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Haischer-Rollo G, Geringer JL, Thomas K, Hale D. Do You See What I See? A Comparison of CCC and Self-Assigned Milestones Across Military Medical Specialties. JOURNAL OF SURGICAL EDUCATION 2024; 81:647-655. [PMID: 38553366 DOI: 10.1016/j.jsurg.2024.02.001] [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: 10/22/2023] [Revised: 01/08/2024] [Accepted: 02/02/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to complete competency-based assessments of medical trainees based on nationally established Milestones. Previous research demonstrates a strong correlation between CCC and resident scores on the Milestones in surgery, but little is known if this is true between specialties. In this study, we investigated a variety of specialties and sought to determine what factors affect self-assessment of milestones. In addition, a post-hoc analysis was completed on the COVID-19 pandemic effects on self-evaluation. METHODS This is an IRB approved observational study on prospectively collected self-evaluation milestone data that is used within each ACGME program's Clinical Competency Committees. Medical trainees within the San Antonio Uniformed Services Health Education Consortium were approached for possible participation in this study with permission from program directors. RESULTS There was no significant difference between self-assessments and CCC-assessments based on self-identified gender or residency type (surgical versus nonsurgical) for any milestone domain. Within the postgraduate year (PGY) groups, the PGY5 and PGY6 tended to rate themselves higher than CCC. Chiefs (Internal Medicine PGY2/3, and General Surgery PGY5/6) tended to be more accurate in scoring themselves than the interns (PGY1) within the milestone of Interpersonal Skills and Communication (chiefs 0.5 vs. interns 0.62, p = 0.03). On post hoc analysis of self-rating, during the first wave of the COVID 19 pandemic, Post-Covid residents were more likely to underrate themselves in Systems-Based Practice compared to the Pre-Covid cohort (-0.49 vs 0.10; p = 0.007) and more likely to rate themselves higher in Professionalism (-0.54 vs. -0.10, p = 0.012). CONCLUSION Unique to this study and our institution, there was no gender difference found in self vs CCC evaluations. With the change in learning environment from COVID, there was also a change in ability for some learners to self-assess accurately. As medical educators, we should understand the importance of both encouraging learners to practice self-assessment as well as give feedback to trainees on their progress. We also need to educate our faculty on the use of milestones for assessment to create a true gold standard in the CCC.
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Affiliation(s)
| | - Jamie Lynn Geringer
- Uniformed Services University, Bethesda, Maryland, USA; Department of Medicine, Brooke Army Medical Center, San Antonio, Texas
| | - Katryna Thomas
- Department of Surgery, Brooke Army Medical Center, San Antonio, Texas, Bethesda, Maryland, USA
| | - Diane Hale
- Department of Surgery, Brooke Army Medical Center, San Antonio, Texas, Bethesda, Maryland, USA.
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Sugo N, Terazono S, Matsuura C, Fuchinoue Y, Sakaeyama Y, Abe M, Mikai M, Kubota S, Kondo K, Shimokawa S, Maehara T, Akutsu H, Ikawa F, Enomoto Y, Kamiya K, Kuroda S, Takeshima H, Tamura N, Hishikawa T, Fujii M, Fujimaki T, Horiuchi T, Yamamoto J, Yamamoto T, Kato Y. Academic Activities of Female Neurosurgeons in All Branch Meetings of the Japan Neurosurgical Society. Neurol Med Chir (Tokyo) 2023; 63:457-463. [PMID: 37495519 PMCID: PMC10687666 DOI: 10.2176/jns-nmc.2023-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/29/2023] [Indexed: 07/28/2023] Open
Abstract
This study aims to evaluate the academic activities of female neurosurgeons at all branch meetings of the Japan Neurosurgical Society and identify related issues they encountered. The programs of all seven branch meetings of the Japan Neurosurgical Society (Hokkaido, Tohoku, Kanto, Chubu, Kinki, Chugoku/Shikoku, and Kyushu) were used to determine the number of presentations and chairpersons by sex. The covered period was from January 2008 to December 2020, which was available for viewing during the survey. Of note, only the Kinki branch used data from January 2008 to December 2019. The Neurologia Medico-chirurgica (NMC), the journal of the Japan Neurosurgical Society, was also reviewed to identify publication achievements during the same period. In all seven branches, the percentage of presentations given by female physicians increased from 7.9% in 2008 to 9.6% in 2020 (p < 0.05).Conversely, the percentage of female chairpersons in all branch meetings did not change over time and it was significantly lower (1.1%) than that of female presenters (7.9%) for all branch meetings combined in over 13 years (p < 0.01). In the NMC, the number of articles with female physicians as first authors did not increase or decrease over the years. We conclude that efforts to smoothly promote female neurosurgeons as chairpersons and increase the number of female first authors are necessary to facilitate their academic activities.
