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Gill GK, Ng SL, Kangasjarvi E, Crukley J, Kumagai A, Simpson JS. From skillful to empathic: evaluating shifts in medical students' perceptions of surgeons through a combined patient as teacher and arts-based reflection program. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:14-21. [PMID: 38045079 PMCID: PMC10690007 DOI: 10.36834/cmej.76536] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Introduction The purpose of this study was to identify whether the incorporation of a combined Patient as teacher (PAT) and arts-based reflection (ABR) program during a surgical clerkship rotation could influence more humanistic perceptions of surgeons, using an innovative evaluation approach. Methods A novel, single question evaluation tool was created. Third year medical-students were asked to "list the top 5 attributes of a surgeon, in order of perceived importance" both before and after their surgical clerkship rotations and participation in the PAT/ABR program. Attributes identified by students were coded as either "humanistic" or "non-humanistic," which were then analyzed using generalized linear regression models under a Bayesian framework. Results After participation in the PAT/ABR program, the predicted probability of students ranking a humanistic characteristic as the most important attribute of a surgeon had increased by 17%, and the predicted probability of students ranking a humanistic characteristic amongst their top three attributes for a surgeon had increased by 21%. Conclusion This innovative evaluative method suggested the success of a combined PAT/ABR program in encouraging a humanistic perspective of surgery and this approach could potentially be explored to evaluate other humanistic education initiatives.
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Affiliation(s)
- Gurjot K Gill
- Department of Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Stella L Ng
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
| | - Emilia Kangasjarvi
- Centre for Faculty Development, University of Toronto at St. Michael’s Hospital, Unity Health Toronto, Ontario, Canada
| | - Jeff Crukley
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
| | - Arno Kumagai
- Faculty of Medicine, University of Toronto, Ontario, Canada
- Women’s College Hospital, University of Toronto, Ontario, Canada
| | - Jory S Simpson
- Department of Surgery, University of Toronto Faculty of Medicine, Ontario, Canada
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Hull B, Pestrin O, Brennan CM, Hackney R, Scott CE. Women in Surgery Events Alone do not Change Medical Student Perceptions of Gender Bias and Discrimination in Orthopaedic Surgery. Front Surg 2022; 9:905558. [PMID: 35693302 PMCID: PMC9174672 DOI: 10.3389/fsurg.2022.905558] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 05/06/2022] [Indexed: 12/05/2022] Open
Abstract
Aims This study investigated the perceptions of medical students regarding the barriers to pursuing a career in trauma and orthopaedics (T&O); and whether these perceptions were altered by attending an event promoting women in T&O. Methods An event consisting of presentations and interactive sessions from two female T&O trainees was hosted online. Attendees completed pre and post-event questionnaires. Students were asked about their previous exposure to T&O, perceptions of gender imbalances in T&O and what barriers they perceived prevented women from entering T&O. Univariate analysis was performed to identify changes in perceptions following the event. Results Pre-event questionnaires were completed by 102 people; and post-event by 52. Although 64/102 respondents were considering a career in T&O, 26/102 were dissuaded by perceived gender disparities. Perceptions of gender disparities were significantly higher in UK based attendees compared to other nationalities (p = 0.047). Attendees were more likely to want to pursue a career in T&O if they had been directly exposed at medical school (p = 0.044), but exposure did not alter perceptions of women in T&O. The most common perceived barrier was the orthopaedic stereotype followed by male dominated workplace culture, and lack of female role models. Pre and post-event responses did not differ significantly for any areas examined. Conclusion There are significant concerns amongst medical students regarding gender based discrimination within T&O, and these perceptions were not altered by attending a one-off women in T&O event. Early exposure to T&O appears important to improve interest in orthopaedics, whereas negative stereotyping is a barrier.
