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Dickinson KJ, Racher ML, Jackman K, McCallie T, Marino K, Langford T, Mustain WC. Surgical Residents' Perception of Multi-Specialty Learning. JOURNAL OF SURGICAL EDUCATION 2022; 79:1363-1378. [PMID: 35902349 DOI: 10.1016/j.jsurg.2022.07.003] [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: 03/20/2022] [Revised: 05/26/2022] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Perceptions are important and can affect efficacy of trainer-trainee interactions. Inherent bias toward other specialties may influence the perceived benefit of a multi-specialty learning environment. The aim of this work was to determine surgical resident perceptions regarding the utility of learning from faculty and with learners from other surgical specialties. DESIGN We measured surgical residents' perceptions before and after a multi-specialty robotic simulation event. Pre- and post-activity surveys were administered electronically to all residents determining previous experience with robotic surgery, perceptions of learning from faculty in different surgical sub-specialties, and of learning from and with residents in other surgical specialties. SETTING Robotic simulation laboratory. PARTICIPANTS General surgery (GS), Obstetrics and gynecology (OBG), and Urology (URO) residents in one academic healthcare program. RESULTS Prior to the simulation, OBG and URO residents perceived highest utility in learning from faculty within their own specialty. While OBG residents reported high pre-activity agreement that learning from other faculty was useful, more than 50% of GS and URO residents were neutral or disagreed that learning from OBG faculty was useful. Pre-activity, all specialties perceived highest value in learning from and about residents of their own specialty. Following the educational event, all specialties reported increased agreement that learning from faculty of different specialties had utility. Following the simulation, the cohort reported the multi-specialty learning environment improved their knowledge and confidence in robotic surgery. CONCLUSIONS Participation in a multi-specialty educational event can improve perceptions of surgical residents regarding the utility of being taught by faculty in different specialties. Resident opinion of the benefits of learning with and about learners from other specialties can also be improved. Multi-specialty learning environments are important in developing communities of practice to allow socialization and promotion of positive identity development in our surgical residents, which may ultimately benefit efficacy of learning and patient care.
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Affiliation(s)
- Karen J Dickinson
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Office of Interprofessional Education, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
| | - Mary Luann Racher
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Kimberly Jackman
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Theresa McCallie
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Katy Marino
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Timothy Langford
- Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - W Conan Mustain
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Ngai J, Capdeville M, Sumler M, Oakes D. A Call for Diversity: Women and Cardiothoracic Anesthesiology Fellowship Education. J Cardiothorac Vasc Anesth 2021; 36:66-75. [PMID: 34330578 DOI: 10.1053/j.jvca.2021.06.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/11/2021] [Accepted: 06/25/2021] [Indexed: 12/27/2022]
Affiliation(s)
- Jennie Ngai
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Health, New York, NY.
| | - Michelle Capdeville
- Department of Cardiothoracic Anesthesia, Cleveland Clinic Lerner College of Medicine, Anesthesiology Institute, Department of Cardiothoracic Anesthesia-J4, Cleveland Clinic, Cleveland, OH
| | - Michele Sumler
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
| | - Daryl Oakes
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA
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Arnold LF, Zargham SR, Gordon CE, Mckinley WI, Bruenderman EH, Weaver JL, Benns MV, Egger ME, Motameni AT. Sexual Harassment during Residency Training: A Cross-Sectional Analysis. Am Surg 2020. [DOI: 10.1177/000313482008600130] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The reality of sexual harassment is unmasking in many fields, and medical trainees constitute a vulnerable and at-risk group. We report the prevalence of sexual harassment among GI, internal medicine, and pediatric residents, with a focus on identifying underlying reasons for lack of victim reporting. A modified previously validated Department of Defense survey on sexual harassment was e-mailed to 261 GI, 132 pediatric, and 271 internal medicine program directors. Three hundred eighty-one residents responded to the survey. Female trainees were more likely to be subject to sexual harassment (83% vs 44%, P <0 .0001). Offensive and/or suggestive jokes and comments were the most common type of harassment experienced. Most residents were unlikely to report the offender (87% females, 93% males). Although 77 per cent of residents believed they would be supported by their program if they reported a sexual harassment event, only 43 per cent were aware of institutional support in place for victims at their program. Although there is a persistently high incidence of harassment in training, the avenues in which to report it are largely unknown and underused. Further research should focus on evidence-based interventions to encourage reporting and to design institutional programs for victims of sexual harassment.