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Affiliation(s)
- Nobuo Sugo
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
| | - Sayaka Terazono
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University
| | - Chie Matsuura
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University
| | - Yutaka Fuchinoue
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University
| | - Yuki Sakaeyama
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University
| | - Mitsuyoshi Abe
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University
| | - Masataka Mikai
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University
| | - Syuhei Kubota
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University
| | - Kosuke Kondo
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University
| | - Shoko Shimokawa
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, Kurume University School of Medicine
| | - Taketoshi Maehara
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, Tokyo Medical and Dental University
| | - Hiroyoshi Akutsu
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, Dokkyo Medical University
| | - Fusao Ikawa
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, Shimane Prefectural Central Hospital
| | - Yukiko Enomoto
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, Gifu University Graduate School of Medicine
| | - Kazuko Kamiya
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, Norikura-Tatamidaira Clinic
| | - Satoshi Kuroda
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Hideo Takeshima
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, Faculty of Medicine, University of Miyazaki
| | - Noriko Tamura
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, Gotenyama Orthopedic Rehab Clinic
| | - Tomohito Hishikawa
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences
| | - Masazumi Fujii
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, Fukushima Medical University School of Medicine
| | - Takamitsu Fujimaki
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, Saitama Medical University
| | - Tetsuyoshi Horiuchi
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, Shinshu University School of Medicine
| | - Junkoh Yamamoto
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, University of Occupational and Environmental Health
| | - Tetsuya Yamamoto
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine
| | - Yoko Kato
- Committee for the Promotion of Diversity, Japan Neurosurgical Society
- Department of Neurosurgery, Fujita Health University, Bantane Hospital
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Deveze E, Traore A, Ribault N, Estoppey D, Latelise B, Fournier HD, Bigorre N. Self-Assessment Versus Peer-Assessment in Microsurgery Learning: A Comparative Retrospective Study in a Surgery Residents Cohort. JOURNAL OF SURGICAL EDUCATION 2023; 80:1472-1478. [PMID: 37524617 DOI: 10.1016/j.jsurg.2023.06.028] [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: 02/22/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 08/02/2023]
Abstract
INTRODUCTION In surgical learning, self-assessment allows the physician to identify and improve his strong and weak points. However, its scientific validity has yet to be demonstrated. The aim of this study was to analyze if there is a link between self-assessment accuracy and improvement in surgical skills. We make the hypothesis that an accurate self-assessment allows a greater improvement MATERIAL AND METHOD: We set up a retrospective cohort study at the tertiary University Hospital of Angers. Between 2019 and 2021, twenty-eight surgery residents took part into a microsurgery program and were included in the study. For two weeks, they performed anastomosis training on inert material and living anesthetized rats under microscope. Each resident was evaluated during the workshop by senior surgeons on 10 items: movement stability and fluidity, instrument manipulation, needles, dissection, clamp setting, vessel manipulation, suture, checking before clamp removal, checking after clamp removal, watertighness. Self-assessment was performed by the residents with the same grid, at the end of the workshop. Residents' and senior's evaluations were double-blind. We retrospectively analyzed the concordance between senior objective assessment and self-assessment, and the effect of an accurate self-assessment on technical improvement. RESULTS Data for twenty-five residents were analyzed, 14 were female (56%). The mean age was 29 years. Surgical specialties were orthopedics (44%), maxillofacial surgery (45.4%), neurosurgery (12%), gynecology (4%) and vascular surgery (4%). According to Cohen's kappa coefficient, 14 residents (56%) underestimated themselves, 7 (28%) were concordant with peer-assessment and 4 (16%) overestimated themselves. The concordance between self and peer assessment during sessions was positive for the most objective items, and negative for the most subjective items. Technical skills improvement in term of peer-assessment averages was positive for each item in each group, without statistical differences between groups. CONCLUSION We found that the ability to self-assess in a fast-track microsurgery module for surgery residents varied according to analyzed gestures. We demonstrated an improvement in term of self-assessment for objective items, and a decrease for subjective items. However, we didn't find any relation between improvement curve and the accuracy of self-assessment.
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Affiliation(s)
- Eva Deveze
- Département de chirurgie vasculaire et thoracique, CHU Angers, 4 Rue Larrey 49000 Angers, France.
| | - Adele Traore
- Département de chirurgie maxillo-faciale, CHU Angers, 4 Rue Larrey, 49000 Angers, France
| | - Nicolas Ribault
- Département de neurochirurgie, CHU Angers, 4 Rue Larrey, 49000 Angers, France
| | - Daniel Estoppey
- Département de chirurgie orthopédique et traumatologie, HFR Fribourg, Hôpital Cantonal, Chemin des Pensionnats 2-6, 1708 Fribourg, Suisse
| | - Benoit Latelise
- Département de chirurgie orthopédique, CHU Poitiers, 2 Rue de la Mileterie, 86000 Poitiers, France
| | - Henri-Dominique Fournier
- Faculté de Médecine, Laboratoire d'Anatomie, Université Angers, Rue Haute de Reculée, 49045 Angers, France
| | - Nicolas Bigorre
- Centre de la Main, 47 rue de la Foucaudière, 49800 Trélazé, France
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Ofshteyn A, Steinhagen E. Surgical Education: Disparities in Education May Impact the Quality and Likelihood of Completion of Training. Clin Colon Rectal Surg 2023; 36:315-320. [PMID: 37564350 PMCID: PMC10411215 DOI: 10.1055/s-0043-1763519] [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: 08/12/2023]
Abstract
Female surgical trainees experience bias that begins at the preclinical stages of medical school, extending into their surgery clerkships, and then into their residency training. There are important implications in terms of training opportunities and career advancement, mentorship, sponsorship, and ultimately burnout. Childbearing and lactation also impact the experiences and perceptions of female trainees who have children. There are limited interventions that have improved the experience of women in surgical training. Mentorship appears to play an important role in ameliorating some of the negative consequences of the training environment and improving outcomes for women surgeons.