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Affiliation(s)
- Bethany Hull
- Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
- Correspondence: Bethany Hull
| | - Olivia Pestrin
- Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Caitlin M. Brennan
- Edinburgh Orthopaedics, Department of Trauma and Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Rosie Hackney
- Edinburgh Orthopaedics, Department of Trauma and Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Chloe E.H. Scott
- Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
- Edinburgh Orthopaedics, Department of Trauma and Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
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Chan KIP, Khu KJO, Brillante EMB, Flores GP, Nakpil AS, Go DAD, Dantes JKC, Manlapid JMC, Legaspi GD. Perceptions and likelihood of medical students to pursue a career in neurosurgery: Findings from the Philippines. World Neurosurg 2022; 164:e590-e598. [DOI: 10.1016/j.wneu.2022.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 10/18/2022]
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Klemmt C, Backhaus J, Jeske D, Koenig S. Psychometric Properties and Calibration of the SPOREEM (Students' Perception of the Operating Room Educational Environment Measure). JOURNAL OF SURGICAL EDUCATION 2021; 78:1151-1163. [PMID: 33168469 DOI: 10.1016/j.jsurg.2020.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/31/2020] [Accepted: 10/17/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The experience in the operating room is considered as a crucial element affecting medical students' satisfaction with workplace-based training in surgery. We developed the "Students' Perception of the Operating Room Educational Environment Measure" (SPOREEM) and applied the approach of Item Response Theory to improve accuracy of its measurement. DESIGN Psychometric analysis determined the factorial structure. Using Item Response Theory, item thresholds were calculated on response option levels. Sum scores in the factors were then computed using calibrated unit weights. SETTING One hundred medical students from the University Medical Center in Goettingen, Germany, enrolled in a one-week surgery rotation completed the SPOREEM. RESULTS The final 19-item questionnaire resulted in 3 factors: "Learning support and inclusion" (1), "Workplace atmosphere" (2), and "Experience of emotional stress" (3). Item calibration resulted in refinement of sum scores in the factors. Male students significantly rated factor 1 more positively. Factor 2 was perceived to a similar degree in all 3 surgical disciplines involved. Factor 3 was rated lower by those students planning a surgical field of postgraduate training. CONCLUSIONS We developed a valid, reliable, and feasible tool to assess the overall educational climate of undergraduate training in the OR. Calibration of items refined the measurement.
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Affiliation(s)
- Chantal Klemmt
- Institute of Medical Teaching and Medical Education Research, Wuerzburg, Germany.
| | - Joy Backhaus
- Institute of Medical Teaching and Medical Education Research, Wuerzburg, Germany
| | - Debora Jeske
- School of Applied Psychology, University College Cork, Cork City, Ireland
| | - Sarah Koenig
- Institute of Medical Teaching and Medical Education Research, Wuerzburg, Germany
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Kangasjarvi E, Ng SL, Friesen F, Simpson JS. Patients as teachers and arts-based reflection in surgical clerkship: A preliminary exploration. MEDICAL TEACHER 2020; 42:1362-1368. [PMID: 32847442 DOI: 10.1080/0142159x.2020.1807482] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Involving patients in medical education as teachers is not a novel approach, yet it has not been widely adopted by undergraduate surgical curricula in Canada. The Patients as Teachers initiative in surgery (PAT) program, with an arts-based reflection assignment, was developed for surgical clerks with the goals of emphasizing patient-centredness in surgical practice, humanistic aspects of medicine, and to counterbalance the commonplace emphasis on technical competency in surgery. METHODS Qualitative data was collected exploring the question: What was the experience and impact of the PAT program on patient teachers and students? Patient teachers (n = 5) were invited to participate in one-on-one interviews and students (n = 46) were invited to participate in focus groups at the end of the program. RESULTS Findings converged around two main themes: what students/patient teachers valued about the PAT program and what they perceived was learned. While patient teachers felt a sense of emotional healing and appreciated a chance to contribute to medical education, students valued having protected time to learn in depth from the patient teachers. Students also begrudgingly came to appreciate the arts-based reflection assignment. CONCLUSION By bringing patient voice to the forefront and encouraging reflection, the PAT program emphasized to students the compassionate and humanistic side of surgical care. Future studies could examine the mechanisms by which learning occurs and long-term impacts.
