Are Female Applicants Disadvantaged in National Institutes of Health Peer Review? Combining Algorithmic Text Mining and Qualitative Methods to Detect Evaluative Differences in R01 Reviewers' Critiques

Gender-based differences in the representation and experiences of academic leaders in medicine and dentistry: a mixed method study from Pakistan

BACKGROUND

Research evidence suggests gender-based differences in the extent and experiences of academic leaders across the globe even in developed countries like USA, UK, and Canada. The under-representation is particularly common in higher education organizations, including medical and dental schools. The current study aimed to investigate gender-based distribution and explore leaders' experiences in the medical and dental institutes in a developing country, Pakistan.

METHODS

A mixed-method approach was used. Gender-based distribution data of academic leaders in 28 colleges including 18 medical and 10 dental colleges of Khyber Pakhtunkhwa, Pakistan were collected. Qualitative data regarding the experiences of academic leaders (n = 10) was collected through semi-structured interviews followed by transcription and thematic analysis using standard procedures.

RESULTS

Gender-based disparities exist across all institutes with the greatest differences among the top-rank leadership level (principals/deans) where 84.5% of the positions were occupied by males. The gender gap was relatively narrow at mid-level leadership positions reaching up to as high as > 40% of female leaders in medical/dental education. The qualitative analysis found gender-based differences in the experiences under four themes: leadership attributes, leadership journey, challenges, and support.

CONCLUSIONS

The study showed that women are not only significantly under-represented in leadership positions in medical and dental colleges in Pakistan, they also face gender-based discrimination and struggling to maintain a decent work life balance. These findings are critical and can have important implications for government, organizations, human resource managers, and policymakers in terms of enacting laws, proposing regulations, and establishing support mechanisms to improve gender-based balance and help current and aspiring leaders in their leadership journey.

The status of academic interventional radiologists in Germany with focus on gender disparity: how can we do better?

PURPOSE

The aim was to characterize the framework conditions in academic interventional radiology (IR) in Germany with focus on differences between genders.

MATERIALS AND METHODS

After IRB approval, all members of The German Society for Interventional Radiology and Minimally Invasive Therapy (n = 1,632) were invited to an online survey on work and research. Statistical comparisons were undertaken with the Fisher's exact test, Wilcoxon rank sum test or Pearson's Chi-squared test.

RESULTS

From 267 available questionnaires (general response rate 16.4%), 200 were fully completed. 40% of these (78/200) were involved in research (71% men vs. 29% women, p < 0.01) and eligible for further analysis. Of these, 6% worked part-time (2% vs. 17%, p < 0.05). 90% of the respondents spent less than 25% of their research during their paid working hours, and 41% performed more than 75% of their research during. leisure time. 28% received exemption for research. 88% were (rather) satisfied with their career. One in two participants successfully applied for funding, with higher success rates among male applicants (90% vs. 75%) and respondents with protected research time (93% vs. 80%). Compared to men, women rated their entrance in research as harder (p < 0.05), their research career as more important (p < 0.05), felt less noticed at congresses (93% vs. 53%, p < 0.01), less confident (98% vs. 71%, p < 0.01), and not well connected (77% vs. 36%, p < 0.01).  CONCLUSION: Women and men did research under the same circumstances; however, women were underrepresented. Future programs should generally focus on protected research time and gather female mentors to advance academic IR in Germany.

Satisfaction of Women Faculty in Academic Medicine

Purpose: Research about academic medicine women faculty has focused on comparisons of men and women or specific groups who achieved leadership. To better understand the low percentages of women in academic medicine leadership, attention should be paid to the career continuum within genders. Study findings will inform policies and programs to support women in building careers and acquiring leadership positions. Materials and Methods: Association of American Medical Colleges (AAMC) StandPoint Faculty Engagement Survey data are used to describe and compare women assistant, associate and full professors' perceptions of (1) career development and advancement opportunities, and (2) a culture and climate that fosters diversity, equity, and inclusion. Specific similarities and differences with men are highlighted. Results: Fifty-nine percent of women respondents were assistant, 25% associate, and 16% full professors. Associate professors of both genders were the least satisfied on the main measures. Women were less satisfied than men at each career stage across the majority of variables. Among women, fewer than half of full and associate professors, and 52% of assistant professors believe they can express their opinions without fear of retribution. While the majority at all ranks (69%-75%) report feeling respected in the workplace, among those who did not, the highest percentage of disrespect based on gender was among associate professors. Conclusions: The perceptions of >7,500 academic medicine women faculty, representing different generations and ranks, underscore the need to broadly address gender inequity and sexism throughout the career continuum. It identifies the mid-career stage as a challenging experience for both men and women. Women, especially at the associate professor rank, remain a critically dissatisfied and underresourced group that is at risk for underutilization and potentially exit from academic medicine. All ranks of women need career development and equitable policies to support their sense of belonging and career advancement.

Importance of Breast Sensation After Mastectomy: Evidence from Three Sources

Background

Every year, more than 90,000 U.S. women undergo mastectomy. More than 40% have reconstruction. Following reconstruction, most women experience persistent partial or complete numbness of the reconstructed breasts, and many experience pain. Yet, breast reconstruction procedures focus largely on esthetic outcomes with mixed impact on sensory outcomes and little attention to pain. This study examines whether and how breast sensation is important to women.

Materials and Methods

Conventional content analysis of extant qualitative data from a clinical registry (29 women with prior breast surgery for cancer, 2008-2022), a volunteer community sample (qualitative interviews with 6 women with and 5 without breast cancer, 2019), and from a Twitter social media survey (N = 32, 2022).

Results

Functions of the breast identified by women with and without cancer include breastfeeding, sexual function, and femininity. Five interrelated themes on the importance of breast sensation emerged among women with breast cancer history: sexual function, experience of partnered sex or relationship with one's sexual partner, breast embodiment, effect of breast pain on sexual function, and importance to psychological wellbeing. Women, advocates, and clinicians described a lack of patient-physician communication in this domain that exacerbates the negative impact of breast sensation loss on health and wellbeing.

Conclusions

Breast sensation is important to women following mastectomy, yet a gap exists in patient-physician communication about the impact of mastectomy and reconstruction on breast sensory function. Lessons for physicians, scientists, and skeptics are conveyed about why the basic integrity of women's bodies matters for practice and science.

Building an inclusive wave in marine science: Sense of belonging and Society for Women in Marine Science symposia

Achieving gender equity is a long-standing and ubiquitous challenge in marine science. Creating equitable experiences for all genders in marine science requires recognizing scientists' intersectional identities, and how this leads to unique lived experiences of privilege and marginalization. One approach to increase equitable experiences for women in marine science is to create affinity groups where women can learn from each other, share their experiences, and provide support and mentorship. The Society for Women in Marine Science (SWMS) is one such organization, founded to amplify the work of early career women in marine science and create community, through events such as full-day symposium events. This study investigates the experiences of symposium attendees for four events held from 2018 through 2020, as reported in pre- and post-symposium surveys. We used quantitative analysis of the open-ended survey questions to examine the demographics of attendees and their fields of study. Qualitative thematic analysis identified the most effective aspects of the symposia, areas of logistical and content improvement for future symposia, and emphasized the unique challenges women in marine science experience. The majority of symposium attendees were white graduate students. Nearly all attendees identified as women, with a small number of men and non-binary individuals. Symposia attendees enjoyed opportunities for professional development and interactions with colleagues across career stages. We present recommendations for continuing to foster a sense of belonging in marine science and STEM more broadly, both specific to SWMS and transferable actions that can be applied for other affinity groups. These suggestions include empathetic event logistics, continual democratic evaluation, identity reflexivity among group leaders, and professional development activities targeted towards the unique needs of the affinity group. The positive responses received from SWMS's adaptive integration of survey results into symposia demonstrate that incorporating these recommendations and findings will help create an inclusive wave in marine science.