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Affiliation(s)
- Asya Ofshteyn
- Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Emily Steinhagen
- Division of Colorectal, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
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5
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Pan TY, Piscioneri F, Owen C. Comparison Between Surgical Trainee Self-Assessment With Supervisor Scores in Technical and Nontechnical Skills to Identify Underperforming Trainees. JOURNAL OF SURGICAL EDUCATION 2023; 80:1311-1319. [PMID: 37407352 DOI: 10.1016/j.jsurg.2023.06.006] [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: 02/08/2023] [Revised: 05/11/2023] [Accepted: 06/07/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE This study aims to compare trainee self-assessment with supervisor assessment to identify differences in correlations of the demographic data and evaluate whether the instrument can be utilized to identify underperforming trainees. DESIGN A novel instrument was designed based off the Royal Australasian College of Surgeons original 9 competencies utilizing the JDocs framework and covers 48-items across all surgical competencies. A multiple regression model using age, gender, postgraduate year, IMG status, and level of training as the variables was performed with backwards elimination, and pairwise comparisons made to identify the degree and direction of influence each variable contributed to trainee and supervisor ratings. SETTING Surgical trainees employed in tertiary centers within the Australian Capital Territory and South-East New South Wales health network in Australia. PARTICIPANTS A total of 36 of 59 (61%) trainees responded. Two grossly incomplete responses were excluded from further analysis resulting in 34 completed self-assessments for analysis. There was a total of 68 supervisor assessments provided by 25 different nominated supervisors. Of these assessments, 67 were fully completed and one was partially complete. RESULTS We identified that for both self-ratings and supervisor ratings, the most significant correlation is with the postgraduate year of the trainee, with correlation identified in 7 out of 9 competencies, although in different competency domains. International Medical Graduate status is associated in 2 of 9 self-ratings, and in 3 of 9 supervisor ratings. Underperforming trainees were able to be identified through supervisor assessment but not self-assessment. CONCLUSION The supervisor assessment form was able to identify underperforming trainees. Our findings resonate with existing literature in other specialty fields, and surgical units that employ assessment forms should feel more confident in the interpretation of the data and provision of feedback to trainees.
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Affiliation(s)
- Tzong-Yang Pan
- Canberra Hospital, Australian National University, Canberra, ACT, Australia.
| | - Frank Piscioneri
- Canberra Hospital, Australian National University, Canberra, ACT, Australia
| | - Cathy Owen
- Australian National University, Canberra, ACT, Australia
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6
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Bao G, Yang P, Yi J, Peng S, Liang J, Li Y, Guo D, Li H, Ma K, Yang Z. Full-sized realistic 3D printed models of liver and tumour anatomy: a useful tool for the clinical medicine education of beginning trainees. BMC MEDICAL EDUCATION 2023; 23:574. [PMID: 37582729 PMCID: PMC10428657 DOI: 10.1186/s12909-023-04535-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 07/24/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Simulation-based medical education (SBME) and three-dimensional printed (3DP) models are increasingly used in continuing medical education and clinical training. However, our understanding of their role and value in improving trainees' understanding of the anatomical and surgical procedures associated with liver surgery remains limited. Furthermore, gender bias is also a potential factor in the evaluation of medical education. Therefore, the aim of this study was to evaluate the educational benefits trainees receive from the use of novel 3DP liver models while considering trainees' experience and gender. METHODS Full-sized 3DP liver models were developed and printed using transparent material based on anonymous CT scans. We used printed 3D models and conventional 2D CT scans of the liver to investigate thirty trainees with various levels of experience and different genders in the context of both small group teaching and formative assessment. We adopted a mixed methods approach involving both questionnaires and focus groups to collect the views of different trainees and monitors to assess trainees' educational benefits and perceptions after progressing through different training programs. We used Objective Structured Clinical Examination (OSCE) and Likert scales to support thematic analysis of the responses to the questionnaires by trainees and monitors, respectively. Descriptive analyses were conducted using SPSS statistical software version 21.0. RESULTS Overall, a 3DP model of the liver is of great significance for improving trainees' understanding of surgical procedures and cooperation during operation. After viewing the personalized full-sized 3DP liver model, all trainees at the various levels exhibited significant improvements in their understanding of the key points of surgery (p < 0.05), especially regarding the planned surgical procedure and key details of the surgical procedures. More importantly, the trainees exhibited higher levels of satisfaction and self-confidence during the operation regardless of gender. However, with regard to gender, the results showed that the improvement of male trainees after training with the 3DP liver model was more significant than that of female trainees in understanding and cooperation during the surgical procedure, while no such trend was found with regard to their understanding of the base knowledge. CONCLUSION Trainees and monitors agreed that the use of 3DP liver models was acceptable. The improvement of the learning effect for practical skills and theoretical understanding after training with the 3DP liver models was significant. This study also indicated that training with personalized 3DP liver models can improve all trainees' presurgical understanding of liver tumours and surgery and males show more advantage in understanding and cooperation during the surgical procedure as compared to females. Full-sized realistic 3DP models of the liver are an effective auxiliary teaching tool for SBME teaching in Chinese continuing medical education.
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Affiliation(s)
- Guoqiang Bao
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Ping Yang
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Jiangpu Yi
- 3D Printing Research Center of Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, China
| | - Shujia Peng
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Jiahe Liang
- 3D Printing Research Center of Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, China
| | - Yajie Li
- Xi 'an Ma Ke Medical Technology Ltd, Room 21516, Block C, Chaoyang International Plaza, Xi'an, Shaanxi, China
| | - Dian Guo
- Xi 'an Ma Ke Medical Technology Ltd, Room 21516, Block C, Chaoyang International Plaza, Xi'an, Shaanxi, China
| | - Haoran Li
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Kejun Ma
- Xi 'an Ma Ke Medical Technology Ltd, Room 21516, Block C, Chaoyang International Plaza, Xi'an, Shaanxi, China
| | - Zhenyu Yang
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710038, China.
