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Pitlick J, Olson E, Halvorsen A, Fischer K, Croghan IT, Nordhues H. Gender and Professional Title Use in Internal Medicine Resident Narrative Assessments. J Womens Health (Larchmt) 2024. [PMID: 38557227 DOI: 10.1089/jwh.2023.0730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Background: Residency is a time of personal and professional growth. Resident assessment and feedback are an integral part of that process. However, assessment may be influenced by various types of bias, including gender bias. Women are less likely than men to be identified by their professional titles in many settings. The use of professional titles for residents in written assessments is unknown and may be a marker of bias. Objective: To assess for differences and trends regarding the use of professional and personal titles in formal resident assessments related to gender-based resident-faculty pairs. Methods: Electronic assessments of postgraduate year 1 (PGY1) internal medicine residents from the 2019-2020 academic year were used. Professional title use was analyzed, as it relates to resident-faculty gendered dyads, among other variables. The primary outcome of professional title usage was split into a binary variable by professional versus other titles and analyzed using logistic regression and random-effects model. Results: We analyzed 1,363 unique electronic assessments (37.8% from female faculty). Female residents were more likely to be addressed by a professional title than their male colleagues (odds ratio [OR], 1.7; confidence interval [CI], 1.2-2.4; p = 0.02). We found no difference in professional title usage based on resident-faculty gendered dyads. After adjusting for repeated faculty and resident encounters with random-effects model, secondary analysis found no significant difference in evaluation of word count between gendered dyads. Conclusions: The analysis found no significant difference in professional title usage based on resident-faculty dyads. In our analysis, female residents were significantly more likely to have their professional title used on assessments than male residents.
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Affiliation(s)
- Jaeda Pitlick
- Department of Internal Medicine, Mayo Clinic, Rochester, New York, USA
- Department of General Internal Medicine, Department of Hospital Medicine, University of Nebraska Medical Center, New York, USA
| | - Emily Olson
- Department of Internal Medicine, Mayo Clinic, Rochester, New York, USA
- Department of Medicine, Northwestern University Feinberg School of Medicine, New York, USA
| | - Andrew Halvorsen
- Department of Internal Medicine, Mayo Clinic, Rochester, New York, USA
| | - Karen Fischer
- Department of Quantitative Health Sciences, Clinical Trials and Biostatistics, Mayo Clinic, Rochester, New York, USA
| | - Ivana T Croghan
- Division of General Internal Medicine, Mayo Clinic, Rochester, New York, USA
| | - Hannah Nordhues
- Division of General Internal Medicine, Mayo Clinic, Rochester, New York, USA
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Shaw RS, Foo KL, Blumer A, Jacobson EL, Sturza J, Hartley S, Lukela JR, Sheffield V, Rappaport L. Gender Disparity in Teaching Evaluations of Pediatric Faculty by Residents. Hosp Pediatr 2023; 13:1067-1076. [PMID: 37933186 DOI: 10.1542/hpeds.2023-007228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
OBJECTIVES Despite their overrepresentation, female physicians continue to have lower rates of promotion compared with male physicians. Teaching evaluations play a role in physician advancement. Few studies have investigated gender disparity in resident evaluations of pediatric faculty. We hypothesized that gender disparities in resident evaluations of faculty exist and vary across subspecialties and primary work environments. METHODS Pediatric faculty institution-specific evaluations completed by residents from January 1, 2015, to March 9, 2020, were obtained from a single academic center. Mean ratings of faculty performance were compared by gender using a Wilcoxon 2-sample test. RESULTS Fifteen-thousand one-hundred and forty-two evaluations (5091 of male faculty and 10 051 of female faculty) were included. Female faculty were rated higher in overall teaching ability (female = 4.67 versus male = 4.65; P = .004). There was no statistical difference in the mean ratings of male and female faculty in the inpatient setting, whereas outpatient female faculty were rated higher in overall teaching ability (female = 4.79 versus male = 4.73; P = .005). For general pediatric faculty, females received higher ratings for overall teaching ability (female = 4.75 versus male = 4.70; P < .001). By contrast, there was no difference in ratings of subspecialty pediatric faculty. CONCLUSIONS Pediatric female faculty were statistically rated higher than male faculty in overall teaching ability, although these findings may not be educationally significant. The difference was driven by evaluations in the outpatient setting and for general pediatricians. This study is one of the first in pediatrics adding to the continued investigation of gender disparities in academic medicine.
