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Lee JK, Tackett S, Skarupski KA, Forbush K, Fivush B, Oliva-Hemker M, Levine RB. Inspiring and Preparing Our Future Leaders: Evaluating the Impact of the Early Career Women's Leadership Program. J Healthc Leadersh 2024; 16:287-302. [PMID: 39099833 PMCID: PMC11298210 DOI: 10.2147/jhl.s470538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 07/20/2024] [Indexed: 08/06/2024] Open
Abstract
Purpose The number of women in high-level leadership in academic medicine remains disproportionately low. Early career programs may help increase women's representation in leadership. We evaluated the Early Career Women's Leadership Program (ECWLP). We hypothesized that participants would rate themselves as having increased confidence in their leadership potential, improved leadership skills, and greater alignment between their goals for well-being and leading after the program. We also explored the participants' aspirations and confidence around pursuing high-level leadership before and after the program. Methods We surveyed women physicians and scientists before and after they participated in the 2023 ECWLP, consisting of 11 seminars over six months. We analyzed pre- and post-program data using Wilcoxon signed-rank tests. We analyzed answers to open-ended questions with a content analysis approach. Results 47/51 (92%) participants responded, and 74% answered pre- and post-program questionnaires. Several metrics increased after the program, including women's confidence in their ability to lead (p<0.001), negotiate (p<0.001), articulate their career vision (p<0.001), reframe obstacles (p<0.001), challenge their assumptions (p<0.001), and align their personal and professional values (p=0.002). Perceptions of conflict between aspiring to lead and having family responsibilities (p=0.003) and achieving physical well-being (p=0.002) decreased. Perceived barriers to advancement included not being part of influential networks, a lack of transparency in leadership, and a competitive and individualistic culture. In the qualitative analysis, women described balancing internal factors such as self-doubt with external factors like competing professional demands when considering leadership. Many believed that becoming a leader would be detrimental to their well-being. Beneficial ECWLP components included support for self-reflection, tactical planning to pursue leadership, and creating a safe environment. Conclusion The ECWLP improved women's confidence and strategic plans to pursue leadership in a way that supported their work-life integration. Early career leadership programs may encourage and prepare women for high-level leadership.
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Affiliation(s)
- Jennifer K Lee
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine (JHU), Baltimore, MD, USA
- Office of Faculty, JHU, Baltimore, MD, USA
- Department of Pediatrics, JHU, Baltimore, MD, USA
| | - Sean Tackett
- Department of Medicine, JHU, Baltimore, MD, USA
- Biostatistics, Epidemiology, and Data Management Core, JHU, Baltimore, MD, USA
| | - Kimberly A Skarupski
- Office of Faculty, JHU, Baltimore, MD, USA
- Department of Medicine, JHU, Baltimore, MD, USA
- Bloomberg School of Public Health, JHU, Baltimore, MD, USA
| | - Kathy Forbush
- Human Resources, Office of Talent Management, JHU, Baltimore, MD, USA
| | - Barbara Fivush
- Office of Faculty, JHU, Baltimore, MD, USA
- Department of Pediatrics, JHU, Baltimore, MD, USA
| | - Maria Oliva-Hemker
- Office of Faculty, JHU, Baltimore, MD, USA
- Department of Pediatrics, JHU, Baltimore, MD, USA
| | - Rachel B Levine
- Office of Faculty, JHU, Baltimore, MD, USA
- Department of Medicine, JHU, Baltimore, MD, USA
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McGourty CA, Castillo F, Donzelli G, Keenan BP, Gilbreth M, Santhosh L. Creation of a sustainable longitudinal women in Leadership Development (WILD) curriculum focused on graduate medical education trainees. BMC MEDICAL EDUCATION 2024; 24:374. [PMID: 38580971 PMCID: PMC10996076 DOI: 10.1186/s12909-024-05369-3] [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: 07/14/2023] [Accepted: 03/28/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Although women comprise the majority of medical students, gender disparities emerge early and remain at the highest levels of academia. Most leadership courses focus on faculty or students rather than women graduate medical education (GME) trainees. AIM To promote the leadership development of women GME trainees through empowerment, community building, networking and mentorship, and concrete leadership skills development. SETTING University of California, San Francisco. PARTICIPANTS 359 women residents and fellows from 41 specialties. PROGRAM DESCRIPTION A longitudinal curriculum of monthly workshops designed to support leadership development for women trainees. Sessions and learning objectives were designed via needs assessments and literature review. PROGRAM EVALUATION A mixed-methods evaluation was performed for 3 years of WILD programming. Quantitative surveys assessed participant satisfaction and fulfillment of learning objectives. Structured interview questions were asked in focus groups and analyzed qualitatively. DISCUSSION 23% of invited participants attended at least one session from 2018 to 2021, despite challenging trainee schedules. Surveys demonstrated acceptability and satisfaction of all sessions, and learning objectives were met at 100% of matched sessions. Focus groups highlighted positive impact in domains of community-building, leadership skills, mentorship, and empowerment. This program has demonstrated WILD's longitudinal sustainability and impact for women trainees.