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Affiliation(s)
- Emilia Kangasjarvi
- Faculty of Medicine, Centre for Faculty Development, University of Toronto at St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Stella L Ng
- Faculty of Medicine, Centre for Faculty Development, University of Toronto at St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Centre for Ambulatory Care Education, Women's College Hospital, Toronto, Ontario, Canada
- Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Farah Friesen
- Faculty of Medicine, Centre for Faculty Development, University of Toronto at St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Jory S Simpson
- Department of Surgery, Division of General Surgery, Faculty of Medicine, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
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Thomas A, Murtaza AN, Michael Spiers HV, Zargaran A, Turki M, Mathur J, Fukui A, Zargaran D, Khan O. Declining interest in general surgical training - Challenging misconceptions and improving access at undergraduate level. Ann Med Surg (Lond) 2018; 40:3-8. [PMID: 30962923 PMCID: PMC6423304 DOI: 10.1016/j.amsu.2018.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 11/29/2022] Open
Abstract
Background In recent years, general surgery has faced a decline in applicants for postgraduate training. The St. George's Surgical Society hosted a national surgical conference with an aim to explore the reasons for the decline and to investigate the effectiveness of a one-day intervention on students' perceptions of general surgery and surgical skills. Materials and methods The conference took place on 20th January 2018 at St. George's, University of London. During the conference, medical students received lectures on "careers in surgery" and small-group workshops introducing students to simulation-based laparoscopic machines. Delegates were invited to complete before and after questionnaires looking at various domains; (1) Perceptions of general surgery, (2) Simulation skills, and (3) Usefulness of the day. Results There were significant impacts on student perceptions of the speciality such as increases in the views that "general surgery contained the opportunities for personal and professional development" (26%, p = 0.04), and of "general surgery as a rewarding speciality" (26%, p = 0.05). There were also negative changes such as an increase in the perception that "general surgery is female unfriendly" (+32%, p = 0.01). There were positive findings in all aspects relating to the use of laparoscopic simulation. Discussion The challenges faced in improving access to general surgery has been highlighted. More importantly the benefits of a one day intervention in addressing misconceptions and improving knowledge was seen. This study also shows the benefits of simulation teaching in the undergraduate curriculum. Conclusion The intervention has improved the perceptions on general surgery, surgical skills and knowledge and provided a platform for engaging students and clinicians.
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Affiliation(s)
- Amal Thomas
- St. George's, University of London, London, UK
| | | | | | | | | | - Jai Mathur
- St. George's, University of London, London, UK
| | - Akiko Fukui
- St. George's, University of London, London, UK
| | - David Zargaran
- Academic Foundation Doctor, Imperial College Healthcare NHS Trust, London, UK
| | - Omar Khan
- St. George's University Hospital NHS Trust, London, UK
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Carpenter AM, Tan SA, Costopoulos K, Cooper LA, Sarosi GA, Shaw CM. Gender Diversity in General Surgery Residency Leadership. JOURNAL OF SURGICAL EDUCATION 2018; 75:e68-e71. [PMID: 30177356 DOI: 10.1016/j.jsurg.2018.07.021] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/17/2018] [Accepted: 07/30/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE This study aimed to evaluate the proportion and characteristics of women who serve in general surgery program director (PD) and associate program director (APD) positions in the United States. DESIGN General surgery programs (n = 276) and directors were identified using the Association for Program Directors in Surgery website; information was cross-referenced with American Medical Association FREIDA and Accreditation Council for Graduate Medical Education databases, current to July 1, 2017. Each program's website was accessed to determine the gender and academic ranking of faculty. RESULTS Results reveal a preponderance of men in PD and APD positions. Women accounted for 18.4% (n = 51) of the 276 PD positions, with more women in APD positions (29.6%). There was no correlation between gender of PD and the corresponding APD, (χ2 = 0.68, p = 0.41; Phi coefficient = -0.0695). Of those with academic appointments, men who were PDs were more likely to be full professors when compared to women PDs (38.5% vs 24.1%, respectively). The median number of days since appointment to PD was similar in both groups (1461 days for men vs 1377 for women, p = 0.18), although more men have held PD positions longer. Programs with a higher proportion of women faculty were more likely to have a woman PD (p = 0.0397), but not those with more women residents (p = 0.225) or a woman Department Chair (p = 0.56). CONCLUSIONS Among general surgery program directorship, men continue to hold more positions of educational leadership, although the trend appears to be shifting toward a more equal balance, particularly in those programs with proportionately more women faculty. This discrepancy may be due to academic rank or length of tenure. As more women hold academic positions in the field of general surgery, an increase in the representation of this group in leadership is anticipated. Although senior leadership (PD) positions remain disproportionately held by men, APD positions are filled by a greater percentage of women than academic surgical faculty, although the absolute percentage remains less than 50%. Educational leadership may be a viable path to academic leadership for both women and men.
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Affiliation(s)
| | - Sanda A Tan
- Department of Surgery, University of Florida College of Medicine, Gainesville, Florida
| | | | - Lou Ann Cooper
- University of Florida, College of Medicine, Gainesville, Florida
| | - George A Sarosi
- Department of Surgery, University of Florida College of Medicine, Gainesville, Florida
| | - Christiana M Shaw
- Department of Surgery, University of Florida College of Medicine, Gainesville, Florida.
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Do female surgeons learn or teach differently? Am J Surg 2017; 213:282-287. [PMID: 28139201 DOI: 10.1016/j.amjsurg.2016.10.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 08/24/2016] [Accepted: 10/20/2016] [Indexed: 11/21/2022]
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