Career Advancement Among Women Physicians in Nine Academic Medicine Specialties

Objective: Gender parity lags in academic medicine. We applied the Rank Equity Index (REI) to compare the longitudinal progress of women's academic medicine careers. We hypothesized that women have different rank parity in promotion by specialty based on the proportion of women in the specialty. Materials and Methods: Aggregate data by sex for medical students, residents, assistant professors, associate professors, and professors in nine specialties were obtained from the Association of American Medical Colleges for 2019-2020. Specialties were clustered into terciles based on the proportion of women in the field: upper (obstetrics and gynecology, pediatrics, psychiatry), middle (internal medicine, emergency medicine, anesthesia), and lower (surgery, urology, and orthopedic surgery). We calculated the percentage representation by sex by specialty and rank to calculate REI. Specialty-specific REI comparisons between each rank were performed to assess parity in advancement. Results: Only specialties in the upper tercile recruited proportionally more women medical students to residency training. All specialties advanced women for the resident-to-assistant professor with psychiatry, internal medicine, emergency medicine, anesthesia, urology, and orthopedic surgery that promoted women faculty at rates above parity. No specialty demonstrated parity in advancement based on sex for the assistant professor-to-associate professor or associate professor-to-professor transitions. Conclusion: Gender inequity in advancement is evident in academic medicine starting at the assistant professor-to-associate professor stage, regardless of overall proportion of women in the specialty. This suggests a common set of barriers to career advancement of women faculty in academic medicine that must be addressed starting at the early career stage.

Effect of a Workshop to Break the Bias Habit for Internal Medicine Faculty: A Multisite Cluster Randomized Controlled Study

PURPOSE

Recognition that cultural stereotypes can unintentionally perpetuate inequities throughout academic medicine has led to calls for "implicit bias training" without strong evidence to support these recommendations and some evidence of potential harm. The authors sought to determine the effectiveness of a single 3-hour workshop in helping department of medicine faculty overcome implicit stereotype-based bias and in improving the climate in the working environment.

METHOD

A multisite cluster randomized controlled study (October 2017 to April 2021) with clustering at the level of divisions within departments and participant-level analysis of survey responses involved 8,657 faculty in 204 divisions in 19 departments of medicine: 4,424 in the intervention group (1,526 attended a workshop) and 4,233 in the control group. Online surveys at baseline (3,764/8,657 = 43.48% response rate) and 3 months after the workshop (2,962/7,715 = 38.39% response rate) assessed bias awareness, bias-reducing intentional behavioral change, and perceptions of division climate.

RESULTS

At 3 months, faculty in the intervention vs control divisions showed greater increases in awareness of personal bias vulnerability ( b = 0.190 [95% CI, 0.031 to 0.349], P = .02), bias reduction self-efficacy ( b = 0.097 [95% CI, 0.010 to 0.184], P = .03), and taking action to reduce bias ( b = 0.113 [95% CI, 0.007 to 0.219], P = .04). The workshop had no effect on climate or burnout, but slightly increased perceptions of respectful division meetings ( b = 0.072 [95% CI, 0.0003 to 0.143], P = .049).

CONCLUSIONS

Results of this study should give confidence to those designing prodiversity interventions for faculty in academic medical centers that a single workshop which promotes awareness of stereotype-based implicit bias, explains and labels common bias concepts, and provides evidence-based strategies for participants to practice appears to have no harms and may have significant benefits in empowering faculty to break the bias habit.

Gender differences in peer reviewed grant applications, awards, and amounts: a systematic review and meta-analysis

BACKGROUND

Differential participation and success in grant applications may contribute to women's lesser representation in the sciences. This study's objective was to conduct a systematic review and meta-analysis to address the question of gender differences in grant award acceptance rates and reapplication award acceptance rates (potential bias in peer review outcomes) and other grant outcomes.

METHODS

The review was registered on PROSPERO (CRD42021232153) and conducted in accordance with PRISMA 2020 standards. We searched Academic Search Complete, PubMed, and Web of Science for the timeframe 1 January 2005 to 31 December 2020, and forward and backward citations. Studies were included that reported data, by gender, on any of the following: grant applications or reapplications, awards, award amounts, award acceptance rates, or reapplication award acceptance rates. Studies that duplicated data reported in another study were excluded. Gender differences were investigated by meta-analyses and generalized linear mixed models. Doi plots and LFK indices were used to assess reporting bias.

RESULTS

The searches identified 199 records, of which 13 were eligible. An additional 42 sources from forward and backward searches were eligible, for a total of 55 sources with data on one or more outcomes. The data from these studies ranged from 1975 to 2020: 49 sources were published papers and six were funders' reports (the latter were identified by forwards and backwards searches). Twenty-nine studies reported person-level data, 25 reported application-level data, and one study reported both: person-level data were used in analyses. Award acceptance rates were 1% higher for men, which was not significantly different from women (95% CI 3% more for men to 1% more for women, k = 36, n = 303,795 awards and 1,277,442 applications, I² = 84%). Reapplication award acceptance rates were significantly higher for men (9%, 95% CI 18% to 1%, k = 7, n = 7319 applications and 3324 awards, I² = 63%). Women received smaller award amounts (g = -2.28, 95% CI -4.92 to 0.36, k = 13, n = 212,935, I² = 100%).

CONCLUSIONS

The proportions of women that applied for grants, re-applied, accepted awards, and accepted awards after reapplication were less than the proportion of eligible women. However, the award acceptance rate was similar for women and men, implying no gender bias in this peer reviewed grant outcome. Women received smaller awards and fewer awards after re-applying, which may negatively affect continued scientific productivity. Greater transparency is needed to monitor and verify these data globally.

Gender Distribution of Authors of Evaluation Letters for Promotion at One Medical School

PURPOSE

Women remain underrepresented in key leadership positions and advanced ranks in academic medicine. This study examines the numbers of men and women letter writers for promotion candidates during a 5-year period across departments, tracks, ranks, and candidate gender.

METHOD

A descriptive study characterized the gender of evaluation letter writers for candidates for promotion to associate or full professor at the University of Minnesota Medical School between 2015 and 2020. Letter writer and candidate gender were characterized by self-identified pronouns in the faculty biography or dossier. Letter writer gender was described by candidate department, promotion track, rank, terminal degree, and gender.

RESULTS

Among 299 candidates for promotion, 172 (58%) were men and 127 (42%) were women; dossiers included 3,995 evaluation letters. Across all years, men wrote more letters than women (external letters, range, 69% in 2019-2020 to 75% in 2015-2016; internal letters, range, 67% in 2018-2019 to 77% in 2015-2016). Candidates in the family medicine and pediatrics departments had the highest percentages of letters written by women (44% and 40%, respectively). No differences were found in the number of women letter writers by candidate promotion track; however, differences were found by candidate rank (associate professor, 30%; full professor, 23%) and terminal degree (MD/DO, 25%; PhD, 33%; MD-PhD, 20%). Regardless of candidate gender, most evaluation letters were written by men. Women candidates had 15% to 20% more letters authored by women than men candidates (34%-40% vs 18%-23%).

CONCLUSIONS

The gender pattern of letter writers may reflect implicit biases regarding gender and perceived leadership status, expertise, and success. Adopting policies that promote or require gender diversity among letter writers for promotion candidates may provide an opportunity to encourage faculty to seek diverse networks and recognize the achievements of women faculty.