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Martinez LR, O'Brien KR, Hebl MR. Fleeing the Ivory Tower: Gender Differences in the Turnover Experiences of Women Faculty. J Womens Health (Larchmt) 2017; 26:580-586. [DOI: 10.1089/jwh.2016.6023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Larry R. Martinez
- Department of Psychology, Portland State University, Portland, Oregon
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Gomez E, Wright JG. A simple strategy to reduce stereotype threat for orthopedic residents. Can J Surg 2014; 57:E19-24. [PMID: 24666454 DOI: 10.1503/cjs.020812] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Stereotype threat, defined as the predicament felt by people in either positive or negative learning experiences where they could conform to negative stereotypes associated with their own group membership, can interfere with learning. The purpose of this study was to determine if a simple orientation session could reduce stereotype threat for orthopedic residents. METHODS The intervention group received an orientation on 2 occasions focusing on their possible responses to perceived poor performance in teaching rounds and the operating room (OR). Participants completed a survey with 7 questions typical for stereotype threat evaluating responses to their experiences. The questions had 7 response options with a maximum total score of 49, where higher scores indicated greater degree of experiences typical of stereotype threat. RESULTS Of the 84 eligible residents, 49 participated: 22 in the nonintervention and 27 in the intervention group. The overall scores were 29 and 29.4, and 26.2 and 25.8 in the nonintervention and intervention groups for their survey responses to perceived poor performance in teaching rounds (p = 0.85) and the OR (p = 0.84), respectively. Overall, responses typical of stereotype threat were greater for perceived poor performance at teaching rounds than in the OR (p = 0.001). CONCLUSION Residents experience low self-esteem following perceived poor performance, particularly at rounds. A simple orientation designed to reduce stereotype threat was unsuccessful in reducing this threat overall. Future research will need to consider longer-term intervention as possible strategies to reduce perceived poor performance at teaching rounds and in the OR.
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Affiliation(s)
- Everlyne Gomez
- The University of California, Irvine, Health & Disease Research Program, Orange, Calif
| | - James G Wright
- The Department of Surgery, Division of Orthopaedic Surgery, University of Toronto, Departments of Public Health Sciences and Health Policy, Management and Evaluation, University of Toronto, Department of Surgery, The Hospital for Sick Children, and Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ont
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Best CL, Smith DW, Raymond JR, Greenberg RS, Crouch RK. Preventing and responding to complaints of sexual harassment in an academic health center: a 10-year review from the Medical University of South Carolina. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2010; 85:721-7. [PMID: 20354396 DOI: 10.1097/acm.0b013e3181d27fd0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
There is a high incidence of sexual harassment and gender discrimination in academic health center (AHC) settings according to multiple surveys of medical students. Therefore, it is incumbent on AHCs to develop programs both to educate faculty, residents, and students and to handle complaints of possible episodes of sexual harassment or gender discrimination. Despite the apparent high prevalence of gender discrimination and sexual harassment, and the importance of handling complaints of gender discrimination and sexual harassment in a prompt, consistent, and rational manner, there are few descriptions of programs that address those concerns in AHCs.Herein, the authors describe their experiences in dealing with complaints of sexual harassment and gender discrimination for a 10-year period of time (late 1997 to early 2007) at the Medical University of South Carolina, through an Office of Gender Equity. They describe their complaint process, components of their prevention training, and the outcomes of 115 complaints. Key elements of their policies are highlighted. The authors offer an approach that could serve as a model for other AHCs.
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Affiliation(s)
- Connie L Best
- Office of Gender Equity, Medical University of South Carolina, Charleston, South Carolina, USA.
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Witte FM, Stratton TD, Nora LM. Stories from the field: students' descriptions of gender discrimination and sexual harassment during medical school. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2006; 81:648-54. [PMID: 16799291 DOI: 10.1097/01.acm.0000232421.04170.d2] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
PURPOSE Previous studies have documented the prevalence of gender discrimination and sexual harassment during medical training, but very few have examined the behaviors that students perceive as discriminatory or harassing. The authors addressed this lack of information by examining graduating medical students' written descriptions of personal experiences with such behaviors during medical school. METHOD The authors reviewed the responses of graduating seniors at 12 U.S. medical schools to a questionnaire, administered in 2001-02, that asked them to provide written descriptions of their personal experiences with gender discrimination and sexual harassment. Seven response categories were created on the basis of recurring themes: educational inequalities; stereotypical comments; sexual overtures; offensive, embarrassing, or sexually explicit comments; inappropriate touching; sexist remarks; and not classifiable. The three authors examined the students' written accounts and placed each into one or more of the categories. RESULTS Of the students' responses, 290 (36.6%) contained 313 written descriptions of personal experiences that the students perceived as either discriminatory or harassing. The most frequently reported experiences involved educational inequalities; experiences in this category were reported more frequently by men than by women. All other categories of experiences were reported more frequently by women. CONCLUSIONS The results support earlier findings of the prevalence of gender discrimination and sexual harassment during undergraduate medical education. Perhaps formal antiharassment policies should provide examples of unacceptable behavior that are based on categories such as those revealed by this analysis. Perhaps, too, medical students' comments could be used to develop educational interventions for physicians in supervisory positions.
