesthesiology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Anita Honkanen
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Shobha Malviya
- Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Jennifer K Lee
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jamie McElrath Schwartz
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Methorst C, Cholley I, Rouache L, Delgal A, Genevois S, Fiard G, Pignot G. [Feminization of urology and glass ceiling: Survey of women urologists in France]. Prog Urol 2023; 33:3-11. [PMID: 36344380 DOI: 10.1016/j.purol.2022.10.002] [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: 06/03/2022] [Revised: 09/07/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Urology has long remained the least feminized specialty. The objective of this study was to assess the demographic characteristics of female urologists and their feelings in terms of discrimination. MATERIAL The survey consisted of a questionnaire of 12 questions, sent by mailing to all female urologists, a first time in May 2016 (n=84), then a second time in January 2020 (n=98). The anonymized answers were analyzed and compared in order to assess the evolution over the last 4 years. The participation rate was 46.4% in 2016 (n=39 respondents) and 50% in 2020 (n=49 respondents). RESULTS The majority of women worked full time (73.5%), with a hospital (38.8%), liberal (46.9%) or mixed (14.3%) activity. Their main theme was women's urology (57.1%). In 2020, 59.2% of respondents had encountered difficulties related to their status as women during their career and 28.1% difficulties related to motherhood. Female urologists in private practice were significantly less concerned than their counterparts with hospital or mixed activity (43.5% versus 73.1%, P=0.035). Women felt that they were underrepresented in association committees at 95.9% (vs. 82.1% in 2016) and in university positions at 79.6% (vs. 89.7% in 2016). Finally, 91.8% were in favor of the creation of an association of women urologists (vs. 53.8% in 2016). CONCLUSION Women urologists may encounter difficulties related to their status as women during their professional career. Between 2016 and 2020, there is an increase in the feeling of under-representation within association committees and an increase in the need to federate. NIVEAU DE PREUVE III, étude rétrospective cas-témoins.
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Affiliation(s)
- C Methorst
- Service d'urologie, CH des quatre villes, 92064 Saint-Cloud, France; Agir pour une urologie diversifiée et équitaire, association loi 1901, France
| | - I Cholley
- Service d'urologie, clinique Saint-Faron, 77100 Mareuil-lès-Meaux, France; Agir pour une urologie diversifiée et équitaire, association loi 1901, France
| | - L Rouache
- Service d'urologie, CH Eure-et-Seine, site hospitalier de Vernon, 27200 Vernon, France; Agir pour une urologie diversifiée et équitaire, association loi 1901, France
| | - A Delgal
- Service d'urologie, polyclinique du Parc, 39100 Dole, France; Agir pour une urologie diversifiée et équitaire, association loi 1901, France
| | - S Genevois
- Service d'urologie, clinique Des Franciscaines, 78000 Versailles, France; Agir pour une urologie diversifiée et équitaire, association loi 1901, France
| | - G Fiard
- Service d'urologie, université de Grenoble, 38700 Grenoble, France; Agir pour une urologie diversifiée et équitaire, association loi 1901, France
| | - G Pignot
- Service de chirurgie oncologique 2, institut Paoli-Calmettes, 232, boulevard de Sainte Marguerite, 13009 Marseille, France; Agir pour une urologie diversifiée et équitaire, association loi 1901, France.
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O'Conor KJ, Young L, Tomobi O, Golden SH, Samen CDK, Banks MC. Implementing pathways to anesthesiology: Promoting diversity, equity, inclusion, and success. Int Anesthesiol Clin 2023; 61:34-41. [PMID: 36480648 DOI: 10.1097/aia.0000000000000386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Katie J O'Conor
- Faculty, Chief Diversity & Equity Officer, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine
| | - Lisa Young
- Johns Hopkins University School of Medicine
| | - Oluwakemi Tomobi
- Global Alliance of Perioperative Professionals, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine
| | - Sherita Hill Golden
- Hugh P. McCormick Family Professor of Endocrinology and Metabolism, Vice President, Chief Diversity Officer, Office of Diversity, Inclusion, and Health Equity, Johns Hopkins Medicine
| | - Christelle D K Samen
- Clinical Fellow, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine
| | - Michael C Banks
- Assistant Professor, Vice Chair for Diversity, Equity, and Inclusion, Assistant Residency Director, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine; Adjunct Faculty, Johns Hopkins School of Education
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24
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Kishi T, Nakano N, Narazaki H, Yashiro M, Hashimoto K, Shinoki T, Sato T, Kinjo N, Imanaka H, Bando Y, Inamo Y, Yamazaki K, Okamoto N. Survey of diversity awareness and environment among members of the Pediatric Rheumatology Association of Japan. Pediatr Int 2023; 65:e15654. [PMID: 37837236 DOI: 10.1111/ped.15654] [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: 04/07/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Diversity management has gained traction in Japan. The Pediatric Rheumatology Association of Japan (PRAJ) has an Advisory Committee for Diversity Promotion with a broader focus on promoting diversity. The objectives of this study were to better understand the problems faced by PRAJ members regarding the work environment, childcare and nursing care, and work-life balance. METHODS A web-based questionnaire was administered to members of the PRAJ and 79 responses were evaluated. RESULTS Of the respondents, 73% were male and 27% were female. A total of 14% worked for more than 12 h on weekdays, and 22% worked for more than 60 h per week and 38% had fewer than 4 days off per month. Regarding childcare, 54% of the respondents were raising preschool children and 83% had taken parental leave for less than 1 year. A total of 17% of participants had family members in need of care. For both childcare and caregiving, the burden was greater for women. Only 18% of the respondents reported a well-balanced work-life balance, and the most common reasons for a lack of balance were not having enough time, heavy workload, and heavy housework load. CONCLUSIONS The working hours of the respondents were long, and female members had a greater burden of childcare and caregiving, which was considered a barrier to the career development of women. In the future, there will be a need to promote a sense of equality in diverse human resources, develop support for family life, and shorten working hours.