Engagement patterns with female and male scientists on Facebook

Social networks are becoming powerful agents mediating between science and the public. Considering the public tendency to associate science with men makes investigating representations of female scientists in social media important. Here we set out to find whether the commenting patterns to text-based science communication are similar. To examine these, we collected and analyzed posts (165) and their comments (10,006) published between 2016 and 2018 on an Israeli popular science Facebook page. We examined post characteristics as well as the relevance and sentiment of comments. Several gendered differences in commenting patterns emerged. Posts published by female scientists received more irrelevant and fewer relevant comments. Female scientists received more hostile and positive comments. These findings are consistent with results of previous research, but also demonstrate a more nuanced understanding that when female scientists write using scientific jargon (usually an unwanted feature of popular science writing), they received less hostile comments and were given less advice.

The dementia research career pipeline: Gender disparities in publication authorships and grant funding outcomes at different career stages

Background

Multiple studies have analysed gender disparities in academic research. Here we study the gender composition of the dementia research field at different stages in the career pipeline.

Methods

We use various data sources to gain insights about the gender ratio across career stages: conference attendance data as a proxy for the field as a whole; bibliometric data to know who publishes, and who occupies positions of seniority among the listed authors; and Alzheimer's Research UK's (ARUK) internal grant funding data to understand who obtains funding. We also analyse the scoring of grant applications based on the gender of the reviewers.

Results

Our results confirm that female researchers leave dementia academic research at higher rates than men, before transitioning into senior positions. In 2020, they comprised over 60% of the field, produced 54% of first authorships, but only accounted for 38% of last authorships. Overall, women received 37% of ARUK's competitive grants, with significant differences between grant schemes awarded for early career researchers (64% female awardees) compared to grant schemes aimed at senior researchers (33% female awardees). Men and women applied for and obtained grants at significantly different rates depending on the career stage at which the grant was aimed.Finally, we also observed that male and female reviewers apply evaluation criteria differently, with men giving better scores than women on average.

Conclusions

Our study adds to the evidence that shows that women get published less, receive less funding, and transition into senior academic positions at disproportionally lower rates than men do. We briefly discuss potential reasons why gender disparities arise as researchers progress into senior positions, and offer interventions ARUK can implement in its application and evaluation process to address those disparities.

U.S. Women Faculty in the Social Sciences Also Face Gender Inequalities

There is a national interest in United States women's underrepresentation in science, technology, engineering, and mathematics (STEM); however, gender inequality in the social sciences has not received similar attention. Although women increasingly earn postgraduate degrees in the social sciences, women faculty still experience gender inequities. Consistent gender inequities include slower career advancement, blunted salaries, unequal workloads, work-life conflict, systemic gender biases, underrepresentation in positions of power, and hostile work environments. Cultural biases suggest that once women have achieved parity, gender bias no longer exists. This review challenges that notion by providing evidence from social science domains in which women are well-represented but continue to face systemic gender biases. We examine cultural influences on gender representation and career advancement in psychology, economics, political science, sociology, and anthropology. We make interdisciplinary comparisons of career trajectories and salaries using national data, documenting patterns across the social sciences. For example, women economists face gendered standards in publishing, and women political scientists are less likely to have their work cited than men. Furthermore, data show that salaries become stagnant as the representation of women in these fields increases. These disparities reflect cultural biases in perceptions of women's competence stemming from social role theory. We discuss best practices to address these problems, focusing on the ADVANCE organizational change programs funded by the National Science Foundation that target (a) improving academic climate, (b) providing professional development, and (c) fostering social networking. Federally supported interventions can reveal systemic gender biases in academia and reduce gender disparities for women academics in the social sciences.

An Eye on Gender Equality: A Review of the Evolving Role and Representation of Women in Ophthalmology

PURPOSE

In recent decades, women have achieved greater representation in ophthalmology. Globally, women now constitute approximately 25%-30% of ophthalmologists and 35%-45% of trainees. Nevertheless, women remain under-represented in key areas, including positions of professional and academic leadership and ophthalmic surgical subspecialization. Furthermore, there is evidence that women in ophthalmology encounter more bias and discrimination across multiple domains than men, including a gender-pay gap that is wider than in many other surgical subspecialties. Women ophthalmologists and trainees report sharply differing training experiences from male peers, including fewer opportunities to operate, more bullying and harassment, less access to mentorship, and contrasting expectations around contributions to family life.

DESIGN

Perspective.

METHODS

An extensive literature search was undertaken to compile and review papers published with a focus on gender equity across ophthalmology, surgery, and medicine.

RESULTS

We identified 8 broad domains that were widely discussed: leadership, research and academics, income, surgical exposure and subspecialization, harassment, career satisfaction, mentorship, and family and marital differences. We have summarized the current research across each of these areas, and discussed possible solutions to reduce the inequities reported.

CONCLUSIONS

This review draws on current research published around representation and experiences of women in ophthalmology and suggests that there are opportunities to improve gender inequity.

Predoctoral MD-PhD grants as indicators of future NIH funding success

MD-PhD trainees constitute an important source of physician-scientists. Persistence on this challenging path is facilitated by success in garnering independent (R grant) support from the NIH. Published research tracks academic appointments and global R01 success for MD-PhD trainees but has not included information on future funding success of individual MD-PhD predoctoral grant holders. Here, we used data from the NIH RePORTER database to identify and track the funding trajectory of physician-scientists who received predoctoral grant support through the F30 mechanism, which is specific for dual-degree candidates. Male and female F30 awardees did not differ in their success in garnering K (postdoctoral training) grants, but, among F30 grant awardees, men were 2.6 times more likely than women to receive R funding. These results underscore the need for analysis of factors that contribute to the disproportionate loss of NIH-supported female physician-scientists between the predoctoral F30 and the independent R grant-supported stages.

Gender Differences in Experiences of Leadership Emergence Among Emergency Medicine Department Chairs

IMPORTANCE

The number of women entering medicine continues to increase, but women remain underrepresented at all tiers of academic rank and chair leadership in EM. The proportion of female chairs in EM has not exceeded 12% in 2 decades.

OBJECTIVE

To compare how male and female EM chairs experience leadership emergence, with attention to factors associated with support of the emergence of female chairs.

DESIGN, SETTING, AND PARTICIPANTS

This qualitative descriptive study was conducted between April 2020 and February 2021 at 36 US academic EM departments. Eligible participants were all current and emeritus female EM academic department chairs (with a possible cohort of 20 individuals) and an equal number of randomly selected male chairs.

INTERVENTIONS

Semistructured interviews were conducted via teleconferencing with an 11-item interview guide.

MAIN OUTCOMES AND MEASURES

Qualitative findings identifying similarities and gender differences in leadership emergence were collected.

RESULTS

Among 20 female chairs in EM, 19 women (mean [SD] age, 56.2 [7.1] years) participated in the study (95.0% response rate). There were 13 active chairs, and 6 women were within 5 years of chair leadership. Among 77 male chairs in EM identified and randomized, 37 men were invited to participate, among whom 19 individuals (51.4%) agreed to participate; 18 men (mean [SD] age, 52.2 [7.5] years) completed their interviews. Reflecting upon their experiences of leadership emergence, male chairs saw leadership as their destiny, were motivated to be chairs to gain influence, were dismissive of risks associated with chairing a department, and were sponsored by senior male leaders to advance in leadership. Female chairs saw leadership as something they had long prepared for, were motivated to be chairs to make a difference, were cautious of risks associated with chairing a department that could derail their careers, and relied on their own efforts to advance in leadership.