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Schaffler-Schaden D, Stöllinger L, Avian A, Terebessy A, Scott AM, Streit S, Piccoliori G, Zelko E, Huter S, Mergenthal K, Bachler H, Flamm M, Siebenhofer A. Gender Differences in Perceived Working Conditions of General Practitioners During the COVID-19 Pandemic-a Cross-Sectional Study. J Gen Intern Med 2023; 38:1894-1901. [PMID: 36971880 PMCID: PMC10042103 DOI: 10.1007/s11606-023-08166-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/10/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND The ongoing COVID-19 pandemic has revealed gender-specific differences between general practitioners in adapting to the posed challenges. As primary care workforce is becoming increasingly female, in many countries, it is essential to take a closer look at gender-specific influences when the global health care system is confronted with a crisis. OBJECTIVE To explore gender-specific differences in the perceived working conditions and gender-specific differences in challenges facing GPs at the beginning of the COVID-19 pandemic in 2020. DESIGN Online survey in seven countries. PARTICIPANTS 2,602 GPs from seven countries (Austria, Australia, Switzerland, Germany, Hungary, Italy, Slovenia). Of the respondents, 44.4% (n = 1,155) were women. MAIN MEASURES Online survey. We focused on gender-specific differences in general practitioners' perceptions of working conditions at the beginning of the COVID-19 pandemic in 2020. KEY RESULTS Female GPs rated their skills and self-confidence significantly lower than male GPs (f: 7.1, 95%CI: 6.9-7.3 vs. m: 7.6, 95%CI 7.4-7.8; p < .001), and their perceived risk (concerned about becoming infected or infecting others) higher than men (f: 5.7, 95%CI: 5.4-6.0 vs. m: 5.1, 95%CI: 4.8-5.5; p = .011). Among female GPs, low self-confidence in the treatment of COVID-19 patients appear to be common. Results were similar in all of the participating countries. CONCLUSIONS Female and male GPs differed in terms of their self-confidence when dealing with COVID-19-related issues and their perceptions of the risks arising from the pandemic. To ensure optimal medical care, it is important that GPs realistically assess their own abilities and overall risk.
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Affiliation(s)
- Dagmar Schaffler-Schaden
- Institute for General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Lena Stöllinger
- Institute for General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Alexander Avian
- Institute for Medical Informatics, Statistics and Documentation, Medical University Graz, Auenbruggerplatz 2/5 8036, Graz, Austria.
| | - András Terebessy
- Department of Public Health - Faculty of Medicine, Semmelweis University Budapest, Budapest, Hungary
| | - Anna M Scott
- Institute for Evidence-Based Healthcare, Bond University Australia, Robina, Australia
| | - Sven Streit
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Giuliano Piccoliori
- Institute of General Practice, Institute for Special Training in General Medicine, Claudiana Bozen, Bolzano, Italy
| | - Erika Zelko
- Faculty of Medicine Johannes, Kepler University of Linz, Linz, Austria
| | - Sebastian Huter
- Institute for General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Karola Mergenthal
- Institute of General Practice, Goethe University Frankfurt, Frankfurt, Germany
| | - Herbert Bachler
- Institute of General Practice, Medical University Innsbruck, Innsbruck, Austria
| | - Maria Flamm
- Institute for General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Andrea Siebenhofer
- Institute of General Practice, Goethe University Frankfurt, Frankfurt, Germany
- Institute for General Practice and Evidence Based Health Services Research, Medical University Graz, Graz, Austria
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8
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Olson EM, Sanborn DM, Dyster TG, Kelm DJ, Murray SG, Santhosh L, DesJardin JT. Gender Disparities in Critical Care Procedure Training of Internal Medicine Residents. ATS Sch 2023; 4:164-176. [PMID: 37538076 PMCID: PMC10394715 DOI: 10.34197/ats-scholar.2022-0025oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 12/22/2022] [Indexed: 08/05/2023] Open
Abstract
Background Procedural training is a required competency in internal medicine (IM) residency, yet limited data exist on residents' experience of procedural training. Objectives We sought to understand how gender impacts access to procedural training among IM residents. Methods A mixed-methods, explanatory sequential study was performed. Procedure volume for IM residents between 2016 and 2020 was assessed at two large academic residencies (Program A and Program B: 399 residents and 4,020 procedures). Procedural rates and actual versus expected procedure volume by gender were compared, with separate analyses by clinical environment (intensive care unit [ICU] or structured procedural service). Semistructured gender-congruent focus groups were conducted. Topics included identity formation as a proceduralist and the resident procedural learning experience, including perceived gender bias in procedure allocation. Results Compared with men, women residents performed disproportionately fewer ICU procedures per month at Program A (1.4 vs. 2.7; P < 0.05) but not at Program B (0.36 vs. 0.54; P = 0.23). At Program A, women performed only 47% of ICU procedures, significantly fewer than the 54% they were expected to perform on the basis of their time on ICU rotations (P < 0.001). For equal gender distribution of procedural volume at Program A, 11% of the procedures performed by men would have needed to have been performed by women instead. Gender was not associated with differences in the Program A structured procedural service (53% observed vs. 52% expected; P = 0.935), Program B structured procedural service (40% observed vs. 43% expected; P = 0.174), or in Program B ICUs (33% observed vs. 34% expected; P = 0.656). Focus group analysis identified that women from both residencies perceived that assertiveness was required for procedural training in unstructured learning environments. Residents felt that gender influenced access to procedural opportunities, ability to self-advocate for procedural experience, identity formation as a proceduralist, and confidence in acquiring procedural skills. Conclusion Gender disparities in access to procedural training during ICU rotations were seen at one institution but not another. There were ubiquitous perceptions that assertiveness was important to access procedural opportunities. We hypothesize that structured allocation of procedures would mitigate disparities by allowing all residents to access procedural training regardless of self-advocacy. Residency programs should adopt structured procedural training programs to counteract inequities.