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Affiliation(s)
- Takayuki Kishi
- Department of Pediatrics, Tokyo Women's Medical University, Tokyo, Japan
| | - Naoko Nakano
- Department of Pediatrics, Ehime Prefectural Central Hospital, Ehime, Japan
| | | | - Masato Yashiro
- Department of Pediatrics, Okayama University Hospital, Okayama, Japan
| | - Kunio Hashimoto
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshihiko Shinoki
- Department of Pediatrics, National Hospital Organization Mie Hospital, Mie, Japan
| | - Tomomi Sato
- Clinical Education Center for Physicians, Shiga University of Medical Science, Shiga, Japan
| | - Noriko Kinjo
- Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine, University of the Ryukyus, Nishibara, Japan
| | | | - Yuki Bando
- Department of Pediatrics, Kitasato University Medical Center, Saitama, Japan
| | - Yasuji Inamo
- Center for Child and Adolescent Health, Pediatric Rheumatology, and Endocrinology, Jiai Hospital, Tokyo, Japan
| | - Kazuko Yamazaki
- Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Nami Okamoto
- Department of Pediatrics, Osaka Rosai Hospital, Sakai, Japan
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25
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Sommerfield A, Farrell TR, von Ungern-Sternberg BS. Should we change women to become leaders or should we change leadership for everyone? Paediatr Anaesth 2023; 33:4-5. [PMID: 36468291 DOI: 10.1111/pan.14543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/03/2022] [Accepted: 08/13/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Aine Sommerfield
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Nedlands, Western Australia, Australia.,Perioperative Medicine Team, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Tanya Rochelle Farrell
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Britta S von Ungern-Sternberg
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Nedlands, Western Australia, Australia.,Perioperative Medicine Team, Telethon Kids Institute, Nedlands, Western Australia, Australia.,Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, The University of Western Australia, Perth, Western Australia, Australia
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26
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Spitzer Y, Garcia-Marcinkiewicz AG, Malinzak EB. Programmatic approaches to achieving equity for women in anesthesiology. Int Anesthesiol Clin 2023; 61:42-48. [PMID: 36374567 DOI: 10.1097/aia.0000000000000388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yelena Spitzer
- Anesthesiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Annery G Garcia-Marcinkiewicz
- Anesthesiology and Critical Care, University of Pennsylvania, The Children's Hospital of Philadelphia, Civic Center Boulevard, Philadelphia, Pennsylvania
| | - Elizabeth B Malinzak
- Department of Anesthesiology, Duke University, Durham, NC, DUMC Erwin Road, Durham, North Carolina
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27
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Rezaiefar P, Abou-Hamde Y, Naz F, Alborhamy YS, LaDonna KA. "Walking on eggshells": experiences of underrepresented women in medical training. PERSPECTIVES ON MEDICAL EDUCATION 2022; 11:325-332. [PMID: 36417160 PMCID: PMC9684928 DOI: 10.1007/s40037-022-00729-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Medicine remains an inequitable profession for women. Challenges are compounded for underrepresented women in medicine (UWiM), yet the complex features of underrepresentation and how they influence women's career paths remain underexplored. This qualitative study examined the experiences of trainees self-identifying as UWiM, including how navigating underrepresentation influenced their envisioned career paths. METHODS Ten UWiM family medicine trainees from one Canadian institution participated in semi-structured group interviews. Thematic analysis of the data was informed by feminist epistemology and unfolded during an iterative process of data familiarization, coding, and theme generation. RESULTS Participants identified as UWiM based on visible and invisible identity markers. All participants experienced discrimination and "otherness", but experiences differed based on how identities intersected. Participants spent considerable energy anticipating discrimination, navigating otherness, and assuming protective behaviours against real and perceived threats. Both altruism and a desire for personal safety and inclusion influenced their envisioned careers serving marginalized populations and mentoring underrepresented trainees. DISCUSSION Equity, diversity, and inclusion initiatives in medical education risk being of little value without a comprehensive and intersectional understanding of the visible and invisible identities of underrepresented trainees. UWiM trainees' accounts suggest that they experience significant identity dissonance that may result in unintended consequences if left unaddressed. Our study generated the critical awareness required for medical educators and institutions to examine their biases and meet their obligation of creating a safer and more equitable environment for UWiM trainees.
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Affiliation(s)
- Parisa Rezaiefar
- Bruyère Academic Family Health Unit, Ottawa, Ontario, Canada.
