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Al Mutair A, Al-Ghuraibi M, Alabbasi Y, Alguthaib F, Woodman A, Elgamri A. Saudi women's leadership experiences in the healthcare sector: A qualitative study. PLoS One 2023; 18:e0285187. [PMID: 37725601 PMCID: PMC10508591 DOI: 10.1371/journal.pone.0285187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 04/17/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Gender equality in the workforce and the promotion of woman leadership is critical to economic growth and the sustainable development of society and the global community. However, gender diversity in leadership positions is a concern as women continue to be underrepresented. Ensuring equal opportunities in leadership positions in the health sector can help advance the achievement of the sustainable development goals (SDGs). PURPOSE The aim of this study was to explore Saudi women's perspectives and leadership experiences at senior-level positions in the healthcare sector. METHODS A descriptive qualitative approach was adopted to address the study aim. This included nine semi-structured interviews with Saudi women who have held leadership positions in the health sector over the past ten years. Reflexive thematic analysis was conducted by adopting the six phases. RESULTS The results showed that internal factors, such as qualifications, experience, and the innate qualities of a winner, are the most important factors that contribute to women's leadership. Women's role expectations, gender norms, and the patriarchal nature of the community have a negative impact on women's leadership. One of the new findings of this study was negative attitudes and lack of support from female colleagues. CONCLUSION Women leaders in health care in Saudi Arabia share similarities and differences with women leaders around the world. However, the Saudi community has its own social norms and gender roles that cannot be denied. While Vision 2030 brought a number of positive changes in women's empowerment that participants spoke of, more research is needed to explore men's perceptions, which can complete the picture and lead to organizational improvement and changes.
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Affiliation(s)
- Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Al-Hasa, Saudi Arabia
- School of Nursing, University of Wollongong, Wollongong, Australia
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
- Department of Nursing, Prince Sultan Military College of Health Sciences, Dahran, Saudi Arabia
- Almoosa College of Health Sciences, Al-Ahsa, Saudi Arabia
| | - Muna Al-Ghuraibi
- Department of Social Studies, College of Humanity and Social Science, King Saud University, Riyadh, Saudi Arabia
| | - Yasmine Alabbasi
- Department of Maternity and Child Health Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Alexander Woodman
- School of Health Science, University of Salford, Manchester, United Kingdom
| | - Alya Elgamri
- Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
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Shaikh AT, Lall MD, Jalal S, Raja AS, Fares S, Siddiqi J, Khosa F. Trends in Racial and Gender Profiles of United States Academic Emergency Medicine Faculty: Cross-Sectional Survey From 2007 to 2018. J Emerg Med 2022; 63:617-628. [PMID: 36244854 DOI: 10.1016/j.jemermed.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 06/03/2022] [Accepted: 07/09/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Numerous studies have reported existing disparities in academic medicine. The purpose of this study was to assess racial and gender disparity in academic emergency medicine (EM) faculty positions across the United States from 2007 to 2018. OBJECTIVE The primary objective was to identify the racial and ethnic and gender distributions across academic ranks in EM. The secondary objective was to describe the racial and gender proportions across different tenure tracks and degrees. METHODS We conducted a retrospective analysis using data from the Association of American Medical Colleges. Simple descriptive statistics and time series analysis were employed to assess the trends and relationship between race and gender across academic rank, type of degree, and tenure status. RESULTS When averaged, 75% of all faculty members were White physicians and 67.5% were male. Asian faculty members showed an increased representation in the lower academic ranks and underrepresented minority groups demonstrated a small increase. Asian faculty members demonstrated a significantly increasing trend at the level of instructor (t = 0.02; p = 0.034; 95% CI 0.05-1.03). Female faculty members showed a significantly decreasing trend over the study period (t = -0.01; p < 0.001; 95% CI 0.68-0.75). White academic physicians and male faculty members made up most of all degree types and tenure categories. CONCLUSIONS Despite an increase in proportional representation, the underrepresentation of female faculty members and those from minority groups persists in emergency medicine. Further studies are needed to identify and address the root causes of these differences.