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Affiliation(s)
- Colleen A McGourty
- University of California, San Francisco, 505 Parnassus Ave., 94143, San Francisco, CA, USA
| | - Francine Castillo
- University of California, San Francisco, 505 Parnassus Ave., 94143, San Francisco, CA, USA
| | - Grace Donzelli
- University of California, San Francisco, 505 Parnassus Ave., 94143, San Francisco, CA, USA
| | - Bridget P Keenan
- University of California, San Francisco, 505 Parnassus Ave., 94143, San Francisco, CA, USA
| | - Margaret Gilbreth
- University of California, San Francisco, 505 Parnassus Ave., 94143, San Francisco, CA, USA
| | - Lekshmi Santhosh
- University of California, San Francisco, 505 Parnassus Ave., 94143, San Francisco, CA, USA.
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Lee JK, Levine RB, Yousem DM, Faraday N, Skarupski KA, Ishii M, Daugherty Biddison EL, Oliva-Hemker M. Commitment to inclusion: The importance of collaboration in gender equity work. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241252574. [PMID: 38742705 PMCID: PMC11095174 DOI: 10.1177/17455057241252574] [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: 09/22/2023] [Revised: 03/12/2024] [Accepted: 04/16/2024] [Indexed: 05/16/2024]
Abstract
Despite decades of faculty professional development programs created to prepare women for leadership, gender inequities persist in salary, promotion, and leadership roles. Indeed, men still earn more than women, are more likely than women to hold the rank of professor, and hold the vast majority of positions of power in academic medicine. Institutions demonstrate commitment to their faculty's growth by investing resources, including creating faculty development programs. These programs are essential to help prepare women to lead and navigate the highly matrixed, complex systems of academic medicine. However, data still show that women persistently lag behind men in their career advancement and salary. Clearly, training women to adapt to existing structures and norms alone is not sufficient. To effectively generate organizational change, leaders with power and resources must commit to gender equity. This article describes several efforts by the Office of Faculty in the Johns Hopkins University School of Medicine to broaden inclusivity in collaborative work for gender equity. The authors are women and men leaders in the Office of Faculty, which is within the Johns Hopkins University School of Medicine dean's office and includes Women in Science and Medicine. Here, we discuss potential methods to advance gender equity using inclusivity based on our institutional experience and on the findings of other studies. Ongoing data collection to evaluate programmatic outcomes in the Johns Hopkins University School of Medicine will be reported in the future.
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Affiliation(s)
- Jennifer K Lee
- Office of Faculty, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
| | - Rachel B Levine
- Office of Faculty, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
| | - David M Yousem
- Office of Faculty, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
- Department of Radiology, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
| | - Nauder Faraday
- Office of Faculty, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
| | - Kimberly A Skarupski
- Office of Faculty, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
| | - Masaru Ishii
- Office of Faculty, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
- Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
- Department of Neurosurgery, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
| | - EL Daugherty Biddison
- Office of Faculty, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
| | - Maria Oliva-Hemker
- Office of Faculty, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine (JHUSOM), Baltimore, MD, USA
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Debets M, Jansen I, Lombarts K, Kuijer-Siebelink W, Kruijthof K, Steinert Y, Daams J, Silkens M. Linking leadership development programs for physicians with organization-level outcomes: a realist review. BMC Health Serv Res 2023; 23:783. [PMID: 37480101 PMCID: PMC10362722 DOI: 10.1186/s12913-023-09811-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Hospitals invest in Leadership Development Programs (LDPs) for physicians, assuming they benefit the organization's performance. Researchers have listed the advantages of LDPs, but knowledge of how and why organization-level outcomes are achieved is missing. OBJECTIVE To investigate how, why and under which circumstances LDPs for physicians can impact organization-level outcomes. METHODS We conducted a realist review, following the RAMESES guidelines. Scientific articles and grey literature published between January 2010 and March 2021 evaluating a leadership intervention for physicians in the hospital setting were considered for inclusion. The following databases were searched: Medline, PsycInfo, ERIC, Web of Science, and Academic Search Premier. Based on the included documents, we developed a LDP middle-range program theory (MRPT) consisting of Context-Mechanism-Outcome configurations (CMOs) describing how specific contexts (C) trigger certain mechanisms (M) to generate organization-level outcomes (O). RESULTS In total, 3904 titles and abstracts and, subsequently, 100 full-text documents were inspected; 38 documents with LDPs from multiple countries informed our MRPT. The MRPT includes five CMOs that describe how LDPs can impact the organization-level outcomes categories 'culture', 'quality improvement', and 'the leadership pipeline': 'Acquiring self-insight and people skills (CMO1)', 'Intentionally building professional networks (CMO2)', 'Supporting quality improvement projects (CMO3)', 'Tailored LDP content prepares physicians (CMO4)', and 'Valuing physician leaders and organizational commitment (CMO5)'. Culture was the outcome of CMO1 and CMO2, quality improvement of CMO2 and CMO3, and the leadership pipeline of CMO2, CMO4, and CMO5. These CMOs operated within an overarching context, the leadership ecosystem, that determined realizing and sustaining organization-level outcomes. CONCLUSIONS LDPs benefit organization-level outcomes through multiple mechanisms. Creating the contexts to trigger these mechanisms depends on the resources invested in LDPs and adequately supporting physicians. LDP providers can use the presented MRPT to guide the development of LDPs when aiming for specific organization-level outcomes.