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
| | - Yara Abou-Hamde
- Bruyère Academic Family Health Unit, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Farah Naz
- Bruyère Academic Family Health Unit, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Yasmine S Alborhamy
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada
| | - Kori A LaDonna
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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28
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Trends in country and gender representation on editorial boards in anaesthesia journals: a pooled cross-sectional analysis. Anaesthesia 2022; 77:981-990. [PMID: 36444890 PMCID: PMC9545632 DOI: 10.1111/anae.15733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/19/2022] [Accepted: 03/23/2022] [Indexed: 12/14/2022]
Abstract
Evidence exists that women and people from low- and middle-income countries are under-represented on the editorial boards of medical journals. This may adversely influence the journal output. We conducted a pooled, cross-sectional evaluation of the editorial board membership of anaesthesia journals. We collected data on members of editorial boards from the founding year and at 5-yearly intervals until 2020. For each editor, we recorded gender, country of affiliation, World Bank income classification (1990 onwards) and editorial role (2020 only). The composite editorial board diversity score was calculated for each editorial board. We obtained complete data for the composition of editorial boards from all 30 journals for 2020, but for only 171 out of 304 editorial boards (56%) over the time period examined. In 2020, 409 out of 1973 (21%) were women (range across the editorial boards 0-39%) and 139 out of 1982 (7%) were from low-, low-middle- and upper-middle-income countries (range across the editorial boards 0-71%). In 2020, of editorial board positions with known seniority status, 109 out of 259 (42%) of women and 306 out of 960 (32%) of men were in senior roles. In the same year, 397 out of 1115 (36%) of people from high-income countries were in senior roles, compared with 19 out of 93 (20%) of people from upper-middle-income countries and 0 out of 14 (0%) people from lower-middle-income countries. The median composite editorial board diversity score was 4 (range 2-6) in 2020 - 5 or less suggests poor diversity, while 8 or more suggests good diversity. Women and people from low- and middle-income countries are under-represented on anaesthesia journal editorial boards. The editorial boards do not reflect the anaesthesia workforce and may act as a barrier to the publication of research produced by these groups. Urgent action is required to improve diversity.
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29
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Pan S, Zheng W, Rong LQ. Gender representation on editorial boards of anaesthesiology journals from 2010 to 2020. Br J Anaesth 2022; 129:e53-e55. [PMID: 35778275 DOI: 10.1016/j.bja.2022.05.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/24/2022] [Accepted: 05/24/2022] [Indexed: 11/02/2022] Open
Affiliation(s)
- Sabrina Pan
- Department of Anesthesiology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, USA
| | - William Zheng
- Department of Anesthesiology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, USA
| | - Lisa Q Rong
- Department of Anesthesiology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, USA.
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30
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Goldstein T, Lessen S, Moon JY, Tsui I, Rosenberg JB. The Significance of Female Faculty and Department Leadership to the Gender Balance of Ophthalmology Residents. Am J Ophthalmol 2022; 238:181-186. [PMID: 35172171 DOI: 10.1016/j.ajo.2022.01.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To examine the gender balance of academic ophthalmology departments by determining the association between the rates of female residents in ophthalmology programs and department chair/residency program director (PD) gender and rate of female faculty within the department. DESIGN Retrospective cross-sectional study. METHODS Demographic information on ophthalmology programs, including size, location, and gender distribution of leadership, faculty, and residents was collected from public online resources. Departments with residency programs were included for analyses if they were both Accreditation Council Graduate Medical Education accredited and available for application through the San Francisco Match for the 2020-2021 application cycle. For analyses, a binomial regression was fitted to identify factors associated with the female faculty and resident proportions. RESULTS In 117 total programs, 16.7% of chairs and 37.7% of PDs were female. There were more female residents at programs with female PDs (P = .02), with more female faculty (P < .001), and at larger departments (P = .001) and residency programs (P = .04). In multivariate analysis, more female faculty members increased the odds of having more female residents (P < .001). Chair gender did not correlate with the proportion of female faculty or residents. There were the most female residents in the Northeast and the fewest in the Southwest (P = .003). CONCLUSIONS Although gender of department chair did not correlate with proportion of female faculty or residents, programs with more female faculty members had more female residents. Deans and programs should strive for departmental diversity and the recruitment and success of female residents to ensure the use of their full academic capital.
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Peel JK, Flexman AM, Cygler J, Kirkham KR, Lorello GR. Standing out or fitting in: A latent projective content analysis of discrimination of women and 2SLGBTQ+ anesthesiologists and providers. J Clin Anesth 2022; 80:110884. [PMID: 35597003 DOI: 10.1016/j.jclinane.2022.110884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/08/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Discrimination toward sex and gender minority anesthesiologists and anesthesia trainees exists. Potential reasons for this discrimination are unclear and incompletely characterized. This study sought to better understand what discrimination looks like for sex and gender minorities in anesthesiology and the culture within anesthesiology that allows this discrimination to occur. MATERIALS AND METHODS With institutional research ethics board approval and informed consent, we performed a qualitative analysis of free-text responses from a previously-published internet-based cross-sectional survey distributed to Canadian anesthesiology residents, fellows, and staff. The purpose of this survey was to characterize intersections between respondent gender or sexuality with experiences of discrimination in the workplace. Separate analysis of qualitative and quantitative components of this survey was planned a priori, and the quantitative component was published elsewhere. Free-text responses were independently coded by two researchers and subsequently synthesized into emerging themes using latent projective content analysis sensitized by Butler's theory of performativity. RESULTS Out of 490 free-text responses from 171 respondents [140 (81.9%) identifying as heterosexual], two themes emerged: i) fitting in: performativity reinforcing the status quo, and ii) standing out: performativity as a means of disruptive social change. Power structures were observed to favour individuals who "fit in" with the normative performances of gender and/or sexuality. DISCUSSION Our study illuminates how individuals whose performances of gender and sexuality "fit in" with those expected normative performances reinforce a workplace culture that advantages them, whereas individuals whose performances of gender and sexuality "stand out" disproportionately experience discrimination. The dismantling of bias and discrimination in the anesthesiology workplace requires individuals (a) who are empowered within their workplace because they "fit in" with the majority; (b) who recognize discrimination toward communities of their peers and/or colleagues; and (c) who actively choose to "stand out".