CONCLUSIONS AND RELEVANCE

This study found that experiences of leadership emergence differed by gender. These results suggest that leadership development strategies tailored to women should promote early internalization of leadership identity, tightly link leadership to purpose, cultivate active sponsorship, and encourage women's risk tolerance through leadership validation to support women's development as leaders and demonstrate a commitment to gender equity in EM leadership.

RASE: Modeling cumulative disadvantage due to marginalized group status in academia

We propose a framework of Resources, Achievement, Status, and Events (RASE) that allows the many disparate but well-documented phenomena affecting underrepresented groups in STEM to be assembled into a story of career trajectories, illuminating the possible cumulative impact of many small inequities. Our framework contains a three-component deterministic cycle of (1) production of Achievements from Resources, (2) updated community Status due to Achievements, and (3) accrual of additional Resources based on community Status. A fourth component, stochastic Events, can influence an individual’s level of Resources or Achievements at each time step of the cycle. We build a specific mathematical model within the RASE framework and use it to investigate the impact of accumulated disadvantages from multiple compounding variables. We demonstrate that the model can reproduce data of observed disparities in academia. Finally, we use a publicly available visualization and networking tool to provide a sandbox for exploring career outcomes within the model. The modeling exercise, results, and visualization tool may be useful in the context of training STEM faculty to recognize and reduce effects of bias.

“This article is interesting, however”: exploring the language use in the peer review comment of articles published in the BMJ

Purpose

The purpose of this paper is to reveal a symbol – “however” that authors are very interested in, but few research studies pay attention to the existing literature. The authors aim to further insight its function.

Design/methodology/approach

In this research, the authors selected 3,329 valid comments on articles published in the British Medical Journal (BMJ) from 2015 to 2020 as the research objects. The authors showed the length distribution of reviewers' comments. In what follows, the authors analyzed the general distribution of words in comments and reviewer comments’ position to understand reviewers' comments qualitatively in word dimension. Specially, the authors analyzed functions of “however” and “but”, words that authors are most concerned with. In addition, the authors also discussed some factors, which may be related to “however,” that reflect reviewers' praise through regression analysis.

Findings

The authors found that there are marked differences in the length of reviewers' comments under different review rounds. By mapping the reviewers' comments to different sections, the authors found that reviewers are deeply concerned to methods section. Adjectives and adverbs in comments written in different sections of the manuscripts also have different characteristics. The authors tried to interpret the turning function of “however” in scientific communication. Its frequency of use is related to reviewers' identities, specifically academic status. More precisely, junior researchers use “however” in praise more frequently than senior researchers do.

Research limitations/implications

The linguistic feature and function of “however” and “but” in the reviewers' comments of the rejected manuscripts may be different from accepted papers and also worth exploring. Regrettably, the authors cannot obtain the peer review comments of rejected manuscripts. This point may limit the conclusion of the investigation of this article.

Originality/value

Overall, the survey results revealed some language features of reviewers' comments, which could provide a basis of future endeavors for many reviewers in open peer review (OPR) field. Specially, the authors also put forward an interesting symbol to examine the review comments, “however”, for the first time.

Extension to 'combined SNA and LDA methods to understand adverse medical events': Doctor and nurse perspectives

BACKGROUND

Physicians and nurses are responsible for reporting medical adverse events. Each views these events through a different lens subject to their role-based perceptions and barriers. Physicians typically engage with diagnosis and treatment while nurses primarily care for patients' daily lives and mental well-being. This results in reporting and describing medical adverse events differently.

OBJECTIVE

We aimed to compare adverse medical event reports generated by physicians and nurses to better understand the differences and similarities in perspective as well as the nature of adverse medical events using social network analysis (SNA) and latent Dirichlet allocation (LDA).

METHODS

The current study examined data from the Maccabi Healthcare Community. Approximately 17,868 records were collected from 2000 to 2017 regarding medical adverse events. Data analysis used SNA and LDA to perform descriptive text analytics and understand underlying phenomenon.

RESULTS

A significant difference in harm levels reported by physicians and nurses was discovered. Shared topic keyword lists broken down by physicians and nurses were derived. Overall, communication, lack of attention, and information transfer issues were reported in medical adverse events data. Specialized keywords, more likely to be used by a physician were determined as: repeated prescriptions, diabetes complications, and x-ray examinations. For nurses, the most common special adverse event behavior keywords were vaccine problem, certificates of fitness, death and incapacity, and abnormal dosage.

CONCLUSIONS

Communication and inattentiveness appeared most frequently in medical adverse events reports regardless of whether doctors or nurses did the reporting. Findings suggest feedback and information sharing processes could be implemented as a step toward alleviating many issues. Institutional management, healthcare managers and government officials should take actions to decrease medical adverse events, many of which may be preventable.

PERCEPTION OF HARASSMENT AMONG FEMALE SURGEONS

INTRODUCTION

the attraction of women by Surgery has always existed. Although Surgery has been considered a specialty for men, several women chose it, despite gender bias issues that have persisted over many years. Several obstacles have impacted the practice of women surgeons, leading them to abandon the profession, while others, perhaps bearers of a stronger spirit, managed to overcome them, and won.

OBJECTIVE

to assess the rates of perception of harassment against female surgeons as a cause of difficulty and negative feelings related to the specialty.

METHODS

we conducted a quantitative and qualitative (personal accounts) research through a questionnaire via Google Forms® sent to all women surgeons registered in the Brazilian College of Surgeons and in a WhatsApp women surgeons' groups. The qualitative analysis was made with the Wordle® app.

RESULTS

from 821 questionnaires sent, we obtained 232 responses (28.2%). Harassment perception during training was 49.1% (n=114). From the women surgeons who perceived harassment, 56.1% reported having undergone different training than expected, with statistical significance (p<0.001). The question of having been treated differently due to being a woman also had an impact on harassment perception (77.2% harassed vs 47.5%; p<0.001). Physical (42.1% vs 6.8%) and emotional (92.1% vs 39.8%) threats were also different between groups.

CONCLUSION

women surgeons still report great harassment perception, both moral and sexual, which impacts their feelings about the specialty.

Women Representation and Gender Equality in Different Academic Levels in Veterinary Science

Women’s participation and completion at veterinary schools has increased globally for the past few decades. However, increased female graduates have not translated into similar patterns of academic staffing. The gender distribution within each academic level at eight accredited veterinary faculties in Australia and New Zealand, 38 accredited faculties in the USA and Canada and 98 accredited faculties in Europe were analyzed. Women occupied 47.9%, 45.5% and 47.5% of the academic positions in Australia/New Zealand, the USA/Canada and Europe, respectively. Compared to their male counterparts, female academics were more likely to hold the lower ranked positions. The gender distribution is skewed toward men in the senior positions at or above associate professor level in all analyzed regions. The findings of this study confirm gender inequality in academic progression meaning there is a continued need to develop strategies to eliminate inequity in veterinary science faculties worldwide.

The Role of Gender in Careers in Medicine: a Systematic Review and Thematic Synthesis of Qualitative Literature

BACKGROUND

Gender disparities exist in the careers of women in medicine. This review explores the qualitative literature to understand how gender influences professional trajectories, and identify opportunities for intervention.

METHODS

A systematic review and thematic synthesis included articles obtained from PubMed, Cochrane Central Register of Controlled Trials (Ovid), EMBASE (Ovid), APA PsycInfo (Ovid), and GenderWatch (ProQuest) on June 26 2020, updated on September 10, 2020. Included studies explored specialty choice, leadership roles, practice setting, burnout, promotion, stigma, mentoring, and organizational culture. Studies taking place outside of the USA, using only quantitative data, conducted prior to 2000, or focused on other health professions were excluded. Data were extracted using a standardized extraction tool and assessed for rigor and quality using a 9-item appraisal tool. A three-step process for thematic synthesis was used to generate analytic themes and construct a conceptual model. The study is registered with PROSPERO (CRD42020199999).