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Affiliation(s)
- Maarten Debets
- Amsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMC, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands.
| | - Iris Jansen
- Amsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMC, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
| | - Kiki Lombarts
- Amsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMC, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
| | - Wietske Kuijer-Siebelink
- School of Education, Research On Responsive Vocational and Professional Education, HAN University of Applied Sciences, Nijmegen, Netherlands
- Research On Learning and Education, Radboud University Medical Centre, Radboudumc Health Academy, Nijmegen, Netherlands
| | - Karen Kruijthof
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands
| | - Yvonne Steinert
- Faculty of Medicine and Health Sciences, Institute of Health Sciences Education, McGill University, Montreal, Canada
| | - Joost Daams
- Medical Library, Amsterdam University Medical Centers, Amsterdam, Noord-Holland, Netherlands
| | - Milou Silkens
- Department of Health Services Research & Management, City University of London, London, UK
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands
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Grando A, Ancker JS, Tao D, Howe R, Coonan C, Johns M, Chapman W. Design and evaluation of a Women in American Medical Informatics Association (AMIA) leadership program. J Am Med Inform Assoc 2021; 29:163-170. [PMID: 34679176 DOI: 10.1093/jamia/ocab232] [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: 07/24/2021] [Revised: 08/10/2021] [Accepted: 10/06/2021] [Indexed: 11/12/2022] Open
Abstract
The objective is to report on the design and evaluation of the inaugural Women in AMIA Leadership Program. A year-long leadership curriculum was developed. Survey responses were summarized with descriptive statistics and quotes selected. Twenty-four scholars participated in the program. There was a significant increase in perceived achievement of learning objectives after the program (P < .0001). The largest improvement was in leadership confidence and presence in work interactions (modal answer Neutral in presurvey from 21 responses rose to Agree in postsurvey from 24 responses). Most (92% of 13) scholars clarified leadership vision and goals and (83% of 18) would be Very Likely to recommend the program to others. The goals of the program-developing women's leader identity, increasing networks, and accumulating experience for future programs-were achieved. The second leadership program is on its way in the United States and Australia. This study may benefit organizations seeking to develop leadership programs for women in informatics and digital health.
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Affiliation(s)
- Adela Grando
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Jessica S Ancker
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Donghua Tao
- Medical Center Library, Saint Louis University, St. Louis, Missouri, USA
| | | | | | - Merida Johns
- The Monarch Center for Women's Leadership Development, Huntley, Illinois, USA
| | - Wendy Chapman
- Centre for Digital Transformation of Health, University of Melbourne, Melbourne, VIC, Australia
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Tricco AC, Bourgeault I, Moore A, Grunfeld E, Peer N, Straus SE. Advancing gender equity in medicine. CMAJ 2021; 193:E244-E250. [PMID: 33593950 PMCID: PMC8034331 DOI: 10.1503/cmaj.200951] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Andrea C Tricco
- Knowledge Translation Program (Tricco, Peer, Straus), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Epidemiology Division and Institute for Health Policy, Management, and Evaluation (Tricco), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; School of Sociology and Anthropology (Bourgeault), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Grunfeld), and Department of Geriatric Medicine (Straus), University of Toronto, Toronto, Ont.