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Affiliation(s)
| | | | | | - Diana J. Kelm
- Department of Medicine and
- Division of Pulmonary and Critical Care,
Mayo Clinic, Rochester, Minnesota
| | - Sara G. Murray
- Department of Medicine
- Division of Hospital Medicine, and
| | | | - Jacqueline T. DesJardin
- Department of Medicine
- Division of Cardiology, University of
California San Francisco, San Francisco, California
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9
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Osunronbi T, Adeboye W, Faluyi D, Sofela J, Shoker S, O'Riordan M, Mitoko CA, Mberu VK, Mandangu C, Madume R, Kolawole AI, Jones RI, Inyang D, Ibrahim U, Ibeanusi IM, Fofanah IJ, Corriero AC, Chimba C, Akhionbare I, Ahmad Z, Adamu-Biu F, Abraha S, Abankwa E, Sofela A. Predictors of self-reported research self-efficacy and perception of research amongst medical students in the United Kingdom: a national cross-sectional survey. Postgrad Med J 2023; 99:69-76. [PMID: 36841225 DOI: 10.1093/postmj/qgad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/24/2022] [Accepted: 01/06/2023] [Indexed: 02/27/2023]
Abstract
PURPOSE There has been a decline in the number of academic clinicians in the UK, and there are ethnic/gender disparities in the academic workforce. Higher research self-efficacy (RSE) and a positive perception of research (PoR) amongst students are associated with a higher motivation to engage in academic medicine. Hence, this study aimed to determine the factors that influence RSE and PoR amongst UK medical students. METHODS This is a multicentre cross-sectional survey of medical students in 36 UK medical schools in the 2020/21 academic year. Multiple linear regression was used to investigate the association between students' demographics and RSE/PoR. P-values less than a Bonferroni-corrected significance level of .05/28 = .0018 were considered statistically significant. RESULTS In total, 1573 individuals participated from 36 medical schools. There were no ethnic differences in PoR or RSE scores. Although there were no gender differences in PoR, female students had lower RSE scores than male students (adjusted β = -1.75; 95% CI: -2.62, -0.89). Research experience before medical school (adjusted β = 3.02; 95% CI: 2.11, 3.93), being in the clinical training phase (adjusted β = 1.99; 95% CI: 1.09, 2.90), and completing a degree before medical school (adjusted β = 3.66; 95% CI: 2.23, 5.09) were associated with higher RSE. CONCLUSION There were no associations between the predictor variables and PoR. Female students had lower self-reported RSE scores. Future studies should investigate the role of targeted research mentorship in improving RSE amongst female medical students.
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Affiliation(s)
- Temidayo Osunronbi
- Melanin Medics Research Network, Luton LU4 8DY, United Kingdom
- Department of Health Sciences, University of York, York YO10 5DD, United Kingdom
| | - William Adeboye
- Melanin Medics Research Network, Luton LU4 8DY, United Kingdom
| | - David Faluyi
- Melanin Medics Research Network, Luton LU4 8DY, United Kingdom
| | - Jasmine Sofela
- Faculty of Health, University of Plymouth, Plymouth PL6 8BT, United Kingdom
| | - Serena Shoker
- Melanin Medics Research Network, Luton LU4 8DY, United Kingdom
| | | | | | | | - Chenai Mandangu
- Melanin Medics Research Network, Luton LU4 8DY, United Kingdom
| | - Rachael Madume
- Melanin Medics Research Network, Luton LU4 8DY, United Kingdom
| | | | - Robert I Jones
- Melanin Medics Research Network, Luton LU4 8DY, United Kingdom
| | - Deborah Inyang
- Melanin Medics Research Network, Luton LU4 8DY, United Kingdom
| | | | | | - Isata J Fofanah
- Melanin Medics Research Network, Luton LU4 8DY, United Kingdom
| | - Anna C Corriero
- Melanin Medics Research Network, Luton LU4 8DY, United Kingdom
| | - Chimba Chimba
- Melanin Medics Research Network, Luton LU4 8DY, United Kingdom
| | | | - Zain Ahmad
- Melanin Medics Research Network, Luton LU4 8DY, United Kingdom
| | | | - Semhar Abraha
- Melanin Medics Research Network, Luton LU4 8DY, United Kingdom
| | - Efua Abankwa
- Melanin Medics Research Network, Luton LU4 8DY, United Kingdom
| | - Agbolahan Sofela
- Faculty of Health, University of Plymouth, Plymouth PL6 8BT, United Kingdom
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10
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Cuevas-Nunez MC, Pulido MT, Harpe S, Stein AB, Lempicki K. Assessment of communication and physical exam skills: A comparison of students, faculty and standardized patients. J Dent Educ 2022; 86:853-862. [PMID: 35181888 DOI: 10.1002/jdd.12892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 12/02/2021] [Accepted: 01/04/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE/OBJECTIVES The objective of this retrospective study was twofold: it aimed to investigate dental students' communication and physical exam self-assessment skills by comparing students' self-evaluations with those completed by faculty and standardized patients (SPs). Second, it aimed to compare faculty and SPs assessment of students' communication skills. METHODS At the end of their first year of training, students (n = 127), participated in one SP encounter about an initial dental consultation. Students completed self-assessment before receiving feedback from faculty (n = 19) and SPs (n = 19). The data source included evaluation forms submitted by students, faculty and SPs. The Wilcoxon signed rank test was used to compare the overall scores between groups. Agreement between evaluations items were analyzed with McNemar's test (p < 0.05). RESULTS Overall, there were no statistically significant differences in how students and faculty graded for either communication (p = 0.6724) or physical exam (p = 0.1921) skills. However, both students and faculty provided less favorable marks than SPs for communication skills with a statistically significant difference in the overall grading between both students and SPs (p = 0.0146) and between faculty and SPs (p = 0.0045). CONCLUSIONS While there was disagreement between students and faculty versus SPs, they weren't meaningful differences in scores and the dissimilarities mainly consisted of ratings of explanation skills. We suggest that, when applicable, dental student's self-evaluations may represent an alternative to faculty assessments of communication and physical exam skills. Nonetheless, we recommend that SPs be included in the assessment of communication skills to provide students with comprehensive feedback that more realistically represents the natural patient-provider relationship.