FINDINGS

Among 1524 studies identified, 64 were eligible for analysis. Five themes contributed to a conceptual model for the influence of gender on women's careers in medicine that resembles a developmental socio-ecological model. Gender influences career development externally through culture which valorizes masculine stereotypes and internally shapes women's integration of personal and professional values.

CONCLUSION

Medical culture and structures are implicitly biased against women. Equitable environments in education, mentoring, hiring, promotion, compensation, and support for work-life integration are needed to address gender disparities in medicine. Explicit efforts to create inclusive institutional cultures and policies are essential to support a diverse workforce.

Occupational segregation by gender in veterinary specialties: Who we are choosing, or who is choosing us

OBJECTIVE

Gender demographics vary across specialties including surgery, internal medicine, cardiology, neurology, and oncology. Our objective was to determine whether residency selection or the decision to apply for training drives these differences.

STUDY DESIGN

Retrospective cohort study.

SAMPLE POPULATION

Matched and unmatched residents lists from Veterinary Internship and Residency Matching Program (VIRMP) from 2011 to 2020. Comparative Data Reports from the American Association of Veterinary Medical Colleges from 2010 to 2019.

METHODS

Names for matched and unmatched residents with addresses in the United States or Canada were coded for gender for seven programs: large and small animal surgery, large and small animal medicine, cardiology, neurology, and oncology. Match rate by gender was compared using chi-square tests. Gender demographics of applicants were compared to demographics of graduates using tests of two proportions.

RESULTS

No differences were observed between genders for the likelihood of successfully matching into each residency program evaluated except in large animal internal medicine. Women (44.2%) were slightly more likely to match, overall, than men (39.0%, p = .003). The proportions of women applying for residencies overall (70.7%), in large and small animal surgery (66.1%, 62.2%), cardiology (70.2%), and neurology (70.7%) were lower than the proportion of female graduates (79%; p's < .001).

CONCLUSION

No evidence for gender bias was detected in the VIRMP resident selection process. Female veterinary graduates seemed less likely to apply for residencies than their male counterparts.

IMPACT

Occupational segregation seems to stem from the decision to apply for residency. Interventions aimed at altering gender demographics in specialized medicine should target potential applicants.

Gender Differences in Research Project Grants and R01 Grants at the National Institutes of Health

Objectives The National Institutes of Health (NIH), which is the world's largest funding source for research, offers various types of competitive grants depending on the duration, research type, and budget. The Research Project Grant (RPG) is the oldest mechanism for grant allocation that is used by the NIH. In this study, we explored the gender trends of NIH RPGs and R01 grants over the last two decades. Methods By utilizing the NIH Research Portfolio Online Reporting Tool (RePORT), data for gender were extracted, and the percentage of women as RPGs Investigators, R01-equivalent grant including R01 type 1 and type 2 grant awardees, from 1998 to 2019 were tabulated. The absolute change was calculated. Results From 1998 to 2019, the percentage of female RPG awardees has increased. However, the success rates for female RPG applicants have decreased during the same period. The funding and success rates for new R01 awards have been similar for both men and women, but women have been less successful at the renewal of R01-equivalent awards. Conclusion Gender disparity exists in awardees of higher RPGs, including the R01 award. This highlights the need for further actions to ensure gender parity in grant allocations at the NIH.

Women in Academic Pathology: Pathways to Department Chair

The Association of Pathology Chairs, an organization of American and Canadian academic pathology departments, has a record percent of women department chairs in its ranks (31%), although still not representative of the percent of women pathology faculty (43%). These women chairs were surveyed to determine what had impeded and what had facilitated their academic advancement before becoming chairs. The 2 most frequently identified impediments to their career advancement were heavy clinical loads and the lack of time, training, and/or funding to pursue research. Related to the second impediment, only one respondent became chair of a department which was in a top 25 National Institutes of Health–sponsored research medical school. Eighty-nine percent of respondents said that they had experienced gender bias during their careers in pathology, and 31% identified gender bias as an important impediment to advancement. The top facilitator of career advancement before becoming chairs was a supportive family. Strikingly, 98% of respondents have a spouse or partner, 75% have children, and 38% had children younger than 18 when becoming chairs. Additional top facilitators were opportunities to attend national meetings and opportunities to participate in leadership. Previous leadership experiences included directing a clinical service, a residency training program, and/or a medical student education program. These results suggest important ways to increase the success of women in academic pathology and increasing the percent of women department chairs, including supporting a family life and providing time, encouragement and resources for research, attending national meetings, and taking on departmental leadership positions.

Research Conducted in Women Was Deemed More Impactful but Less Publishable than the Same Research Conducted in Men

Background: Female scientists, who are more likely than their male counterparts to study women and report findings by sex/gender, fare worse in the article peer review process. It is unknown whether the gender of research participants influences the recommendation to publish an article describing the study. Materials and Methods: Reviewers were randomly assigned to evaluate one of three versions of an article abstract describing a clinical study conducted in men, women, or individuals. Reviewers assessed the study's scientific rigor, its level of contribution to medical science, and whether they would recommend publishing the full article. Responses were analyzed with logistic regression controlling for reviewer background variables, including sex and experience level. Results: There was no significant difference in perceived research rigor by abstract condition; contribution to medical science was perceived to be greater for research conducted in women than men (odds ratio = 1.7; p = 0.030). Nevertheless, reviewers were almost twice as likely to recommend publication for research conducted in men than the same research conducted in women (predicted probability 0.606 vs. 0.322; p = 0.000). Conclusions: These results are consistent with abundant data from multiple sources showing a lower societal value placed on women than men. Because female investigators are more likely than male investigators to study women, our findings suggest a previously unrecognized bias that could contribute to gender asymmetries in the publication outcomes of peer review. This pro-male publication bias could be an additional barrier to leadership attainment for women in academic medicine and the advancement of women's health.

Equity for women in medicine-neonatologists identify issues

OBJECTIVE

Inequity between genders with regards to leadership achievement, compensation, scholarly productivity, and grant funding exist among physicians. This study explores whether similar inequities exist among board certified neonatologists within the USA.

STUDY DESIGN

A voluntary anonymous survey was distributed to 3575 members of the American Academy of Pediatrics Section on Neonatal-Perinatal Medicine with 560 respondents (15.7% response rate). The survey contained questions assessing clinician characteristics, work environment, compensation, professional productivity, and social factors. Statistical analysis was done using JMP Pro 15.0.0 by SAS.

RESULTS

Female neonatologists, compared to male peers, were less likely to hold leadership positions (OR 0.36, p = 0.005), received lower compensation by an average of $34,916 or 12.47% (p < 0.001), and had 6.71 fewer primary authored publications (p = 0.025) after adjusting for several confounding factors.

CONCLUSION

Gender remains a significant independent factor influencing leadership attainment, compensation, and academic productivity in this cohort of neonatologists.

Representation of Women on National Institutes of Health Study Sections

This cross-sectional study examines the proportion of women represented on National Institutes of Health study sections and whether there is an association with research funding levels.