| | - Ivy Bourgeault
- Knowledge Translation Program (Tricco, Peer, Straus), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Epidemiology Division and Institute for Health Policy, Management, and Evaluation (Tricco), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; School of Sociology and Anthropology (Bourgeault), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Grunfeld), and Department of Geriatric Medicine (Straus), University of Toronto, Toronto, Ont
| | - Ainsley Moore
- Knowledge Translation Program (Tricco, Peer, Straus), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Epidemiology Division and Institute for Health Policy, Management, and Evaluation (Tricco), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; School of Sociology and Anthropology (Bourgeault), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Grunfeld), and Department of Geriatric Medicine (Straus), University of Toronto, Toronto, Ont
| | - Eva Grunfeld
- Knowledge Translation Program (Tricco, Peer, Straus), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Epidemiology Division and Institute for Health Policy, Management, and Evaluation (Tricco), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; School of Sociology and Anthropology (Bourgeault), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Grunfeld), and Department of Geriatric Medicine (Straus), University of Toronto, Toronto, Ont
| | - Nazia Peer
- Knowledge Translation Program (Tricco, Peer, Straus), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Epidemiology Division and Institute for Health Policy, Management, and Evaluation (Tricco), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; School of Sociology and Anthropology (Bourgeault), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Grunfeld), and Department of Geriatric Medicine (Straus), University of Toronto, Toronto, Ont
| | - Sharon E Straus
- Knowledge Translation Program (Tricco, Peer, Straus), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Epidemiology Division and Institute for Health Policy, Management, and Evaluation (Tricco), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; School of Sociology and Anthropology (Bourgeault), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Grunfeld), and Department of Geriatric Medicine (Straus), University of Toronto, Toronto, Ont
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Tricco AC, Bourgeault I, Moore A, Grunfeld E, Peer N, Straus SE. Promouvoir l’équité entre les genres en médecine. CMAJ 2021; 193:E664-E671. [PMID: 33941530 PMCID: PMC8112631 DOI: 10.1503/cmaj.200951-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Andrea C Tricco
- Programme d'application des connaissances (Tricco, Peer, Straus), Institut du savoir Li Ka Shing, Hôpital St. Michael, Unity Health Toronto; Division d'épidémiologie et Institut de gestion, d'évaluation et de politiques de santé (Tricco), École de santé publique Dalla Lana, Université de Toronto, Toronto, Ont.; École de sociologie et d'anthropologie (Bourgeault), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Moore), Université McMaster, Hamilton, Ont.; Département de médecine familiale et communautaire (Grunfeld) et Département de médecine gériatrique (Straus), Université de Toronto, Toronto, Ont.
| | - Ivy Bourgeault
- Programme d'application des connaissances (Tricco, Peer, Straus), Institut du savoir Li Ka Shing, Hôpital St. Michael, Unity Health Toronto; Division d'épidémiologie et Institut de gestion, d'évaluation et de politiques de santé (Tricco), École de santé publique Dalla Lana, Université de Toronto, Toronto, Ont.; École de sociologie et d'anthropologie (Bourgeault), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Moore), Université McMaster, Hamilton, Ont.; Département de médecine familiale et communautaire (Grunfeld) et Département de médecine gériatrique (Straus), Université de Toronto, Toronto, Ont
| | - Ainsley Moore
- Programme d'application des connaissances (Tricco, Peer, Straus), Institut du savoir Li Ka Shing, Hôpital St. Michael, Unity Health Toronto; Division d'épidémiologie et Institut de gestion, d'évaluation et de politiques de santé (Tricco), École de santé publique Dalla Lana, Université de Toronto, Toronto, Ont.; École de sociologie et d'anthropologie (Bourgeault), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Moore), Université McMaster, Hamilton, Ont.; Département de médecine familiale et communautaire (Grunfeld) et Département de médecine gériatrique (Straus), Université de Toronto, Toronto, Ont
| | - Eva Grunfeld
- Programme d'application des connaissances (Tricco, Peer, Straus), Institut du savoir Li Ka Shing, Hôpital St. Michael, Unity Health Toronto; Division d'épidémiologie et Institut de gestion, d'évaluation et de politiques de santé (Tricco), École de santé publique Dalla Lana, Université de Toronto, Toronto, Ont.; École de sociologie et d'anthropologie (Bourgeault), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Moore), Université McMaster, Hamilton, Ont.; Département de médecine familiale et communautaire (Grunfeld) et Département de médecine gériatrique (Straus), Université de Toronto, Toronto, Ont
| | - Nazia Peer
- Programme d'application des connaissances (Tricco, Peer, Straus), Institut du savoir Li Ka Shing, Hôpital St. Michael, Unity Health Toronto; Division d'épidémiologie et Institut de gestion, d'évaluation et de politiques de santé (Tricco), École de santé publique Dalla Lana, Université de Toronto, Toronto, Ont.; École de sociologie et d'anthropologie (Bourgeault), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Moore), Université McMaster, Hamilton, Ont.; Département de médecine familiale et communautaire (Grunfeld) et Département de médecine gériatrique (Straus), Université de Toronto, Toronto, Ont