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Affiliation(s)
- Ali Tariq Shaikh
- Department of Internal Medicine, United Health Services Hospitals, Johnson City, New York
| | - Michelle D Lall
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Sabeena Jalal
- Department of Emergency and Trauma Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Ali S Raja
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Saleh Fares
- Department of Emergency Medicine, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Javed Siddiqi
- Arrowhead Regional Medical Center, Colton, California
| | - Faisal Khosa
- Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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Khader Y, Essaid AA, Alyahya MS, Al-Maaitah R, Gharaibeh MK, Dababneh AB, AbuAlRub RF. Women's career progression to management positions in Jordan's health sector. Leadersh Health Serv (Bradf Engl) 2022; ahead-of-print. [PMID: 35877554 DOI: 10.1108/lhs-05-2022-0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aims to identify and explore experiences, perspectives, barriers and enablers to women's career progression to management positions in the health-care sector and to assess women's and men's perceptions of the policies and practices of the health-care system concerning gender equality and nondiscrimination between women and men. DESIGN/METHODOLOGY/APPROACH A cross-sectional survey was conducted among health-care professionals in ten selected hospitals, including physicians, registered nurses/midwives and pharmacists with or without managerial positions. FINDINGS This study included a total of 2,082 female and 1,100 male health-care professionals. Overall, 70% of women and men reported that opportunities for advancement are based on knowledge and skills in their institution. However, 58.9% of women (p < 0.001) reported that women are more likely to face barriers to career advancement than men do in their workplace. Lack of women in general/line management and discrimination against women by supervisors at the point of promotion were the main barriers to women's career progression, as they were reported by two-thirds of women. The main barrier, as perceived by men (62.3%) was that women have family and domestic responsibilities. PRACTICAL IMPLICATIONS To overcome barriers in women's career progression, there is a need to establish a career planning and capacity-building program for women in the health sector. ORIGINALITY/VALUE Jordanian female health-care professionals face different barriers that affect their career progression, including inequity and discrimination in the workplace, negative views about women's abilities, lack of qualifications and training, hostile cultural beliefs and family responsibilities.
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Affiliation(s)
- Yousef Khader
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Aida Asim Essaid
- Information and Research Center, King Hussein Foundation, Amman, Jordan
| | - Mohammad S Alyahya
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rowaida Al-Maaitah
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Muntaha K Gharaibeh
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan and Faculty of Nursing, Al-Ahliyya Amman University, Amman, Jordan
| | | | - Raeda F AbuAlRub
- Community and Mental Health Nursing Department, College of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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Linden JA, Baird J, Madsen TE, Rounds K, Lall MD, Raukar NP, Fang A, Lin M, Sethuraman K, Dobiesz VA. Diversity of leadership in academic emergency medicine: Are we making progress? Am J Emerg Med 2022; 57:6-13. [PMID: 35462120 DOI: 10.1016/j.ajem.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Faculty who identify as women or racial/ethnic groups underrepresented in medicine (URiM) are less likely to occupy senior leadership positions or be promoted. Recent attention has focused on interventions to decrease this gap; thus, we aim to evaluate changes in leadership and academic promotion for these populations over time. METHODS Successive cross-sectional observational study of six years (2015 to 2020) of data from the Academy of Administrators/Association of Academic Chairs of Emergency Medicine- Benchmark Survey. Primary analyses focused on gender/URiM differences in leadership roles and academic rank. Secondary analysis focused on disparities during the first 10 years of practice. Statistical modeling was conducted to address the primary aim of assessing differences in gender/URiM representation in EM leadership roles/rank over time. RESULTS 12,967 responses were included (4589 women, 8378 men). Women had less median years as faculty (7 vs 11). Women and URiM were less likely to hold a leadership role and had lower academic rank with no change over the study period. More women were consistently in the early career cohort (within 10 years or less as faculty) : 2015 =-75.0% [95% CI:± 3.8%] v 61.4% [95% CI:± 3.0%]; 2020 =-75.1% [95% CI: ± 2.9%] v 63.3%, [95% CI:: ± 2.5%]. Men were significantly more likely to have any leadership role compared to women in 2015 and 2020 (2015 = 54.3% [95% CI: ± 3.1%] v 44.8%, [95% CI: ± 4.3%]; 2020 = 43.1% [95% CI:± 2.5%] v 34.8 [95% CI:± 3.1%]). Higher academic rank (associate/professor) was significantly more frequent among early career men than women in 2015 (21.1% [95% CI:± 2.58%] v 12.9%; [95% CI:± 3.0%]) and 2020 (23.1% [95% CI:± 2.2%] v 17.4%; [95% CI:± 2.5%]). CONCLUSIONS Disparities in women and URiM faculty leadership and academic rank persist, with no change over a six-year time span. Men early career faculty are more likely to hold leadership positions and be promoted to higher academic rank, suggesting early career inequities must be a target for future interventions.