The leaky pipeline in research grant peer review and funding decisions: challenges and future directions

The growing literature on gender inequality in academia attests to the challenge that awaits female researchers during their academic careers. However, research has not yet conclusively resolved whether these biases persist during the peer review process of research grant funding and whether they impact respective funding decisions. Whereas many have argued for the existence of gender inequality in grant peer reviews and outcomes, others have demonstrated that gender equality is upheld during these processes. In the present paper, we illustrate how these opinions have come to such opposing conclusions and consider methodological and contextual factors that render these findings inconclusive. More specifically, we argue that a more comprehensive approach is needed to further the debate, encompassing individual and systemic biases as well as more global social barriers. We also argue that examining gender biases during the peer review process of research grant funding poses critical methodological challenges that deserve special attention. We conclude by providing directions for possible future research and more general considerations that may improve grant funding opportunities and career paths for female researchers.

Gender Effects in Assessment of Clinical Teaching: Does Concordance Matter?

BACKGROUND

Gender bias is thought to exist in the assessment of clinical teachers, yet its extent in different specialties is not well-documented nor has it been studied at the individual-dyadic level.

OBJECTIVE

The authors sought to determine whether gender bias exists in residents' assessments of faculty teaching in 3 clinical departments, and if present, whether this is influenced by gender concordance or discordance between the faculty and resident.

METHODS

Residents' ratings of faculty in internal medicine (800 faculty, 5753 ratings), surgery (377, 2249), and family medicine (672, 3438) at the University of Toronto from 2016-2017 were analyzed using the overall global rating on a 5-point scale. A mixed-effects linear regression analysis accounted for nesting of ratings within each faculty member.

RESULTS

Overall scores of teaching effectiveness showed a strong skew to favorable ratings for all faculty and a ceiling effect. However, gender effects differed across departments. In internal medicine (38.5% female faculty), no significant gender effects were detected. In surgery (16.2% female) and family medicine (53.0% female), male faculty received significantly higher scores than female faculty. In surgery this was driven by male residents giving male faculty higher ratings (4.46 vs 4.26, P < .001). In family medicine this was driven by male faculty receiving higher ratings regardless of resident gender (4.65 to 4.57, P < .001).

CONCLUSIONS

Although effects were very small and inconsistent, with gender concordance mattering only for one department, it suggests that gender is a meaningful source of variance in teaching assessments.

Are Women Disadvantaged in Academic Radiology?

RATIONALE AND OBJECTIVES

Women remain underrepresented in leadership positions in radiology. We sought to determine if 1) women are equitably represented in the senior author positions in radiology journals and 2) if women's contributions to the radiology literature and their individual productivity are proportional to their representation at senior academic rank.

MATERIALS AND METHODS

The gender of 3,702 first and last authors listed for manuscripts published in nine high-impact American radiology journals was assessed between 2002-2017. For the same years, the gender composition of academic faculty and ranks based on AAMC data was queried. Statistical tests were employed to detect discrepancies and changes over time.

RESULTS

First authorship by women grew from 26.9% to 37.4% and from 15.7% to 23.9% as senior author between 2002-2017 (P<.0001). Although the index of manuscript productivity rate was nearly equal for men and women over the 16-year study period, women remained under-represented in senior radiology faculty rank over the same period.

CONCLUSIONS

Although women have proportionally increased their contribution to the radiology literature over the years, commensurate increased representation of women in senior authorship and faculty positions was not observed. Despite increased involvement of women in research over time, they remain disproportionately at junior faculty positions.

Gender gap in mental health research productivity: Results from Qatar

OBJECTIVES

Qatar's contribution to biomedical research has increased significantly in the past couple of decades, but the exact participation of women researchers remains obscure. This study aims to explore the gender gap in research production of Qatar in the field of mental health.

METHODS

The authors searched five databases for published articles from Qatar in the field of mental health from 2015 to 2019. The authors examined the retrieved articles for the gender gap in 1) the number of researchers. 2) the numbers of articles produced by men-only research teams vs. the research teams included women. 3) h-index. 4) foreign collaboration. 5) research design and themes.

RESULTS

The authors identified 152 published articles in the field of mental health. Men researchers outnumbered women researchers (124 vs. 81). Men had statistically significant higher h-index compared to women (14.6 ± 1.4 vs 4.6 ± 0.9; p < 0.001). Research teams that included women had produced fewer articles compared to men-only groups (41.4 %), they also had less foreign collaborators (68 % vs. 91 %, p = 0.001). They were less involved in experimental research and more involved in observational research compared to male-only research groups (15.90 % vs. 38.6 % and 47.6 % vs. 25 % respectively; p = 0.034). In articles with women authors, women were the first authors in 50.8 % of the articles, and men were the senior authors in 79.4 % of them.

CONCLUSION

The study identifies gender gaps in some aspects of research productivity in Qatar. This data will provide a benchmark for future research in the field.

Gender inequality in academia: Problems and solutions for women faculty in STEM

Recently there is widespread interest in women's underrepresentation in science, technology, engineering, and mathematics (STEM); however, progress toward gender equality in these fields is slow. More alarmingly, these gender disparities worsen when examining women's representation within STEM departments in academia. While the number of women receiving postgraduate degrees has increased in recent years, the number of women in STEM faculty positions remains largely unchanged. One explanation for this lack of progress toward gender parity is negative and pervasive gender stereotypes, which may facilitate hiring discrimination and reduce opportunities for women's career advancement. Women in STEM also have lower social capital (e.g., support networks), limiting women's opportunities to earn tenure and learn about grant funding mechanisms. Women faculty in STEM may also perceive their academic climate as unwelcoming and threatening, and report hostility and uncomfortable tensions in their work environments, such as sexual harassment and discrimination. Merely the presence of gender-biased cues in physical spaces targeted toward men (e.g., "geeky" décor) can foster a sense of not belonging in STEM. We describe the following three factors that likely contribute to gender inequalities and women's departure from academic STEM fields: (a) numeric underrepresentation and stereotypes, (b) lack of supportive social networks, and (c) chilly academic climates. We discuss potential solutions for these problems, focusing on National Science Foundation-funded ADVANCE organizational change interventions that target (a) recruiting diverse applicants (e.g., training search committees), (b) mentoring, networking, and professional development (e.g., promoting women faculty networks); and (c) improving academic climate (e.g., educating male faculty on gender bias).

Identifying #addiction concerns on twitter during the COVID-19 pandemic: A text mining analysis

BACKGROUND

The 2019 Novel Coronavirus (COVID-19) is responsible for thousands of deaths and hospitalizations. To curb the spread of this highly transmissible disease, governments enacted protective guidelines for its citizens, including social distancing and stay-at-home orders. These restrictions on social interactions can be especially problematic for individuals managing or recovering from addiction given that treatment often involves access to services and resources that became limited or even unavailable at this time. Social media sites like Twitter serve as a space for users to post questions and concerns about timely topics and allow for researchers to track common themes among the public. The goal of this study was to identify how the public was discussing addiction on Twitter during the COVID pandemic. Methods: We performed a text mining analysis to analyze tweets that contained "addiction" and "covid" to capture posts from the public that illustrated comments and concerns about addiction during the COVID-19 pandemic. We report on 3,301 tweets captured between January 31 and April 23, 2020. The study was conducted in the United States, but contained tweets from multiple countries. Results: The most prevalent topics had to do with services offered by Acadia Healthcare and Serenity Healthcare Centers, attempts to manage time while home, difficulties of coping with alcoholism amidst rising sales of alcohol, and attention to ongoing health crises (e.g.,., opioids, vaping). Additional topics included affordable telehealth services, research from France on the relationship between nicotine and COVID-19, concerns about gambling addiction, and changing patterns in substance misuse as drug availability varies. Conclusions: Analyzing Twitter content enables health professionals to identify the public's concerns about addiction during the COVID-19 pandemic. Findings from text mining studies addressing timely health topics can serve as preliminary analyses for building more comprehensive models, which can then be used to generate recommendations for the larger public and inform policy.