| | - Sharon E Straus
- Programme d'application des connaissances (Tricco, Peer, Straus), Institut du savoir Li Ka Shing, Hôpital St. Michael, Unity Health Toronto; Division d'épidémiologie et Institut de gestion, d'évaluation et de politiques de santé (Tricco), École de santé publique Dalla Lana, Université de Toronto, Toronto, Ont.; École de sociologie et d'anthropologie (Bourgeault), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Moore), Université McMaster, Hamilton, Ont.; Département de médecine familiale et communautaire (Grunfeld) et Département de médecine gériatrique (Straus), Université de Toronto, Toronto, Ont
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Alexandraki I, Rosasco RE, Mooradian AD. An Evaluation of Faculty Development Programs for Clinician-Educators: A Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:599-606. [PMID: 33116061 DOI: 10.1097/acm.0000000000003813] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE Faculty development (FD) has become increasingly important for clinician-educators. An array of FD programs has been developed, but the impact of these programs on clinician-educators and their learners and workplace is less known. The authors conducted a scoping review to explore the status of program evaluation in FD for clinician-educators to inform future planning and research. METHOD Five databases were searched for articles published from January 1998 to August 2018 using Arksey and O'Malley's framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Studies that described evaluation methods and outcomes of FD programs for clinician-educators were included. Data were collected and organized according to program domain (teaching, research/scholarship, leadership, or a combination of skills). A modified version of the Kirkpatrick model was used to compare results among studies. RESULTS From a total of 2,091 articles, 1,095 were eligible for full review, and 31 met the inclusion criteria. Seven programs targeted only teaching skills, 3 research/scholarship skills, 7 leadership skills, and 14 a combination of skills. Eighteen programs required the completion of a project; fewer offered fellowships, master's degrees, or certificates. Participant surveys were the most common evaluation method across all domains. Often used metrics included participant satisfaction and self-reported knowledge, skills, behavior changes, scholarly output, and leadership positions. Less common evaluation methods included learner and peer evaluations, interviews, and focus groups. Change at the institutional level was evaluated in 11 programs. CONCLUSIONS Program evaluation remains an underdeveloped area in FD for clinician-educators. Developers expend significant effort on program design and implementation but approach evaluation less purposefully. Rigorous metrics that align with program goals and are used longitudinally are needed to accurately assess the impact of FD programs on participants and their learners, workplace, and institutions at large.
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Affiliation(s)
- Irene Alexandraki
- I. Alexandraki is professor of medicine and course director, Florida State University College of Medicine, Tallahassee, Florida
| | - Robyn E Rosasco
- R.E. Rosasco is head of research services, Charlotte Edwards Maguire Medical Library, Florida State University College of Medicine, Tallahassee, Florida
| | - Arshag D Mooradian
- A.D. Mooradian is professor and chair, Department of Medicine, University of Florida College of Medicine, Jacksonville, Florida
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Lydon S, O'Dowd E, Walsh C, O'Dea A, Byrne D, Murphy AW, O'Connor P. Systematic review of interventions to improve gender equity in graduate medicine. Postgrad Med J 2021; 98:300-307. [PMID: 33637640 DOI: 10.1136/postgradmedj-2020-138864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 01/21/2021] [Accepted: 01/28/2021] [Indexed: 11/03/2022]
Abstract
Women are substantially underrepresented in senior and leadership positions in medicine and experience gendered challenges in their work settings. This systematic review aimed to synthesise research that has evaluated interventions for improving gender equity in medicine. English language electronic searches were conducted across MEDLINE, CINAHL, Academic Search Complete, PsycINFO and Web of Science. Reference list screening was also undertaken. Peer-reviewed studies published between 2000 and March 2020 that evaluated interventions to improve gender equity, or the experiences of women, in academic or clinical medicine were reviewed. Dual reviewer data extraction on setting, participants, type of intervention, measurement and outcomes was completed. Methodological rigour and strength of findings were evaluated. In total, 34 studies were included. Interventions were typically focused on equipping the woman (82.4%), that is, delivering professional development activities for women. Fewer focused on changing cultures (20.6%), ensuring equal opportunities (23.5%) or increasing the visibility or valuing of women (23.5%). Outcomes were largely positive (87.3%) but measurement typically relied on subjective, self-report data (69.1%). Few interventions were implemented in clinical settings (17.6%). Weak methodological rigour and a low strength of findings was observed. There has been a focus to-date on interventions which Equip the Woman Interventions addressing systems and culture change require further research consideration. However, institutions cannot wait on high quality research evidence to emerge to take action on gender equity. Data collated suggest a number of recommendations pertaining to research on, and the implementation of, interventions to improve gender equity in academic and clinical settings.