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Affiliation(s)
| | - M Teresa Pulido
- College of Dental Medicine, Midwestern University, Glendale, Arizona, USA
| | - Spencer Harpe
- Pharmacy Practice, Midwestern University, Downers Grove, Illinois, USA
| | - Amy B Stein
- BioClinical Statistics, Research Sponsored Programs, Midwestern University, Glendale, Arizona, USA
| | - Kelly Lempicki
- Simulation Center, Midwestern University, Downers Grove, Illinois, USA
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11
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Misra V, Safi F, Brewerton KA, Wu W, Mason R, Chan AW, Rochon PA, Lega IC, Abdel-Qadir H. Gender disparity between authors in leading medical journals during the COVID-19 pandemic: a cross-sectional review. BMJ Open 2021; 11:e051224. [PMID: 34261692 PMCID: PMC8282422 DOI: 10.1136/bmjopen-2021-051224] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Evaluate gender differences in authorship of COVID-19 articles in high-impact medical journals compared with other topics. DESIGN Cross-sectional review. DATA SOURCES Medline database. ELIGIBILITY CRITERIA Articles published from 1 January to 31 December 2020 in the seven leading general medical journals by impact factor. Article types included primary research, reviews, editorials and commentaries. DATA EXTRACTION Key data elements were whether the study topic was related to COVID-19 and names of the principal and the senior authors. A hierarchical approach was used to determine the likely gender of authors. Logistic regression assessed the association of study characteristics, including COVID-19 status, with authors' likely gender; this was quantified using adjusted ORs (aORs). RESULTS We included 2252 articles, of which 748 (33.2%) were COVID-19-related and 1504 (66.8%) covered other topics. A likely gender was determined for 2138 (94.9%) principal authors and 1890 (83.9%) senior authors. Men were significantly more likely to be both principal (1364 men; 63.8%) and senior (1332 men; 70.5%) authors. COVID-19-related articles were not associated with the odds of men being principal (aOR 0.99; 95% CI 0.81 to 1.21; p=0.89) or senior authors (aOR 0.96; 95% CI 0.78 to 1.19; p=0.71) relative to other topics. Articles with men as senior authors were more likely to have men as principal authors (aOR 1.49; 95% CI 1.21 to 1.83; p<0.001). Men were more likely to author articles reporting original research and those with corresponding authors based outside the USA and Europe. CONCLUSIONS Women were substantially under-represented as authors among articles in leading medical journals; this was not significantly different for COVID-19-related articles. Study limitations include potential for misclassification bias due to the name-based analysis. Results suggest that barriers to women's authorship in high-impact journals during COVID-19 are not significantly larger than barriers that preceded the pandemic and that are likely to continue beyond it. PROSPERO REGISTRATION NUMBER CRD42020186702.
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Affiliation(s)
- Vaidehi Misra
- Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
| | - Frozan Safi
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Wei Wu
- Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
| | - Robin Mason
- Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - An-Wen Chan
- Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
| | - Paula A Rochon
- Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
| | - Iliana C Lega
- Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Husam Abdel-Qadir
- Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
- Peter Munk Cardiac Centre (PMCC), University Health Network (UHN), Toronto, Ontario, Canada
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12
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Kornmehl DL, Patel E, Agrawal R, Harris JR, Ba AK, Ohyama H. The effect of gender on student self-assessment skills in operative preclinical dentistry. J Dent Educ 2021; 85:1511-1517. [PMID: 33990132 DOI: 10.1002/jdd.12638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/06/2021] [Accepted: 04/13/2021] [Indexed: 11/06/2022]
Abstract
PURPOSE/OBJECTIVE Self-assessment is a fundamental skill for dentists and other health care providers. It enables these professionals' ability to critically evaluate the quality of their clinical work and improve through self-directed learning. Researchers have investigated how gender affects self-assessment skills and have shown that male students tend to overestimate their performance while female students tend to underestimate theirs as compared to peer or faculty assessment. The goal of this study was to evaluate how the self-assessment skills of dental students differ by gender in operative preclinical dentistry. METHODS Third-year dental students (N = 208, Class of 2016-2021) self-assessed their work using the same rubrics as faculty on four operative dentistry competency examination procedures: Class II amalgam preparation and restoration and Class III resin-composite preparation and restoration. Two calibrated full-time faculty graded all procedures independently. The Student self-assessment-Faculty grade (S-F) gap scores were calculated and statistically analyzed. RESULTS Overall, both genders overestimated their self-assessment for all four procedures as compared to actual scores given by faculty. Males overestimated more significantly than females for Class II Amalgam preparation, but not for the other three procedures. However, when the S-F gap for all procedures was combined and analyzed together, male students significantly overestimated their self-assessments compared to female students. When female and male students grading scores were stratified into quartiles, there were significantly larger differences between males and females in the lower quartiles, which suggest that difference in self-assessment abilities was more prominent among the lower performing students. CONCLUSION The results of this study demonstrate that gender may affect the accuracy of self-assessment in operative preclinical dentistry.
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Affiliation(s)
| | - Eshani Patel
- VA Loma Linda Healthcare System, Loma Linda, California, USA
| | - Ruchika Agrawal
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | | | - Aisha K Ba
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Hiroe Ohyama
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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13
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Ryan JF, Istl AC, Luhoway JA, Davidson J, Christakis N, Bütter A, Mele TS. Gender Disparities in Medical Student Surgical Skills Education. JOURNAL OF SURGICAL EDUCATION 2021; 78:850-857. [PMID: 33020039 DOI: 10.1016/j.jsurg.2020.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Female medical students and surgical trainees are more likely to lack confidence in their clinical abilities than their male peers despite equal or superior performance. This study aims to examine the role of gender in medical student experience and confidence performing technical skills in surgical clerkship. DESIGN This was a single-center survey study conducted over 2 academic years (2016-2018). Students were surveyed on their experience and confidence performing a set of 9 technical skills during surgical clerkship and to identify skill-specific barriers to learning. SETTING This study was performed at Western University, London, Ontario, Canada. PARTICIPANTS All third-year medical students were invited to participate. RESULTS A total of 253 students participated yielding a survey response rate of 74.0%. Both male and female students reported similar levels of preclerkship interest in a surgical career, enjoyment in performing technical skills, confidence in ability to learn surgical skills and pursuit of available learning opportunities. At the conclusion of their surgical rotations, female students reported less experience and confidence performing technical skills compared to their male colleagues. Female students were more likely to cite an insufficient number of learning opportunities from consultant and resident teachers, time constraints, and lack of confidence as barriers to the achievement of technical proficiency. CONCLUSIONS Female gender was associated with less procedural experience and inferior confidence performing procedural skills. It is important for educators to be aware of this gender disparity and to actively promote equitable learning opportunities for female trainees.