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Affiliation(s)
| | - Katrina L Foo
- Robert Wood Johnson Barnabas, Rutgers University Medical School, New Brunswick, New Jersey
| | | | | | - Julie Sturza
- Departments of Pediatrics
- Biostatistics and Data Management Unit, University of Michigan Medical School, Ann Arbor, Michigan
| | - Sarah Hartley
- Internal Medicine
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
| | | | - Virginia Sheffield
- Internal Medicine
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Leah Rappaport
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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Redelmeier DA, Etchells EE, Najeeb U. Honest communication and social asymmetries inside a hospital: Pitfalls for clinicians. J Hosp Med 2022; 17:405-409. [PMID: 35535568 DOI: 10.1002/jhm.12827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 04/05/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Donald A Redelmeier
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Evaluative Clinical Sciences Platform, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences in Ontario, Population Health Division, Toronto, Ontario, Canada
- Division of General Internal Medicine, Sunnybrook Health Science Centre, Toronto, Ontario, Canada
- Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada
| | - Edward E Etchells
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of General Internal Medicine, Sunnybrook Health Science Centre, Toronto, Ontario, Canada
- Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada
- Division of General Internal Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | - Umberin Najeeb
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of General Internal Medicine, Sunnybrook Health Science Centre, Toronto, Ontario, Canada
- Office of Inclusion and Diversity, Temerty Faculty of Medicine, Toronto, Ontario, Canada
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Olson EM, Dines VA, Ryan SM, Halvorsen AJ, Long TR, Price DL, Thompson RH, Tollefson MM, Van Gompel JJ, Oxentenko AS. Physician Identification Badges: A Multispecialty Quality Improvement Study to Address Professional Misidentification and Bias. Mayo Clin Proc 2022; 97:658-667. [PMID: 35379420 DOI: 10.1016/j.mayocp.2022.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 12/10/2021] [Accepted: 01/11/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate whether providing resident physicians with "DOCTOR" role identification badges would impact perceptions of bias in the workforce and alter misidentification rates. PARTICIPANTS AND METHODS Between October 2019 and December 2019, we surveyed 341 resident physicians in the anesthesiology, dermatology, internal medicine, neurologic surgery, otorhinolaryngology, and urology departments at Mayo Clinic in Rochester, Minnesota, before and after an 8-week intervention of providing "DOCTOR" role identification badges. Differences between paired preintervention and postintervention survey answers were measured, with a focus on the frequency of experiencing perceived bias and role misidentification (significance level, α=.01). Free-text comments were also compared. RESULTS Of the 159 residents who returned both the before and after surveys (survey response rate, 46.6% [159 of 341]), 128 (80.5%) wore the "DOCTOR" badge. After the intervention, residents who wore the badges were statistically significantly less likely to report role misidentification at least once a week from patients, nonphysician team members, and other physicians (50.8% [65] preintervention vs 10.2% [13] postintervention; 35.9% [46] vs 8.6% [11]; 18.0% [23] vs 3.9% [5], respectively; all P<.001). The 66 female residents reported statistically significantly fewer episodes of gender bias (65.2% [43] vs 31.8% [21]; P<.001). The 13 residents who identified as underrepresented in medicine reported statistically significantly less misidentification from patients (84.6% [11] vs 23.1% [3]; P=.008); although not a statistically significant difference, the 13 residents identifying as underrepresented in medicine also reported less misidentification with nonphysician team members (46.2% [6] vs 15.4% [2]; P=.13). CONCLUSION Residents reported decreased role misidentification after use of a role identification badge, most prominently improved among women. Decreasing workplace bias is essential in efforts to improve both diversity and inclusion efforts in training programs.