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Affiliation(s)
- Sinéad Lydon
- School of Medicine, National University of Ireland, Galway, Ireland .,Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
| | - Emily O'Dowd
- Department of General Practice, National University of Ireland, Galway, Ireland
| | - Chloe Walsh
- Department of General Practice, National University of Ireland, Galway, Ireland
| | - Angela O'Dea
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Dara Byrne
- School of Medicine, National University of Ireland, Galway, Ireland.,Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
| | - Andrew W Murphy
- Department of General Practice, National University of Ireland, Galway, Ireland
| | - Paul O'Connor
- School of Medicine, National University of Ireland, Galway, Ireland.,Department of General Practice, National University of Ireland, Galway, Ireland
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10
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Marshall AL, Durani U, Mikhael J. Women in academic medicine leadership: correlation between sex of medical school deans and affiliated academic hospital system CEOs. BMJ LEADER 2020. [DOI: 10.1136/leader-2019-000151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundWomen are currently under-represented in ‘C-suite’ leadership positions at academic medical centres, including medical school deans, department chairs and hospital chief executive officers (CEOs). There are many potential reasons for the low percentage of women in academic medical leadership, including lack of mentorship and sponsorship, increased non-work responsibilities compared with men, implicit bias, and others.MethodsWe collected data from 136 fully accredited US allopathic medical schools regarding sex of the medical school dean and sex of the CEO of the largest academic medical centre/teaching hospital affiliate. Schools where students rotate at non-academic centres were excluded from the final analysis, leaving 124 schools where we investigated the relationship between sex of US medical school dean and affiliated academic medical centre CEO.Results16.9% of current medical school deans and 17.7% of affiliated academic medical centre CEOs were female. Systems with one female leader were significantly (6.25-fold, 95% CI 2.22 to 17.56, p=0.001) more likely to have a second female leader, regardless of geographical region or institution type (public vs private).ConclusionsThere is a significant positive association between medical school dean and affiliated academic hospital centre CEO sex. There are many potential factors that could contribute to this positive association, including mentorship, sponsorship and medical system consciousness about gender equity, among others. This relationship is important to recognise as we strive for more gender parity for women in positions of leadership in academic medicine.
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11
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Alwazzan L, Al-Angari SS. Women's leadership in academic medicine: a systematic review of extent, condition and interventions. BMJ Open 2020; 10:e032232. [PMID: 31948988 PMCID: PMC7044906 DOI: 10.1136/bmjopen-2019-032232] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/24/2019] [Accepted: 11/26/2019] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Because culture reflects leadership, the making of diverse and inclusive medical schools begins with diversity among leaders. The inclusion of women leaders remains elusive, warranting a systematic exploration of scholarship in this area. We ask: (1) What is the extent of women's leadership in academic medicine? (2) What factors influence women's leadership? (3) What is the impact of leadership development programmes? DESIGN Systematic review. DATA SOURCES A systematic search of six online databases (OvidMEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library and ERIC) from the earliest date available to April 2018 was conducted. Bridging searches were conducted from April 2018 until October 2019. ELIGIBILITY CRITERIA: (1) Peer-reviewed; (2) English; (3) Quantitative studies (prospective and retrospective cohort, cross-sectional and preintervention/postintervention); evaluating (4) The extent of women's leadership at departmental, college and graduate programme levels; (5) Factors influencing women's leadership; (6) Leadership development programmes. Quantitative studies that explored women's leadership in journal editorial boards and professional societies and qualitative study designs were excluded. DATA EXTRACTION AND SYNTHESIS Two reviewers screened retrieved data of abstracts and full-texts for eligibility, assessment and extracted study-level data independently. The included studies were objectively appraised using the Medical Education Research Quality Study Instrument with an inter-rater reliability of (κ=0.93). RESULTS Of 4024 records retrieved, 40 studies met the inclusion criteria. The extent of women's leadership was determined through gender distribution of leadership positions. Women's leadership emergence was hindered by institutional requirements such as research productivity and educational credentials, while women's enactment of leadership was hindered by lack of policy implementation. Leadership development programmes had a positive influence on women's individual enactment of leadership and on medical schools' cultures. CONCLUSIONS Scholarship on women's leadership inadvertently produced institute-centric rather than women-centric research. More robust contextualised scholarship is needed to provide practical-recommendations; drawing on existing conceptual frameworks and using more rigorous research methods.