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Affiliation(s)
- John K Peel
- University of Toronto, Department of Anesthesiology and Pain Medicine, Toronto, ON, Canada
| | - Alana M Flexman
- The University of British Columbia, Department of Anesthesiology, Pharmacology and Therapeutics, Vancouver, BC, Canada
| | - Jeremy Cygler
- University of Toronto, Department of Medicine, Toronto, ON, Canada
| | - Kyle R Kirkham
- University of Toronto, Department of Anesthesiology and Pain Medicine, Toronto, ON, Canada; University Health Network - Toronto Western Hospital, Department of Anesthesia and Pain Management, Toronto, ON, Canada
| | - Gianni R Lorello
- University of Toronto, Department of Anesthesiology and Pain Medicine, Toronto, ON, Canada; University Health Network - Toronto Western Hospital, Department of Anesthesia and Pain Management, Toronto, ON, Canada; The Wilson Centre, University Health Network, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
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Lee JY, Rahouma M, O'Shaughnessy SM, Lopes AJ, Pryor KO, Gaudino M, Rong LQ. Characterizing factors associated with high authorship in contemporary anesthesia literature: a cross-sectional study. Minerva Cardiol Angiol 2022; 70:123-124. [PMID: 35261224 DOI: 10.23736/s2724-5683.21.05937-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jerry Y Lee
- Department of Anesthesiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA -
| | - Mohamed Rahouma
- Department of Cardiothoracic Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA
| | - Sinead M O'Shaughnessy
- Department of Anesthesiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA
| | - Alexandra J Lopes
- Department of Anesthesiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA
| | - Kane O Pryor
- Department of Anesthesiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA
| | - Mario Gaudino
- Department of Cardiothoracic Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA
| | - Lisa Q Rong
- Department of Anesthesiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA
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Noronha B, Fuchs A, Zdravkovic M, Berger-Estilita J. Gender balance in the medical workplace – A snapshot into anesthesia. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2022. [DOI: 10.1016/j.tacc.2022.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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34
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Shamsher S. Motherhood in the life of anaesthesiologists. Indian J Anaesth 2021; 65:709. [PMID: 34764511 PMCID: PMC8577708 DOI: 10.4103/ija.ija_552_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/09/2021] [Accepted: 09/17/2021] [Indexed: 11/07/2022] Open
Affiliation(s)
- Shivali Shamsher
- Anaesthesia Unit, Faculty of Medicine, Asian Institute of Medicine, Science and Technology (AIMST) University, Bedong, Kedah, Malaysia
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35
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Pan S, Shillcutt S, Oakes D, Muehlschegel JD, Shore-Lesserson L, Rong LQ. Gender of Abstract Presenters at the Annual Meetings of the Society of Cardiovascular Anesthesiologists and American Society of Anesthesiologists: 2016 to 2020. J Cardiothorac Vasc Anesth 2021; 36:1867-1872. [PMID: 34916140 DOI: 10.1053/j.jvca.2021.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/31/2021] [Accepted: 11/03/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The purpose of this study was to assess gender in abstract poster presentations at the Society of Cardiovascular Anesthesiologists (SCA) and American Society of Anesthesiologists (ASA) Annual Meetings from 2016 through 2020 to determine possible gender disparities in anesthesia overall as compared to cardiothoracic anesthesia. DESIGN A bibliometric study SETTING: Publicly available data from the SCA and ASA websites. PARTICIPANTS Presenting and senior authors of abstracts at the SCA and ASA Annual Meetings. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Abstract data on presenting and senior authors were collected for the years 2016 through 2020 for both annual meetings. Observed gender of abstract authors was compared to expected gender based on the gender distribution of cardiac anesthesiologists for the SCA or of all anesthesiologists for the ASA. From 2016 to 2020, the proportion of women senior authors on abstracts was significantly underrepresented (2016-2019, p < 0.05). At the SCA meetings, there was no significant difference in the observed versus expected proportion of women presenting and senior authors. The percentage of woman physicians' abstract-presenting authors at the ASA was overrepresented compared to the expected proportion for each year (2016-2020, p < 0.001). CONCLUSION At the SCA, women were appropriately represented as both presenting and senior abstract authors. At the ASA, there was significant overrepresentation of women as presenting authors and underrepresentation of women as senior authors. These results suggested that abstract presentation is not a barrier to academic advancement.