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Affiliation(s)
| | - Virginia A Dines
- Department of Medicine, Mayo Clinic, Rochester, MN; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN
| | - Samantha M Ryan
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | | | - Timothy R Long
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Daniel L Price
- Department of Otolaryngology (ENT)/Head and Neck Surgery, Mayo Clinic, Rochester, MN
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Sheffield V, Hartley S, Stansfield RB, Mack M, Blackburn S, Vaughn VM, Heidemann L, Chang R, Lukela JR. Gendered Expectations: the Impact of Gender, Evaluation Language, and Clinical Setting on Resident Trainee Assessment of Faculty Performance. J Gen Intern Med 2022; 37:714-722. [PMID: 34405349 PMCID: PMC8904706 DOI: 10.1007/s11606-021-07093-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Gender inequity is pervasive in academic medicine. Factors contributing to these gender disparities must be examined. A significant body of literature indicates men and women are assessed differently in teaching evaluations. However, limited data exist on how faculty gender affects resident evaluation of faculty performance based on the skill being assessed or the clinical practice settings in which the trainee-faculty interaction occurs. OBJECTIVE Evaluate for gender-based differences in the assessment of general internal medicine (GIM) faculty physicians by trainees in inpatient and outpatient settings. DESIGN Retrospective cohort study SUBJECTS: Inpatient and outpatient GIM faculty physicians in an Internal Medicine residency training program from July 1, 2015, to December 31, 2018. MAIN MEASURES Faculty scores on trainee teaching evaluations including overall teaching ability and Accreditation Council for Graduate Medical Education (ACGME) competencies (medical knowledge [MK], patient care [PC], professionalism [PROF], interpersonal and communication skills [ICS], practice-based learning and improvement [PBLI], and systems-based practice [SBP]) based on the institutional faculty assessment form. KEY RESULTS In total, 3581 evaluations by 445 trainees (55.1% men, 44.9% women) assessing 161 GIM faculty physicians (50.3% men, 49.7% women) were included. Male faculty were rated higher in overall teaching ability (male=4.69 vs. female=4.63, p=0.003) and in four of the six ACGME competencies (MK, PROF, PBLI, and SBP) based on our institutional evaluation form. In the inpatient setting, male faculty were rated more favorably for overall teaching (male = 4.70, female = 4.53, p=<0.001) and across all ACGME competencies. The only observed gender difference in the outpatient setting favored female faculty in PC (male = 4.65, female = 4.71, p=0.01). CONCLUSIONS Male and female GIM faculty performance was assessed differently by trainees. Gender-based differences were impacted by the setting of evaluation, with the greatest difference by gender noted in the inpatient setting.
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Affiliation(s)
- Virginia Sheffield
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sarah Hartley
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | - Megan Mack
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Staci Blackburn
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Valerie M Vaughn
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.,Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Lauren Heidemann
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Robert Chang
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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Katz SJ. The Influence of Applicant and Reviewer Gender on Resident Selection for Internal Medicine. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2021; 8:23821205211016502. [PMID: 34104786 PMCID: PMC8150434 DOI: 10.1177/23821205211016502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 04/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND While gender bias in medicine, including physician training, has been well described, less is known about gender bias in the selection process for post graduate residency training programs. This analysis reviews the potential role of gender on resident selection for an internal medicine residency program. METHODS File review and interview overall and component scores were analyzed based on the gender of the applicant. File review scores were further analyzed based on the reviewer's gender. RESULTS Women applicants scored higher than men applicants on their file review. There were no differences in any one component score except for leadership in art. Women file reviewers scored applicants higher than men file reviewers, but there was no difference between gender scores. There was no difference in overall or component interview scores between men or women applicants. Scoring did not impact the expected rank performance of applicants based on gender at any stage of the selection process. CONCLUSIONS While higher scores were observed in women applicants upon their file review, and women reviewers provided higher file review scores, this did not appear to impact the expected number of women and men applicants at each stage of the applicant process. This suggests a potential lack of gender bias at these stages of applicant selection.
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Affiliation(s)
- Steven J Katz
- Steven J Katz, University of Alberta, 8-130 Clinical Sciences Building, Edmonton, AB T6G 2G3, Canada.
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