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Affiliation(s)
- Lulu Alwazzan
- Medical Education, Al Imam Mohammed Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Samiah S Al-Angari
- Otolaryngology, Head & Neck surgery, King Saud University, Riyadh, Saudi Arabia
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12
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Newman C, Templeton K, Chin EL. Inequity and Women Physicians: Time to Change Millennia of Societal Beliefs. Perm J 2020; 24:1-6. [PMID: 33482936 DOI: 10.7812/tpp/20.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Gender inequities date back thousands of years, with women expected to be caregivers at home and men expected to be leaders with occupations outside the home. In more recent history, women have trained in various professions, including medicine. Although the number of female physicians has risen consistently over the past several decades and half of US medical students now are women, gender inequities persist and are due, at least in part, to implicit (unconscious) biases held by doctors, other health care professionals, and patients and their families. Implicit biases negatively affect women in their medical careers and contribute to slower advancement, less favorable evaluations, underrepresentation in leadership positions, fewer invited lectures, lower salaries, impostor syndrome, and burnout. Despite efforts to address gender biases, studies in academic medical centers indicate no major change over a 20-year span. Management of implicit gender bias at the organizational level is imperative. Strategies include implicit bias training for doctors and other staff; development of a transparent and equitable compensation plan; and transparent processes for promotion and hiring, mentorship, and sponsorship of women physicians for grand rounds, lectureships, committees, leadership positions, and awards. Achievement of equity for women physicians requires effort and ultimately a culture change. Gender equity in the medical profession will lead to improved physician wellness, retention of women physicians, and improved access to and quality of health care.
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Affiliation(s)
- Connie Newman
- Division of Endocrinology and Metabolism, Department of Medicine, New York University Grossman School of Medicine, New York, NY.,Past President, American Medical Women's Association, Schaumburg, IL
| | - Kim Templeton
- Past President, American Medical Women's Association, Schaumburg, IL.,Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, KS
| | - Eliza Lo Chin
- American Women's Association, Schaumburg, IL, and University of California, San Fransisco, San Fransisco, CA
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13
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Yount KM, Cheong YF, Miedema SS, Chen JS, Menstell E, Maxwell L, Ramakrishnan U, Clark CJ, Rochat R, Del Rio C. Gender equality in global health leadership: Cross-sectional survey of global health graduates. Glob Public Health 2019; 15:852-864. [PMID: 31869280 DOI: 10.1080/17441692.2019.1701057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Women comprise two-thirds of the global-health (GH) workforce but are underrepresented in leadership. GH departments are platforms to advance gender equality in GH leadership. Using a survey of graduates from one GH department, we compared women's and men's post-training career agency and GH employment and assessed whether gender gaps in training accounted for gender gaps in career outcomes. Master-of-Public-Health (MPH) and mid-career-fellow alumni since 2010 received a 31-question online survey. Forty-four per cent of MPH alum and 24% of fellows responded. Using logistic regression, we tested gender gaps in training satisfaction, career agency, and GH employment, unadjusted and adjusted for training received. Women (N = 293) reported lower satisfaction with training (M7.6 vs 8.2) and career agency (leadership ability: M6.3 vs 7.4) than men (N = 60). Women more often than men acquired methods-related skills (95% vs 78%), employment recommendations (42% vs 18%), and group membership. Men more often than women acquired leadership training (43% vs 23%), award recommendations (53% vs 17%), and conference support (65% vs 35%). Women and men had similar odds of GH employment. Accounting for confounders and gender-gaps in training eliminated gender gaps in five of six career-agency outcomes. Panel studies of women's and men's career trajectories in GH are needed.