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Affiliation(s)
- Sabrina Pan
- Department of Anesthesiology, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - Sasha Shillcutt
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE
| | - Daryl Oakes
- Department of Anesthesiology, Stanford University School of Medicine, Stanford, CA
| | - Jochen D Muehlschegel
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham, and Women's Hospital, Boston, MA
| | - Linda Shore-Lesserson
- Department of Anesthesiology, Zucker School of Medicine at Hofstra/Northwell Northshore University Hospital, Manhasset, NY
| | - Lisa Q Rong
- Department of Anesthesiology, Weill Cornell Medicine/New York-Presbyterian, New York, NY.
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Jahshan A, Aoun M, Dekhou A, Folbe A. The underrepresentation of women and ethnic minorities in anesthesiology. J Natl Med Assoc 2021; 114:26-29. [PMID: 34756737 DOI: 10.1016/j.jnma.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/30/2021] [Accepted: 09/21/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE Diversity is crucial in the medical field, where patients have a significantly wide range of ethnic and racial backgrounds. With the increase in diversity in medical school and the growing list of subspecialties in medicine, we would expect to see a rise in diversity in the field of anesthesiology. The purpose of this study is to analyze the representation of gender and underrepresented minorities in anesthesiology residency programs from 2013 through 2019. METHODS To study the ethnic, racial and gender diversity in residents in the field of anesthesiology, data was analyzed from the self-reported data collected in the Journal of the American Medical Association annual report on Graduate Medical Education over the academic period from 2013 through 2019. RESULTS In 2013, female trainees made up 36.0% and Black trainees encompassed 5.9% whereas in 2019, female trainees comprised a mere 33.0% of total anesthesiology residents while Black trainees decreased to 5.5%. CONCLUSION This study illustrates the disparity in the demographic composition of anesthesiology trainees and emphasizes the importance of having a more diverse workforce in the field of anesthesiology.
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Affiliation(s)
- Anna Jahshan
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
| | - Mariam Aoun
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Antonio Dekhou
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Adam Folbe
- William Beaumont Hospital - Royal Oak, Department of Otolaryngology, Royal Oak, MI, USA
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Gupta N, Banerjee S, Choudhury KJ, Prabhakar H. Women Representation as First and Corresponding Authors in Neuroanesthesiology and Neurocritical Care Journals: A Retrospective Analysis. J Neurosurg Anesthesiol 2021; 33:308-314. [PMID: 34238912 DOI: 10.1097/ana.0000000000000788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 05/25/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION There is limited literature on the representation of women in leading roles in neuroanesthesiology and neurocritical care academia. We aimed to determine the representation of women as first and corresponding authors in articles published in 3 dedicated journals of neuroanesthesiology and neurocritical care during last 5 years. METHODS Articles published in the Journal of Neurosurgical Anesthesiology, Neurocritical Care, and Journal of Neuroanaesthesiology and Critical Care between July 1, 2015 and June 30, 2020 were included in this study. The primary outcome was the proportion of women first authors, and secondary outcomes were the percentage of women corresponding authors, and representation of women as first and corresponding author by article type and country of affiliation. RESULTS Of the 1164 articles included in the study, 403 (34.6%) had a woman first author. Women first authorship was highest for Special Articles (5/11; 45.5%), Clinical Reports (44/113; 38.9%) and Narrative Review Articles (58/151; 38.4%) and lowest for Original Research Articles (198/597; 33.2%). Women accounted for 29.6% (344/1164) of corresponding authors across all article types. Overall, the United States and India had the highest representation of women first authors (159/403; 39.0% and 107/344; 31.0%, respectively), and India also had highest proportion of women corresponding authors (107/272; 39.3%). CONCLUSIONS Women were underrepresented compared with men as first author of articles published in 3 dedicated neuroanesthesiology and neurocritical care journals over the last 5 years. Women had the lowest representation as authors of Original Research Articles.