The Future of Women in Psychological Science

There has been extensive discussion about gender gaps in representation and career advancement in the sciences. However, psychological science itself has yet to be the focus of discussion or systematic review, despite our field's investment in questions of equity, status, well-being, gender bias, and gender disparities. In the present article, we consider 10 topics relevant for women's career advancement in psychological science. We focus on issues that have been the subject of empirical study, discuss relevant evidence within and outside of psychological science, and draw on established psychological theory and social-science research to begin to chart a path forward. We hope that better understanding of these issues within the field will shed light on areas of existing gender gaps in the discipline and areas where positive change has happened, and spark conversation within our field about how to create lasting change to mitigate remaining gender differences in psychological science.

Large-scale language analysis of peer review reports

Peer review is often criticized for being flawed, subjective and biased, but research into peer review has been hindered by a lack of access to peer review reports. Here we report the results of a study in which text-analysis software was used to determine the linguistic characteristics of 472,449 peer review reports. A range of characteristics (including analytical tone, authenticity, clout, three measures of sentiment, and morality) were studied as a function of reviewer recommendation, area of research, type of peer review and reviewer gender. We found that reviewer recommendation had the biggest impact on the linguistic characteristics of reports, and that area of research, type of peer review and reviewer gender had little or no impact. The lack of influence of research area, type of review or reviewer gender on the linguistic characteristics is a sign of the robustness of peer review.

Promotion of Women Physicians in Academic Medicine

Women currently represent nearly half of all medical school graduates and assistant professors at academic institutions. Despite the large pool of women in the academic medicine pipeline, relatively few ascend to top leadership positions and women remain grossly underrepresented among full professors, permanent department chairs, and highest-level deans/interim deans. Considerable evidence suggests that the gender imbalance observed at the top tiers of academic medicine is, in part, due to gender differences in promotional rates, with women being promoted more slowly than their male colleagues. The well-documented gender gaps in publications, grant support, recognition awards, speaker invitations, and leadership positions contribute to the slow progression of women in medicine, as promotions committees rely heavily upon these traditional measures of academic success to select candidates for career advancement. Additionally, implicit biases, which have been shown to favor men over women in science and leadership, influence decision-making processes relevant to the promotion of women in academia. With the large number of highly qualified women entering medicine, it is imperative that organizations, academic institutions, and leaders in the medical community address the systemic inequities that are preventing half the workforce from reaching its full potential.

Influence of speaker's gender on speaker introductions at the 2018 ACVS Surgical Summit

OBJECTIVE

To evaluate whether formality of introduction differed between male vs female speakers at the 2018 American College of Veterinary Surgeons (ACVS) scientific meeting and identify other variables that predisposed introducers or chairs to informal introduction.

STUDY DESIGN

Observational study.

SAMPLE POPULATION

Thirteen session chairs introducing 68 lectures (41 by females, 27 by males) by 63 speakers.

METHODS

Observers recorded the session introducer, speaker, and whether speakers were introduced with a formal or informal title. Information evaluated included type of oral presentation; introducer gender, year, and country of graduation from veterinary school; speaker gender; whether the speaker was a resident; and speaker's year of graduation.

RESULTS

Female speakers were introduced by their first name in 9 of 41 introductions compared to in 1 of 27 introductions for male speakers. This difference reached statistical significance when data independence was assumed (P = .043); however, this significance was narrowly lost when data clustering on session introducer was controlled for (P = .067).

CONCLUSION

In this study, female speakers were more likely than male speakers to be introduced by their first and last names rather than with their professional title at a recent ACVS scientific meeting.

IMPACT

Additional research is required to determine the effect of this type of subordinate language and gender bias in veterinary surgery.

Gender distribution and leadership trends in trauma surgery societies

Introduction

Women are under-represented in the surgical disciplines and gender bias is believed to play a factor. We aimed to understand the gender distribution of membership, leadership opportunities, and scientific contributions to annual trauma professional meetings as a case study of gender issues in trauma surgery.

Methods

Retrospective collection of membership, leadership, presentation and publication data from 2016 to 2018 Trauma/Acute Care Surgery/Surgical Critical Care (TACSCC) Annual Meetings. Gender was assigned based on self-identification in demographic information, established relationships, or public sources.

Results

Women remain under-represented with only 28.1% of those ascertaining American Board of Surgery certification in critical care self-identifying as female. The proportion of female members in Eastern Association for the Surgery of Trauma (EAST) was comparable (29.4%), slightly lower for Western Trauma Association (WTA) (19.0%), and lowest for American Association for the Surgery of Trauma (AAST) (12.8%, p<0.05). In contrast, AAST had the highest proportion of female participants in executive leadership (AAST 32.5%, WTA 19.0%, EAST 18.8%) and WTA the highest for committee chairs (WTA 33.3%, AAST 27.8%, EAST 20.5%). AAST had the most significant increase in executive leadership during the last 3 years (AAST 28.6% to 41.6%). Invited lectureships, masters, panelists and senior author scientific contributions demonstrated the largest gap of academic representation of female TACSCC surgeons.

Conclusion

Fewer women than men pursue careers in the trauma field. Continuing to provide mentorship, leadership, and scientific recognition will increase gender diversity in TACSCC. We must continue to promote, sponsor, recognize, invite, and elect ‘her’.

Level of evidence

III, Epidemiology.

Unconscious Gender Bias in Academia: Scarcity of Empirical Evidence

Implicit or unconscious bias is commonly proposed to be responsible for women’s underrepresentation in academia. The aim of this scoping review was to identify and discuss the evidence supporting this proposition. Publications about unconscious/implicit gender bias in academia indexed in Scopus or psycInfo up to February 2020 were identified. More than half were published in the period 2018–2020. Studies reporting empirical data were scrutinized for data, as well as analyses showing an association of a measure of implicit or unconscious bias and lesser employment or career opportunities in academia for women than for men. No studies reported empirical evidence as thus defined. Reviews of unconscious bias identified via informal searches referred exclusively to studies that did not self-identify as addressing unconscious bias. Reinterpretations and misrepresentations of studies were common in these reviews. More empirical evidence about unconscious gender bias in academia is needed. With the present state of knowledge, caution should be exercised when interpreting data about gender gaps in academia. Ascribing observed gender gaps to unconscious bias is unsupported by the scientific literature.

Combined SNA and LDA methods to understand adverse medical events

OBJECTIVE

To compare primary medical adverse event keywords from reporters (e.g. physicians and nurses) and harm level perspectives to explore the underlying behaviors of medical adverse events using social network analysis (SNA) and latent Dirichlet allocation (LDA) leading to process improvements.

DESIGN

Used SNA methods to explore primary keywords used to describe the medical adverse events reported by physicians and nurses. Used LDA methods to investigate topics used for various harm levels. Combined the SNA and LDA methods to discover common shared topic keywords to better understand underlying behaviors of physicians and nurses in different harm level medical adverse events.

SETTING

Maccabi Healthcare Community is the second largest healthcare organization in Israel.

DATA

17,868 medical adverse event data records collected between 2000 and 2017.

METHODS

Big data analysis techniques using social network analysis (SNA) and latent Dirichlet allocation (LDA).

RESULTS

Shared topic keywords used by both physicians and nurses were determined. The study revealed that communication, information transfer, and inattentiveness were the most common problems reported in the medical adverse events data.

CONCLUSIONS

Communication and inattentiveness were the most common problems reported in medical adverse events regardless of healthcare professional reporting or harm levels. Findings suggested that an information-sharing and feedback mechanism should be implemented to eliminate preventable medical adverse events. Healthcare institutions managers and government officials should take targeted actions to decrease these preventable medical adverse events through quality improvement efforts.