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Affiliation(s)
- Joanna F Ryan
- Division of General Surgery, University of Western Ontario, London, Ontario, Canada
| | - Alexandra C Istl
- Division of General Surgery, University of Western Ontario, London, Ontario, Canada
| | - Jacqueline A Luhoway
- Division of General Surgery, University of Western Ontario, London, Ontario, Canada
| | - Jacob Davidson
- Division of Pediatric Surgery, University of Western Ontario, London, Ontario, Canada
| | - Nicole Christakis
- Division of General Surgery, University of Western Ontario, London, Ontario, Canada
| | - Andreana Bütter
- Division of Pediatric Surgery, University of Western Ontario, London, Ontario, Canada
| | - Tina S Mele
- Division of General Surgery, University of Western Ontario, London, Ontario, Canada.
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14
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Pastor-Cabeza M, Torné R, García-Armengol R, Menéndez-Osorio B, Mosteiro-Cadaval A, Bollar A, Rimbau JM, Sarabia R, Rodríguez-Hernández A. Women's role in neurosurgical research: is the gender gap improving? Neurosurg Focus 2021; 50:E6. [PMID: 33789230 DOI: 10.3171/2020.12.focus20911] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/21/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The percentage of women publishing high-impact neurosurgical research might be perceived as a representation of our specialty and may influence the perpetuation of the existing gender gap. This study investigated whether the trend in women taking lead roles in neurosurgical research has mirrored the increase in female neurosurgeons during the past decade and whether our most prestigious publications portray enough female role models to stimulate gender diversity among the new generation of neurosurgeons. METHODS Two of the most prominent neurosurgical journals-Journal of Neurosurgery and Neurosurgery-were selected for this study, and every original article that was published in 2009 and 2019 in each of those journals was investigated according to the gender of the first and senior authors, their academic titles, their affiliations, and their institutions' region. RESULTS A total of 1328 articles were analyzed. The percentage of female authors was significantly higher in Europe and Russia compared with the US and Canada (first authors: 60/302 [19.9%] vs 109/829 [13.1%], p = 0.005; and senior authors: 32/302 [10.6%] vs 57/829 [6.9%], p = 0.040). Significantly increased female authorship was observed from 2009 to 2019, and overall numbers of both first and senior female authors almost doubled. However, when analyzing by regions, female authorship increased significantly only in the US and Canada. Female authors of neurosurgical research articles were significantly less likely to hold an MD degree compared with men. Female neurosurgeons serving as senior authors were represented in only 3.6% (48/1328) of articles. Women serving as senior authors were more likely to have a female colleague listed as the first author of their research (29/97 [29.9%] vs 155/1231 [12.6%]; χ2 = 22.561, p = 0.001). CONCLUSIONS Although this work showed an encouraging increase in the number of women publishing high-impact neurosurgical research, the stagnant trend in Europe may suggest that a glass ceiling has been reached and further advances in equity would require more aggressive measures. The differences in the researchers' profiles (academic title and affiliation) suggest an even wider gender gap. Cultural unconscious bias may explain why female senior authors have more than double the number of women serving as their junior authors compared with men. While changes in the workforce happen, strategies such as publishing specific issues on women, encouraging female editorials, and working toward more gender-balanced editorial boards may help our journals to portray a more equitable specialty that would not discourage bright female candidates.
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Affiliation(s)
- Marta Pastor-Cabeza
- 1Department of Neurosurgery, Germans Trias i Pujol University Hospital, Barcelona
| | - Ramon Torné
- 2Department of Neurosurgery, Hospital Clinic de Barcelona, Universidad de Barcelona
| | | | | | | | - Alicia Bollar
- 3Department of Neurosurgery, Donostia University Hospital, Guipúzcoa; and
| | - Jordi M Rimbau
- 1Department of Neurosurgery, Germans Trias i Pujol University Hospital, Barcelona
| | - Rosario Sarabia
- 4Department of Neurosurgery, Hospital Universitario Río Hortega, Valladolid, Spain
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15
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Kinney CL, Raddatz MM, Robinson LR. Influence of Sex and Age on Ratings of Confidence and Relevance in Continuing Certification Longitudinal Assessment: A Pilot Study. Am J Phys Med Rehabil 2021; 100:S3-S6. [PMID: 33141772 DOI: 10.1097/phm.0000000000001635] [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: 11/26/2022]
Abstract
OBJECTIVE Longitudinal assessments use spaced repetition of items to facilitate learning. Algorithms selecting repetition items can prioritize various properties for future presentation. The purpose of this pilot study was to evaluate the relationship between participant ratings of item-specific confidence and/or practice relevance and participant age, sex, and response correctness. DESIGN This is a prospective quality improvement study of 403 American Board of Physical Medicine and Rehabilitation diplomates with time-limited certificates. Participants answered 20 items quarterly over four quarters, rating each item on its relevance to their practice and their confidence in their response. RESULTS The relationship between sex and ratings of response confidence was significant, with women less likely than men to be confident in their responses, regardless of correctness. Younger physicians were significantly more confident in their responses and rated items as more practice relevant. CONCLUSIONS Women physicians were less confident than men in their item-specific confidence ratings, regardless of correctness, on the American Board of Physical Medicine and Rehabilitation continuing certification longitudinal knowledge assessment. Older physicians were less confident in their responses than younger physicians. The findings supported the American Board of Physical Medicine and Rehabilitation prioritization of response correctness and practice relevance, rather than response confidence, to select items for spaced repetition in American Board of Physical Medicine and Rehabilitation's continuing certification longitudinal assessment.