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Affiliation(s)
- Nidhi Gupta
- Department of Neuroanesthesiology, Indraprastha Apollo Hospital
| | - Shraya Banerjee
- Department of Neuroanesthesiology, Indraprastha Apollo Hospital
| | | | - Hemanshu Prabhakar
- Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India
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Lorello GR, Flexman AM. Authorship of Women in Neuroanesthesia and Neurocritical Care: Publish or Perish? J Neurosurg Anesthesiol 2021; 33:283-284. [PMID: 34267155 DOI: 10.1097/ana.0000000000000792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Gianni R Lorello
- Department of Anesthesiology and Pain Medicine, University of Toronto
- Department of Anesthesia and Pain Management, Toronto Western Hospital-University Health Network
- The Wilson Centre, University Health Network
- Women's College Research Institute, Women's College Hospital, Toronto, ON
| | - Alana M Flexman
- Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia
- Department of Anesthesia, St. Paul's Hospital, Vancouver, BC, Canada
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Women in anesthesiology: is it different in the Arab world? Int Anesthesiol Clin 2021; 58:78-83. [PMID: 32756219 DOI: 10.1097/aia.0000000000000288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Gender distribution in awarded Canadian Institutes of Health Research grants among anesthesiologists: a retrospective analysis between 2008 and 2020. Can J Anaesth 2021; 68:1580-1581. [PMID: 34105068 DOI: 10.1007/s12630-021-02043-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 10/21/2022] Open
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Lorello GR, Silver JK, Flores LE, Larson AR, McCarthy K, Odonkor CA, Flexman AM. Diversity of residency applicants to anaesthesiology and other specialties in the USA from 2014 to 2019. Br J Anaesth 2021; 127:e27-e30. [PMID: 34045063 DOI: 10.1016/j.bja.2021.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Gianni R Lorello
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada; Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, ON, Canada; The Wilson Centre, Toronto General Hospital, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA; Massachusetts General Hospital, Boston, MA, USA; Brigham and Women's Hospital, Boston, MA, USA; Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Laura E Flores
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Kristian McCarthy
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Charles A Odonkor
- Department of Orthopaedics and Rehabilitation, Division of Physiatry, Yale New Haven Hospital, New Haven, CT, USA
| | - Alana M Flexman
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada; Department of Anesthesiology, St Paul's Hospital/Providence Health Care, Vancouver, BC, Canada
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Peel JK, Flexman AM, Kirkham KR, Lorello GR. Gender and sexuality-based discrimination in anesthesiology within Canada: a cross-sectional survey. Can J Anaesth 2021; 68:1263-1265. [PMID: 33890238 DOI: 10.1007/s12630-021-01997-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 03/27/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022] Open
Affiliation(s)
- John K Peel
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada
| | - Alana M Flexman
- Department of Anesthesiology, Pharmacology &Therapeutics, The University of British Columbia, Vancouver, BC, Canada.,Department of Anesthesia, St. Paul's Hospital, Vancouver, BC, Canada
| | - Kyle R Kirkham
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.,Department of Anesthesia and Pain Management, Toronto Western Hospital - University Health Network, Toronto, ON, Canada
| | - Gianni R Lorello
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada. .,Department of Anesthesia and Pain Management, Toronto Western Hospital - University Health Network, Toronto, ON, Canada. .,The Wilson Centre, University Health Network, Toronto, ON, Canada. .,Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
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Lorello GR, Gautam M, Barned C, Peer M. Impact of the intersection of anaesthesia and gender on burnout and mental health, illustrated by the COVID-19 pandemic. Anaesthesia 2021; 76 Suppl 4:24-31. [PMID: 33682104 PMCID: PMC8251311 DOI: 10.1111/anae.15360] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2020] [Indexed: 12/15/2022]
Abstract
Physician burnout and poor mental health are prevalent and often stigmatised. Anaesthetists may be at particular risk and this is further increased for women anaesthetists due to biases and inequities within the specialty. However, gender-related risk factors for and experiences of burnout and poor mental health remain under-researched and under-reported. This negatively impacts individual practitioners, the anaesthesia workforce and patients and carries significant financial implications. We discuss the impact of anaesthesia and gender on burnout and mental health using the COVID-19 pandemic as an example illustrating how women and men differentially experience stressors and burnout. COVID-19 has further accentuated the gendered effects of burnout and poor mental health on anaesthetists and brought further urgency to the need to address these issues. While both personal and organisational factors contribute to burnout and poor mental health, organisational changes that recognise and acknowledge inequities are pivotal to bolster physician mental health.
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Affiliation(s)
- G. R. Lorello
- Department of Anesthesiology and Pain MedicineUniversity of TorontoTorontoONCanada
- Department of Anesthesiology and Pain MedicineUniversity Health NetworkToronto Western HospitalTorontoONCanada
| | - M. Gautam
- Department of PsychiatryUniversity of OttawaOttawaONCanada
| | - C. Barned
- University Health NetworkToronto Western HospitalTorontoONCanada
- Pragmatic Health Ethics Research UnitInstitut de recherches cliniques de MontrealMontrealQCCanada
| | - M. Peer
- Department of Anesthesiology and Pain MedicineUniversity Health NetworkToronto Western HospitalTorontoONCanada
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Jaulin F, Nguyen DP, Marty F, Druette L, Plaud B, Duret C, Fletcher D. Perceived stress, anxiety and depressive symptoms among anaesthesia and intensive care residents: A French national survey. Anaesth Crit Care Pain Med 2021; 40:100830. [PMID: 33744493 DOI: 10.1016/j.accpm.2021.100830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/05/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Mental health and well-being is a significant problem for medical students in training. In this study, we aim to estimate the prevalence of anxiety and depressive symptoms, burnout and psychosocial distress in French anaesthesia and intensive care residents. METHODS A national online observational study used validated questionnaires (Hospital Anxiety and Depression Scale (HADS), Copenhagen Burnout Inventory (CBI), Perceived Stress Scale (PSS) and work-related questions (work-hours per week, night shift per month, safety rest after night shift, average time to start and end work, break time and time for lunch) to assess mental health and well-being of French residents in anaesthesia and intensive care. RESULTS We obtained 519 answers (22.5% of 2302 students), 55% of respondents working in anaesthesia, 41% in intensive care at the time of study. Residents describe certain symptomatology in anxiety (19.8%) and depressive symptoms (7.8%). PSS identifies a perceived high stress (score > 27) for 55.7% of the subjects. The CBI questionnaire identifies 205 (38.9%) residents undergoing burnout, 80.7% working more than 48 h per week and 39.1% more than 60 h. The duration of work per week (> 50 h), gender (female) and on-going training in intensive care are independent risk factors of psychological suffering. Lifestyle and level of training are not statistically identified risk factors. CONCLUSION This first online survey of French anaesthesia and intensive care residents reveals a significant frequency of anxiety and depressive symptoms, burnout and a link to potential targets of improvement in work conditions mainly related to the number of work hours per week.