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Wilkinson TJ, Gill DJ, Fitzjohn J, Palmer CL, Mulder RT. The impact on students of adverse experiences during medical school. MEDICAL TEACHER 2006; 28:129-35. [PMID: 16707293 DOI: 10.1080/01421590600607195] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
This study aimed to determine the consequences for, and coping method used by, medical students who experienced adverse experiences during their training. A nationwide questionnaire based census of all current medical students in New Zealand. The response rate was 83% (1384/1660). Two-thirds of students had at least one adverse experience, with humiliation being the most common and having the greatest adverse impact. Unwanted sexual advances, unfair treatment on the basis of gender or race had a lesser impact for most students. Most students took several hours or several days to get over an adverse episode and most commonly they then avoided that person or department. Around one half sought help. Only one-quarter felt it motivated their learning while one-sixth felt it made them consider leaving medical school. The most common perpetrators were senior doctors or nurses. Unwanted sexual advances were most common from other students or from patients. Humiliation is the experience that affected students the most and had a significant adverse effect on learning. There is a disturbing rate of unacceptable practice within medical schools, not all of which is from doctors.
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Affiliation(s)
- Tim J Wilkinson
- Christchurch School of Medicine and Health Sciences, University of Otago, New Zealand.
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Stratton TD, McLaughlin MA, Witte FM, Fosson SE, Nora LM. Does students' exposure to gender discrimination and sexual harassment in medical school affect specialty choice and residency program selection? ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2005; 80:400-8. [PMID: 15793027 DOI: 10.1097/00001888-200504000-00020] [Citation(s) in RCA: 150] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
PURPOSE To examine the role of gender discrimination and sexual harassment in medical students' choice of specialty and residency program. METHOD Anonymous, self-administered questionnaires were distributed in 1997 to fourth-year students enrolled in 14 public and private U.S. medical schools. In addition to reporting the frequency of gender discrimination and sexual harassment encountered during preclinical coursework, core clerkships, elective clerkships, and residency selection, students assessed the impact of these exposures (none, a little, some, quite a bit, the deciding factor) on their specialty choices and rankings of residency programs. RESULTS A total of 1,314 (69%) useable questionnaires were returned. Large percentages of men (83.2%) and women (92.8%) experienced, observed, or heard about at least one incident of gender discrimination and sexual harassment during medical school, although more women reported such behavior across all training contexts. Compared with men, significantly (p </= .01) more women who reported exposure indicated that gender discrimination and sexual harassment influenced their specialty choices (45.3% versus 16.4%) and residency rankings (25.3% versus 10.9%). Across all specialties, more women than men experienced gender discrimination and sexual harassment during residency selection, with one exception: a larger percentage of men choosing obstetrics and gynecology experienced such behavior. Among women, those choosing general surgery were most likely to experience gender discrimination and sexual harassment during residency selection. Interestingly, correlations between exposure to gender discrimination and sexual harassment and self-assessed impact on career decisions tended to be larger for men, suggesting that although fewer men are generally affected, they may weigh such experiences more heavily in their choice of specialty and residency program. CONCLUSION This study suggests that exposure to gender discrimination and sexual harassment during undergraduate education may influence some medical students' choice of specialty and, to a lesser degree, ranking of residency programs.
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Affiliation(s)
- Terry D Stratton
- Student Assessment & Program Evaluation, Office of Academic Affairs, University of Kentucky College of Medicine, MN104 Medical Science Building, Lexington, KY 40536-0298, USA.