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Affiliation(s)
- Judith A Linden
- Boston University School of Medicine, Boston, MA, United States of America.
| | - Janette Baird
- Warren Alpert School of Medicine at Brown University, Providence, RI, United States of America.
| | - Tracy E Madsen
- Warren Alpert School of Medicine at Brown University, United States of America.
| | - Kirsten Rounds
- Warren Alpert School of Medicine at Brown University, Providence, RI, Colorado Animal Specialty & Emergency, United States of America.
| | - Michelle D Lall
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States of America.
| | - Neha P Raukar
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN, United States of America.
| | - Andrea Fang
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, United States of America.
| | - Michelle Lin
- Departments of Emergency Medicine and Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
| | - Kinjal Sethuraman
- Department of Emergency Medicine, University of Maryland, Baltimore, MD, United States of America.
| | - Valerie A Dobiesz
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America.
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Murray S, Bosch A. Courage and equality – Women doctors’ thriving at work. SA JOURNAL OF INDUSTRIAL PSYCHOLOGY 2021. [DOI: 10.4102/sajip.v47i0.1924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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The Experience of Women in Hospital Medicine Leadership: a Qualitative Study. J Gen Intern Med 2021; 36:2678-2682. [PMID: 33532961 PMCID: PMC8390599 DOI: 10.1007/s11606-020-06458-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/13/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Since 2017, women have made up over 50% of medical school matriculants; however, only 16% of department chairs are women-a number that has remained stagnant and demonstrates the underrepresentation of women in leadership positions in medicine. OBJECTIVE To better understand the challenges women face in leadership positions and to inform how best to advance women leaders in Hospital Medicine. DESIGN, SETTING, AND PARTICIPANTS Using hermeneutical phenomenological methods, we performed semi-structured qualitative interviews of ten female division heads from hospital medicine groups in the USA, transcribed verbatim, and coded for thematic saturation using Atlas.ti software. MEASUREMENTS Qualitative themes and subthemes. KEY RESULTS Ten women hospitalist leaders were interviewed from September through November 2019. Participants identified four key challenges in their leadership journeys: lack of support to pursue leadership training, bullying, a sense of sacrifice in order to achieve balance, and the need for internal and external validation. Participants also suggested key interventions in order to support women leaders in the future: recommending a platform to share experiences, combat bullying, advocate for themselves, and bolster each other in sponsorship and mentorship roles. Finally, participants identified how they have unique strengths as women in leadership, and are transforming the culture of medicine with a focus on diversity and flexibility. CONCLUSION Women in leadership positions face unique challenges, but also have a unique perspective as to how to support the next generation of leaders.
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Cogen FE, Vaidyanathan P. Shared leadership in a medical division of an academic hospital. J Health Organ Manag 2020; ahead-of-print. [PMID: 31846248 DOI: 10.1108/jhom-05-2019-0137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to describe a successful model of shared medical leadership within an academic division of an urban children's hospital. DESIGN/METHODOLOGY/APPROACH Experience and outcomes were tracked over a three-year period during which two physicians shared the role of interim division chief of pediatric endocrinology and diabetes, resulting in a working model of shared leadership. FINDINGS An evolutionary trajectory occurred over three years in which the strengths of the leaders were combined to optimize decision making in a complex medical division. Improvements in team satisfaction and additional positive outcomes were achieved. PRACTICAL IMPLICATIONS Benefits of and challenges tackled by the strategic approach to shared leadership are identified to inform other medical institutions, particularly those with many team members or combined programs that include strong clinical and research components. ORIGINALITY/VALUE Little has been written within medical literature regarding shared leadership. The shared leadership model described in this paper can be implemented by others in a complex academic setting and will hopefully lead to more robust divisions.
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Affiliation(s)
- Fran Ellen Cogen
- Division of Endocrinology and Diabetes, Children's National Health System, Washington, District of Columbia, USA
| | - Priya Vaidyanathan
- Division of Endocrinology and Diabetes, Children's National Health System, Washington, District of Columbia, USA
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Onyura B, Crann S, Freeman R, Whittaker MK, Tannenbaum D. The state-of-play in physician health systems leadership research. Leadersh Health Serv (Bradf Engl) 2019; 32:620-643. [DOI: 10.1108/lhs-03-2019-0017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to review a decade of evidence on physician participation in health system leadership with the view to better understand the current state of scholarship on physician leadership activity in health systems. This includes examining the available evidence on both physicians’ experiences of health systems leadership (HSL) and the impact of physician leadership on health system reform.