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Affiliation(s)
- François Jaulin
- Facteur Humains en Santé Association, Patient Safety Database, Young Anaesthetists Association (AJAR), Sorbonne University, Paris, France
| | | | - François Marty
- Young Anaesthetists Association (AJAR), Bicêtre Hospital, Kremlin Bicêtre, France
| | | | - Benoit Plaud
- Université de Paris & APHP. Nord, DMU PARABOL, hôpital Saint-Louis, service d'anesthésie, de réanimation et centre de traitement des brûlés, 1, avenue Claude Vellefaux, 75010 Paris, France
| | | | - Clément Duret
- Occupational Health Unit, Raymond Poincaré Hospital, Assistance Publique Hôpitaux de Paris, Garches, France
| | - Dominique Fletcher
- Ambroise Paré Hospital, Assistance Publique Hôpitaux de Paris, Boulogne Billancourt, France; Versailles Saint-Quentin University, France; Paris Saclay University, Saint-Aubin, France.
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Flexman AM, Shillcutt SK, Davies S, Lorello GR. Current status and solutions for gender equity in anaesthesia research. Anaesthesia 2021; 76 Suppl 4:32-38. [PMID: 33682100 DOI: 10.1111/anae.15361] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 11/24/2022]
Abstract
Despite increasing numbers of women entering anaesthesia, they remain persistently under-represented within academic anaesthesia and research. Gender discordance is seen across multiple aspects of research, including authorship, editorship, peer review, grant receipt, speaking and leading. Women are also under-represented at higher faculty ranks and in department chair positions. These inequities are further magnified for women with intersectional identities, such as those who identify as Black, indigenous and women of colour. Several barriers to participation in research have been identified to date, including a disproportionate amount of family responsibilities, a disproportionate burden of clinical service, gender bias, sexual harassment and the gender pay gap. Several strategies to improve gender equity have been proposed. Increasing access to formal mentorship of women in academic medicine is frequently cited and has been used by healthcare institutions and medical societies. Senior faculty and leaders must also be conscious of including women in sponsorship and networking opportunities. Institutions should provide support for parents of all genders, including supportive parental leave policies and flexible work models. Women should also be materially supported to attend formal educational conferences targeted for women, aimed at improving networking, peer support and professional development. Finally, leaders must display a clear intolerance for sexual harassment and discrimination to drive culture change. Peers and leaders alike, of all genders, can act as upstanders and speak up on behalf of targets of discrimination, both in the moment or after the fact. Gender inequities have persisted for far too long and can no longer be ignored. Diversifying the anaesthesia research community is essential to the future of the field.
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Affiliation(s)
- A M Flexman
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - S K Shillcutt
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - S Davies
- Trinity College, Cambridge University, Cambridge, UK
| | - G R Lorello
- Department of Anesthesiology and Pain Medicine, University Health Network and University of Toronto, Toronto, ON, Canada
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Gender differences among medical students learning tracheal intubation: A prospective cohort study. Eur J Anaesthesiol 2021; 38:309-311. [PMID: 33538431 DOI: 10.1097/eja.0000000000001405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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47
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Rong LQ, Khan FM, Naik A, Robinson NB, Hameed I, Anderson LP, Rahouma M, Monteiro A, Sandner SE, Girardi LN, Pryor KO, Gaudino M. Gender differences in the authorship of contemporary anaesthesia literature: a cross-sectional study. Br J Anaesth 2021; 126:e162-e164. [PMID: 33640120 DOI: 10.1016/j.bja.2021.01.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
- Lisa Q Rong
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
| | - Faiza M Khan
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Ajita Naik
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | - N Bryce Robinson
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Irbaz Hameed
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Lillye P Anderson
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA
| | - Mohamed Rahouma
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Ajit Monteiro
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | | | - Leonard N Girardi
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Kane O Pryor
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA
| | - Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
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48
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Institutional commitment to reduce gender gap. Anaesth Crit Care Pain Med 2021; 40:100801. [PMID: 33453455 DOI: 10.1016/j.accpm.2021.100801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/08/2020] [Accepted: 10/08/2020] [Indexed: 11/22/2022]
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Mainali S, Moheet AM, McCredie VA, Livesay S, Manners J, Rhoney DH, Muehlschlegel S. The Neurocritical Care Society Gender Parity Analysis in Grants and Recognition Awards. Neurocrit Care 2021; 35:358-366. [PMID: 33442813 DOI: 10.1007/s12028-020-01164-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 11/23/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Several recent studies across the field of medicine have indicated gender disparity in the reception of prestigious awards and research grants, placing women in medicine at a distinct disadvantage. Gender disparity has been observed in neurology, critical care medicine and within various professional societies. In this study, we have examined the longitudinal trends of gender parity in awards and grants within the Neurocritical Care Society (NCS). METHODS A retrospective analysis was conducted of all available data longitudinally from 2004, when NCS first granted awards through 2019. We used self-identified gender in the membership roster to record gender for each individual. For individuals without recorded gender, we used a previously validated double verification method using a systematic web-based search. We collected data on six awards distributed by the NCS and divided these awards into two main categories: (1) scientific category: (a) Christine Wijman Young Investigator Award; (b) Best Scientific Abstract Award; (c) Fellowship Grant; (d) INCLINE Grant; and (2) non-scientific category: (a) Travel Grant; and (b) Presidential Citation. Available data were analyzed to evaluate longitudinal trends in awards using descriptive statistics and simple or multiple linear regression analyses, as appropriate. RESULTS A total of 445 awards were granted between the years 2004 and 2019. Thirty-six awards were in the scientific category, while 409 awards were in the non-scientific category. Only 8% of women received NCS awards in the scientific awards category, whereas 44% of women received an award in the non-scientific category. Most notable in the scientific category are the Best Scientific Abstract Award and the Fellowship Grant, in which no woman has ever received an award to date, compared to 18 men between both awards. In contrast, women are well represented in the non-scientific awards category with an average of 5% increase per year in the number of women awardees. CONCLUSIONS Our data reveal gender disparity, mainly for scientific or research awards. Prompt evaluation of the cause and further actions to address gender disparity in NCS grants and recognition awards is needed to establish gender equity in this area.