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Risberg G, Hamberg K, Johansson EE. Gender awareness among physicians--the effect of specialty and gender. A study of teachers at a Swedish medical school. BMC MEDICAL EDUCATION 2003; 3:8. [PMID: 14577837 PMCID: PMC280661 DOI: 10.1186/1472-6920-3-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2003] [Accepted: 10/27/2003] [Indexed: 05/20/2023]
Abstract
BACKGROUND An important goal for medical education today is professional development including gender equality and awareness of gender issues. Are medical teachers prepared for this task? We investigated gender awareness among physician teachers, expressed as their attitudes towards the role of gender in professional relationships, and how it varied with physician gender and specialty. We discuss how this might be related to the gender climate and sex segregation in different specialties. METHOD Questionnaires were sent to all 468 specialists in the clinical departments and in family medicine, who were engaged in educating medical students at a Swedish university. They were asked to rate, on visual analogue scales, the importance of physician and patient gender in consultation, of preceptor and student gender in clinical tutoring and of physician gender in other professional encounters. Differences between family physicians, surgical, and non-surgical hospital doctors, and between women and men were estimated by chi-2 tests and multivariate logistic regression analyses. RESULTS The response rate was 65 %. There were differences between specialty groups in all investigated areas mainly due to disparities among men. The odds for a male family physician to assess gender important were three times higher, and for a male non-surgical doctor two times higher when compared to a male surgical doctor. Female teachers assessed gender important to a higher degree than men. Among women there were no significant differences between specialty groups. CONCLUSIONS There was an interaction between physician teachers' gender and specialty as to whether they identified gender as important in professional relationships. Male physicians, especially from the surgical group, assessed gender important to a significantly lower degree than female physicians. Physicians' degree of gender awareness may, as one of many factors, affect working climate and the distribution of women and men in different specialties. Therefore, to improve working climate and reduce segregation we suggest efforts to increase gender awareness among physicians, for example educational programs where continuous reflections about gender attitudes are encouraged.
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Affiliation(s)
- Gunilla Risberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Sweden
| | - Katarina Hamberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Sweden
| | - Eva E Johansson
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Sweden
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Bickel J. Gender equity in undergraduate medical education: a status report. JOURNAL OF WOMEN'S HEALTH & GENDER-BASED MEDICINE 2001; 10:261-70. [PMID: 11389786 DOI: 10.1089/152460901300140013] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This status report summarizes recent data on and studies of women's experiences as medical students. Women medical students in the United States now number over 29,000--44% of enrollees. Despite large increases in the numbers of women students, harassment and gender stereotyping continue to detract from their education and opportunities. Moreover, specialty choices have remained remarkably stable, with comparatively few women entering surgery and most subspecialties. Because equal opportunity has not yet been achieved, medical schools need to monitor the experiences of their trainees and to target interventions where problems still exist in order to ensure that progress toward gender equity continues.
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Affiliation(s)
- J Bickel
- Association of American Medical Colleges, 2450 N Street N.W., Washington, DC 20037-1127, USA
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Carvajal MJ, Hardigan P. First-job preferences and expectations of pharmacy students: intergender and interethnic comparisons. JOURNAL OF THE AMERICAN PHARMACEUTICAL ASSOCIATION (WASHINGTON, D.C. : 1996) 1999; 39:32-40. [PMID: 9990185 DOI: 10.1016/s1086-5802(16)30413-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To identify and measure intergender and interethnic differences in preferences and expectations of pharmacy students. DESIGN Two-part survey. One part addressed systematic variations in work-related expectations and preferences between the sexes and among ethnic minorities that may result from cumulative disadvantage or attitudinal traits; the other part focused on similarities and differences in expected sources of job satisfaction and dissatisfaction. SETTING College of Pharmacy, Nova Southeastern University. PARTICIPANTS 171 students enrolled in their final semester of didactic training (that is, immediately before rotations or internship). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Significance of intergender and interethnic disparities was determined using t tests. RESULTS No significant intergender disparities were detected in income expectations, anticipated level of job satisfaction, estimated time from graduation to passing the Board exam or working, or in preferred or expected sector of first job. African American students expected to earn lower levels of income, experience less satisfaction in their first job as a pharmacist, and work longer hours. Hispanic and Asian American students exhibited less confidence in their ability to pass the Board exam and in the allocative function of the job market. Salary and ability to help patients were the two sources of job satisfaction anticipated most frequently, whereas work overload ranked first among the anticipated sources of job dissatisfaction. CONCLUSION The rapidly changing gender composition of the profession has altered traditional integender differences in outlook and attitudinal traits, contributing to the disappearance of intergender disparities identified in previous research. However, significant interethnic differences in preferences and expectations suggest the presence of cumulative disadvantage among minorities.
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Affiliation(s)
- M J Carvajal
- Department of Economics, Florida International University, Miami 33199, USA.
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