Quantifying gender disparity in physician authorship among commentary articles in three high-impact medical journals: an observational study

BACKGROUND

Scholarship plays a direct role in career advancement, promotion and authoritative recognition, and women physicians remain under-represented as authors of original research articles.

OBJECTIVE

We sought to determine if women physician authors are similarly under-represented in commentary articles within high-impact journals.

DESIGN/SETTING/PARTICIPANTS

In this observational study, we abstracted and analysed author information (gender and degree) and authorship position from commentary articles published in three high-impact journals between 1 January 2014 and 16 October 2018.

PRIMARY OUTCOME MEASURE

Authorship rate of commentary articles over a 5-year period by gender, degree, authorship position and journal.

SECONDARY OUTCOME MEASURES

To compare the proportion of men and women physician authorship of commentaries relative to the proportion of men and women physician faculty within academic medicine; and to examine the gender concordance among the last and first authors in articles with more than one author.

RESULTS

Of the 2087 articles during the study period, 48% were men physician first authors compared with 17% women physician first authors (p<0.0001). Of the 1477 articles with more than one author, similar distributions were found with regard to last authors: 55% were men physicians compared with only 12% women physicians (p<0.0001). The proportion of women physician first authors increased over time; however, the proportion of women physician last authors remained stagnant. Women coauthored with women in the first and last authorship positions in 9% of articles. In contrast, women coauthored with men in the first and last author positions, respectively, in 55% of articles.

CONCLUSIONS

Women physician authors remain under-represented in commentary articles compared with men physician authors in the first and last author positions. Women also coauthored commentaries with other women in far fewer numbers.

Perceptions of Pressures to Alter or Misrepresent Time Allocation Among Clinician-Researchers With NIH Career Development Awards

PURPOSE

National Institutes of Health career development (K) awards mandate specific allocations of effort to research and training. The authors sought to understand pressures perceived by award recipients to change or misrepresent effort, and whether these perceptions differed by gender.

METHOD

In 2010-2011 and 2014, the authors surveyed K08 and K23 award recipients. Questions evaluated perceived pressure to change or misrepresent time allocation. Multivariable logistic regression modeling of pressure to misrepresent effort evaluated associations with individual and basic job characteristics.

RESULTS

Of the 1,719 faculty in the initial target population, 493 women and 573 men (1,066, 62%) responded at both time points. Most respondents reported feeling pressure to increase time spent on professional activities other than their K award-related research or career development or to decrease time on their K award-related research. The likelihood of perceiving pressure differed significantly by gender: 68% of women vs 55% of men (P < .001). A minority reported perceiving pressure to misrepresent professional time (women, 29%, vs men, 27%, P = .52). Multivariable analysis revealed that pressure to misrepresent professional time was less likely among respondents at institutions with the most extramural funding (P = .02). A significant pairwise interaction between gender and K award type suggested that female K08 awardees had higher odds than male peers of perceiving pressure to misrepresent time.

CONCLUSIONS

Most K award recipients reported feeling pressure to do more non-K award-related activities. More than a quarter reported feeling pressure to misrepresent effort. Additional research is needed to evaluate the proportion of academic medical faculty who actually misrepresent professional effort.

Whose Voices Are Heard? Speaker Gender Representation at the Society of Cardiovascular Anesthesiologists Annual Meeting

OBJECTIVE

Gender disparities in academic medicine continue to be prevalent despite significant advances in the number of women entering medicine over the last decades. The purpose of the present study was to investigate gender representation of speakers at Society of Cardiovascular Anesthesiologists (SCA) Annual Scientific Sessions meetings from 2015 to 2018.

DESIGN

Observational study.

SETTING

Internet analysis and cross-sectional survey.

PARTICIPANTS

Speakers at the SCA Annual Scientific Sessions meetings from 2015 to 2018.

INTERVENTIONS

Individual speakers in the main program, problem-based learning discussions, workshops, and fellow sessions were analyzed for speaker gender. Speakers' names, pronouns, institutional biographies, and accompanying images were matched with public online data and were used to identify gender. Gender data from the 2019 SCA Diversity Survey respondents were used to estimate gender of the SCA membership.

MEASUREMENTS AND MAIN RESULTS

Between 2015 and 2018, the number of lectures given by women was 22% to 25%. A statistically significant difference was found in the expected versus observed proportion of women in speaking slots for all combined sessions (2015-2018; p = 0.0027, 0.0023, 0.0018, 0.025, respectively). There also was a statistically significant difference in the expected versus observed proportion of women in speaking slots in the main sessions (2015-2018; p ≤ 0.0001, 0.00069, 0.00019, 0.00019, respectively). For the workshops, problem-based learning discussions, and fellow sessions, no statistically significant difference was found in the observed versus expected proportion of women in speaker slots.

CONCLUSIONS

Between 2015 and 2018, the majority of lectures at the SCA annual meetings were given by men, with women consistently giving 22% to 25% of individual lectures. When all sessions were combined, there was a statistically significant difference in the expected versus observed proportion of women in speaking slots.

Gender Disparities in Awards to Neuroscience Researchers

Women in academia receive fewer prestigious awards than their male counterparts. This gender gap may emerge purely from structural factors (e.g., gender differences in time spent in academia, institutional prestige, and academic performance), or from a combination of structural and psychological factors (e.g., gender schemas). To test these competing predictions, we assessed the independent contribution of year of degree, institutional prestige (a composite of prestige of PhD school and current affiliation), academic performance (total publications, total cites, and h-index), and gender to the prestige of awards earned by male (N = 298) and female (N = 134) academic neuroscientists. Award prestige was determined by an independent set of neuroscientists. Men earned more prestigious awards than women after controlling for institutional prestige, year of degree, and total publications. But after controlling for total citations or h-index, no gender difference appeared. Mediation analyses revealed that the gender disparity in awards was mediated by a gender difference in total cites and h-index. There was a reciprocal effect as well, in that the gender disparity in total cites and h-index was partially mediated by awards. These results point to an indirect path by which psychological factors may create gender disparities in academic awards: gender schemas may lead to women's papers receiving fewer citations than men's papers, resulting in more prestigious awards for men than for women. Additionally, our results suggest that gender disparities in awards and citations may reinforce each other. Practical implications for promoting gender equality in academic awards are discussed.

The effect of gender on operative autonomy in general surgery residents

BACKGROUND

Despite an increasing number of women in the field of surgery, bias regarding cognitive or technical ability may continue to affect the experience of female trainees differently than their male counterparts. This study examines the differences in the degree of operative autonomy given to female compared with male general surgery trainees.

METHODS

A smartphone app was used to collect evaluations of operative autonomy measured using the 4-point Zwisch scale, which describes defined steps in the progression from novice ("show and tell") to autonomous surgeon ("supervision only"). Differences in autonomy between male and female residents were compared using hierarchical logistic regression analysis.

RESULTS

A total of 412 residents and 524 faculty from 14 general surgery training programs evaluated 8,900 cases over a 9-month period. Female residents received less autonomy from faculty than did male residents overall (P < .001). Resident level of training and case complexity were the strongest predictors of autonomy. Even after controlling for potential confounding factors, including level of training, intrinsic procedural difficulty, patient-related case complexity, faculty sex, and training program environment, female residents still received less operative autonomy than their male counterparts. The greatest discrepancy was in the fourth year of training.

CONCLUSION

There is a sex-based difference in the autonomy granted to general surgery trainees. This gender gap may affect female residents' experience in training and possibly their preparation for practice. Strategies need to be developed to help faculty and residents work together to overcome this gender gap.