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Affiliation(s)
- Shraddha Mainali
- Department of Neurology, Division of Stroke and Neurocritical Care, The Ohio State University, Columbus, OH, USA.
| | - Asma M Moheet
- Neurocritical Care, OhioHealth Riverside Methodist Hospital, Columbus, OH, USA
| | - Victoria A McCredie
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.,Toronto Western Hospital, University Health Network, Toronto, ON, Canada.,Krembil Research Institute, Toronto Western Hospital, Toronto, ON, Canada
| | - Sarah Livesay
- College of Nursing, Rush University, Chicago, IL, USA
| | - Jody Manners
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Denise H Rhoney
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Susanne Muehlschlegel
- Department of Neurology, Anesthesia/Critical Care and Surgery, University of Massachusetts Medical School, Worcester, MA, USA
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Margolis RD, Strupp KM, Beacham AO, Yaster M, Austin TM, Macrae AW, Diaz-Berenstain L, Janosy NR. The effects of COVID-19 on pediatric anesthesiologists: A survey of the members of the Society for Pediatric Anesthesia. Anesth Analg 2021; 134:348-356. [PMID: 33439606 DOI: 10.1213/ane.0000000000005422] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The COVID-19 pandemic has affected the personal and professional lives of all healthcare workers. Anesthesiologists frequently perform virus-aerosolizing procedures, such as intubation and extubation, that place them at increased risk of infection. We sought to determine how the initial COVID-19 outbreak affected members of the Society for Pediatric Anesthesia (SPA) on both personal and professional levels. Specifically, we examined the potential effects of gender and age on personal stress, burnout, sleep deprivation, anxiety, and depression, assessed job satisfaction, and explored financial impact. METHODS After receiving approval from the SPA Committees for Research and Quality and Safety, and the Colorado Multiple Institutional Review Board, we emailed a questionnaire to all 3,245 SPA members. The survey included 22 questions related to well-being and 13 questions related to effects of COVID-19 on current and future practice, finances, retirement planning, academic time and productivity, and clinical and home responsibilities. To address low initial response rates and quantify nonresponse bias, we sent a shortened follow-up survey to a randomly selected subsample (n=100) of SPA members who did not respond to the initial survey. Response differences between the two cohorts were determined. RESULTS A total of 561 (17%) members responded to the initial questionnaire. Because of COVID-19, 21.7% of respondents said they would change their clinical responsibilities and 10.6% would decrease their professional working time. Women were more likely than men to anticipate a future COVID-19-related job change (OR = 1.92, 95% CI = 1.12 to 2.63, P = 0.011), perhaps because of increased home responsibilities (OR = 2.63, 95% CI = 1.74 to 4.00, P <0.001). Additionally, 14.2% of respondents planned to retire early and 11.9% planned to retire later. Women and non-whites had higher likelihoods of burnout on univariate analysis (OR = 1.75, 95% CI = 1.06 to 2.94, P = 0.026 and OR = 1.82, 95% CI = 1.08 to 3.04, P = 0.017, respectively) and 25.1% of all respondents felt socially isolated. In addition, both changes in retirement planning and future occupational planning were strongly associated with total job satisfaction scores (both P<0.001). CONCLUSIONS The COVID-19 pandemic has affected the personal and professional lives of pediatric anesthesiologists, albeit not equally, as women and non-whites have been disproportionately impacted. The pandemic has significantly affected personal finances, home responsibilities, and retirement planning, reduced clinical and academic practice time and responsibilities, and increased feelings of social isolation, stress, burnout, and depression/anxiety.
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Affiliation(s)
- Rebecca D Margolis
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA
| | - Kim M Strupp
- Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Abbie O Beacham
- Director of Behavioral Science, University of Louisville School of Dentistry, Louisville, KY
| | - Myron Yaster
- Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Thomas M Austin
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
| | - Andrew W Macrae
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
| | - Laura Diaz-Berenstain
- Department of Anesthesiology, Division of Pediatric Cardiac Anesthesiology, Children's Hospital of Cincinnati, Cincinnati, OH
| | - Norah R Janosy
- Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
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