Design/methodology/approach
A state-of-the-art review of studies (between 2007 and 2017); 51 papers were identified, analyzed thematically and synthesized narratively.
Findings
Six main themes were identified in the literature as follows: (De)motivation for leadership, leadership readiness and career development, work demands and rewards, identity matters: acceptance of self (and other) as leader, leadership processes and relationships across health systems and leadership in relation to health system outcomes. There were seemingly contradictory findings across some studies, pointing to the influence of regional and cultural contextual variation on leadership practices as well entrenched paradoxical tensions in health system organizations.
Research limitations/implications
Future research should examine the influence of varying structural and psychological empowerment on physician leadership practices. Empirical attention to paradoxical tensions (e.g. between empowerment and control) in HSL is needed, with specific attention to questions on how such tensions influence leaders’ decision-making about system reform.
Originality/value
This review provides a broad synthesis of diverse papers about physician participation in health system leadership. Thus, it offers a comprehensive empirical synthesis of contemporary concerns and identifies important avenues for future research.
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Gilbert MH, Dextras-Gauthier J, Fournier PS, Côté A, Auclair I, Knani M. Organizational constraints as root causes of role conflict. J Health Organ Manag 2019; 33:204-220. [PMID: 30950308 DOI: 10.1108/jhom-07-2017-0169] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to gain a better understanding of the difficulties encountered in the hybrid roles of physician-managers (P-Ms), examine the impact of organizational constraints on the role conflicts experienced by P-Ms and explore the different ways their two roles are integrated. DESIGN/METHODOLOGY/APPROACH A qualitative approach was adopted, using six focus groups made up of clinical co-managers, medical directors and P-Ms. In all, 43 different people were interviewed to obtain their perceptions of the day-to-day realities of the role of the P-M. The data collected were subsequently validated. FINDINGS Although the expectations of the different groups involved regarding the role of P-Ms are well understood and shared, there are significant organizational constraints affecting what P-Ms are able to do in their day-to-day activities, and these constraints can result in role conflicts for the people involved. Such constraints also affect the ways P-Ms integrate the two roles. The authors identify three role hybridization profiles. PRACTICAL IMPLICATIONS The results afford a better understanding of how organizational constraints might be used as levers of organizational change to achieve a better hybridization of the dual roles of P-Ms. ORIGINALITY/VALUE This paper seeks to reach beyond a simple identification of constraints affecting the dual roles of P-Ms by analyzing how such constraints impact on these professionals' day-to-day activities. Results also enable us to further refine Katz and Kahn's (1966) role model, in addition to identifying hybridization profiles.
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Affiliation(s)
| | | | | | - André Côté
- Department of Management, Université Laval , Quebec City, Canada
| | - Isabelle Auclair
- Department of Management, Université Laval , Quebec City, Canada
| | - Mouna Knani
- Department of Human Resource Management, Ecole des Hautes Etudes Commerciales, Montreal, Canada
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Jackson BN, Purdy SC, Cooper-Thomas H. Professional expertise amongst speech-language therapists: “willing to share”. J Health Organ Manag 2017; 31:614-629. [DOI: 10.1108/jhom-03-2017-0045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The current healthcare environment provides several challenges to the existing roles of healthcare professionals. The value of the professional expert is also under scrutiny. The purpose of this paper is to generate a construction of professional expertise amongst practitioners in the current healthcare environment. It used the speech-language therapy community in New Zealand (NZ) as an example.
Design/methodology/approach
Speech-language therapists currently practicing in NZ completed an online survey including qualitative and quantitative components. The range of experience and work settings of participants (n=119) was representative of the workforce.
Findings
Participants clearly identified being “highly experienced” and “having in-depth knowledge” as essential elements of professional expertise. Thematic analysis generated two interconnected themes of a professional expert being a personal leader and teacher, and a highly experienced, knowledgeable and skilful practitioner. Additionally, practitioners needed to be seen to contribute to the community in order to be known as experts. Clinical practice was valued differently from research generation.
Originality/value
This study is novel in exploring a construction of professional expertise amongst practitioners in a current healthcare community. Within that community, experts could be viewed as highly effective practitioners that visibly contribute to the professional community. The study draws attention to the role of reputation and the impacts of being a clinical teacher or leader compared with pursuing a research role. This could be particularly relevant in the promotion of evidence-based practice.
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