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Affiliation(s)
- Kathryn M Yount
- Hubert Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, GA, USA.,Department of Sociology, Emory University, Atlanta, GA, USA
| | - Yuk Fai Cheong
- Department of Psychology, Emory University, Atlanta, GA, USA
| | | | - Julia S Chen
- Hubert Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, GA, USA
| | - Elizabeth Menstell
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, GA, USA
| | - Lauren Maxwell
- Hubert Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, GA, USA
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, GA, USA
| | - Cari Jo Clark
- Hubert Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, GA, USA
| | - Roger Rochat
- Hubert Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, GA, USA
| | - Carlos Del Rio
- Hubert Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, GA, USA.,Department of Medicine, Division of Infectious Diseases, Emory University, Atlanta, GA, USA
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14
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Hilty DM, Liu HY, Stubbe D, Teshima J. Defining Professional Development in Medicine, Psychiatry, and Allied Fields. Psychiatr Clin North Am 2019; 42:337-356. [PMID: 31358116 DOI: 10.1016/j.psc.2019.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Professional development refers to training, formal education, and/or advanced professional learning intended to help clinicians, teachers, researchers, and administrators improve their professional knowledge and effectiveness. Institutions have been trying to adapt to a rapidly changing internal and external environment, with resource constraints and competitive health care. Professional development may be contextualized using adult development, educational, and organizational perspectives, and most best practices overlap. Key partners are faculty, departments, institutions, and national organizations. Interprofessional, team-based and project-based longitudinal initiatives may ignite educational innovations, and serve as a method to learn authentically in the workplace, promote socialization, and change attitudes.
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Affiliation(s)
- Donald M Hilty
- Mental Health, Northern California Veterans Administration Health Care System, Department of Psychiatry and Behavioral Sciences, University of California Davis, 10535 Hospital Way, Mather, Sacramento, CA 95655, USA.
| | - Howard Y Liu
- Department of Psychiatry, University of Nebraska Medical Center, 42nd and Emile, Omaha, NE 68198, USA; Behavioral Health Education Center of Nebraska, Omaha, NE, USA
| | - Dorothy Stubbe
- Child Study Center, Child and Adolescent Psychiatry, Yale School of Medicine, 230 South Frontage Road, New Haven, CT 06519, USA
| | - John Teshima
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Room FG-62, Toronto, Ontario M4N 3M5, Canada
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15
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Noah TL, Tolleson-Rinehart S, Meltzer-Brody S, Jordan JM, Kelly KJ, Eimers KM, Burks AW. Application of Assessment Metrics for an Academic Department Faculty Development Program. J Pediatr 2018; 195:5-8.e1. [PMID: 29576182 DOI: 10.1016/j.jpeds.2018.01.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 01/03/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Terry L Noah
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC.
| | - Sue Tolleson-Rinehart
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC; Gillings School of Global Public Health, Chapel Hill, NC
| | - Samantha Meltzer-Brody
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC; Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Joanne M Jordan
- Department of Internal Medicine, University of North Carolina School of Medicine, Chapel Hill, NC; Office of the Dean, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Kevin J Kelly
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Kathryn M Eimers
- Office of the Dean, University of North Carolina School of Medicine, Chapel Hill, NC
| | - A Wesley Burks
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC; Office of the Dean, University of North Carolina School of Medicine, Chapel Hill, NC
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16
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Laver KE, Prichard IJ, Cations M, Osenk I, Govin K, Coveney JD. A systematic review of interventions to support the careers of women in academic medicine and other disciplines. BMJ Open 2018; 8:e020380. [PMID: 29572397 PMCID: PMC5875640 DOI: 10.1136/bmjopen-2017-020380] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To summarise quantitative evaluations of interventions designed to support the careers of women in academia of any discipline. METHOD A systematic search of English entries in PubMed, CINAHL and Google Scholar was conducted in September 2017. Methodological quality of the studies was independently assessed by two authors using the Joanna Briggs Institute quality appraisal checklists. Meta-analysis was not possible due to heterogeneity in methods and outcomes; results were synthesised and displayed narratively. RESULTS Eighteen eligible studies were identified, mostly evaluating programmes in academic medicine departments. The most common interventions were mentoring, education, professional development and/or networking programmes. All programmes took a 'bottom-up' approach in that women were responsible for opting into and devoting time to participation. Study quality was low overall, but all studies reported positive outcomes on at least one indicator. Most often this included improvements in self-rated skills and capabilities, or satisfaction with the programme offered. Results regarding tangible outcomes were mixed; while some studies noted improvements in promotion, retention and remuneration, others did not. CONCLUSIONS This review suggests that targeted programmes have the potential to improve some outcomes for women in academia. However, the studies provide limited high-quality evidence to provide information for academic institutions in terms of the best way to improve outcomes for women in academia. The success of an intervention appears to be undermined when it relies on the additional labour of those it is intending to support (ie, 'bottom-up' approaches). As such, academic institutions should consider and evaluate the efficacy of 'top-down' interventions that start with change in practice of higher management.
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Affiliation(s)
- Kate E Laver
- Department of Rehabilitation, Aged and Extended Care, Flinders University, Adelaide, Australia
| | - Ivanka J Prichard
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Monica Cations
- Department of Rehabilitation, Aged and Extended Care, Flinders University, Adelaide, Australia
| | - Ivana Osenk
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Kay Govin
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - John D Coveney
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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