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Affiliation(s)
- Carolyn L Kinney
- From the American Board of Physical Medicine and Rehabilitation, Rochester, Minnesota (CLK, MMR); Department of Physical Medicine and Rehabilitation, Mayo Clinic, Phoenix, Arizona (CLK); and Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada (LRR)
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16
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Brown A, Bonneville G, Glaze S. Nevertheless, They Persisted: How Women Experience Gender-Based Discrimination During Postgraduate Surgical Training. JOURNAL OF SURGICAL EDUCATION 2021; 78:17-34. [PMID: 32654996 DOI: 10.1016/j.jsurg.2020.06.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE More women than ever are pursuing surgical specialties despite historical dominance by men. The objective of this study was to examine how surgical residents experience gender-based discrimination during their residency training, including the common sources, settings, and implications of these experiences. DESIGN A sequential explanatory mixed methods design was used to combine results from an initial quantitative survey of surgical residents of all genders at the University of Calgary with qualitative data derived from interviews with surgical residents who identified as women. PARTICIPANTS Thirty-seven surgical residents of all genders completed a survey. Fourteen women completed a one-to-one, semistructured interview. RESULTS Women reported significantly more frequent experiences of gender-based discrimination than men, particularly regarding lack of respect from others, inappropriate jokes or comments, and hostile or humiliating behaviors. Nursing staff and patients were reported as prominent sources of discrimination, and the emergency and operating rooms were the most common settings. The qualitative findings highlighted the additional challenges for women during surgical residency, including navigating the relationships with nursing, having to work "twice as hard" to receive respect from patients and nurses, reports of persistent harassment and bullying, becoming desensitized to mistreatment and discrimination, and the influence of their gender on the quality of their education as well as their well-being. CONCLUSIONS Despite the increasing number of women entering surgical specialties, women surgical residents report frequent and severe experiences of gender-based discrimination during their training, even at an academic institution where over half of residents are women.
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Affiliation(s)
- Allison Brown
- University of Calgary, Cumming School of Medicine, Department of Medicine, Calgary, Alberta, Canada; University of Calgary, Department of Community Health Sciences, Calgary, Alberta, Canada.
| | - Gabrielle Bonneville
- University of Calgary, Department of Obstetrics & Gynecology, Calgary, Alberta, Canada
| | - Sarah Glaze
- University of Calgary, Department of Obstetrics & Gynecology, Calgary, Alberta, Canada; Foothills Medical Centre, Department of Obstetrics of Gynecology, Division of Gynecologic Oncology, Calgary, Alberta, Canada
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17
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Iguchi A, Hasegawa Y, Fujii K. Student Potential for Self-assessment in a Clinical Dentistry Practical Training Course on Communication Skills. MEDICAL SCIENCE EDUCATOR 2020; 30:1503-1513. [PMID: 34457818 PMCID: PMC8368263 DOI: 10.1007/s40670-020-01061-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study aimed to investigate student potential for self-assessment in a clinical dentistry practical training course focused on communication skills. Participants were 124 fourth-year students (70 males, 54 females; all Japanese) in 2017 and 2018 at the Nippon Dental University, School of Life Dentistry at Niigata. Participating students belonged to different cohorts in 2017 and 2018. Participants were asked to complete a self-evaluation sheet at the end of each unit of the course. Their self-evaluation scores and the faculty evaluation scores for each student for Units 1-1, 1-2, and 1-3 were statistically analyzed. The results showed that females tended to rate themselves significantly higher than males. Furthermore, there were significant differences in evaluation scores between students and faculty for nine of 11 evaluation items for male students and 10 of 11 items for female students in Unit 1-3. Faculty expectations increased from Unit 1-1 to Unit 1-3, although students were satisfied with their performance and had a sense of achievement. However, students' actual performance was below faculty expectations, suggesting faculty evaluations were stricter than students' self-evaluation. Self-assessment may enhance students' ability for self-directed learning and may also inform how faculty can effectively educate dental students. Dental educators should support students to increase their levels of self-efficacy, which will enhance their self-evaluation skills.
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Affiliation(s)
- Asami Iguchi
- School of Life Dentistry at Niigata, The Nippon Dental University, 1-8, Hamaura-cho, Chuo-ku, Niigata, 951-8580 Japan
| | - Yuh Hasegawa
- The Nippon Dental University College at Niigata, 1-8, Hamaura-cho, Chuo-ku, Niigata, 951-8580 Japan
| | - Kazuyuki Fujii
- School of Life Dentistry at Niigata, The Nippon Dental University, 1-8, Hamaura-cho, Chuo-ku, Niigata, 951-8580 Japan
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Pelley E, Carnes M. When a Specialty Becomes "Women's Work": Trends in and Implications of Specialty Gender Segregation in Medicine. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:1499-1506. [PMID: 32590470 PMCID: PMC7541620 DOI: 10.1097/acm.0000000000003555] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The gender composition of physician specialties varies dramatically with some becoming increasingly female predominant while others remain overwhelmingly male. In their analysis of physician workforce data, the authors demonstrate that despite large increases in the number of female physicians over 4 decades, the degree of gender segregation between specialties has not declined. The authors describe lessons from the highly gender-segregated U.S. workforce as a whole to understand these demographic patterns in the physician workforce. Echoing U.S. workforce findings, women physicians are becoming overrepresented in certain specialties, and this appears to be associated with a relative decline in earnings for physicians in these specialties over time. The authors found a strong negative relationship between the proportion of female physicians in a specialty and its mean salary, with gender composition explaining 64% of the variation in salaries among the medical specialties.Female physicians face biases in the workplace and fall behind male peers in leadership attainment, academic advancement, and earnings. Tenacious gender stereotypes and the conflation of gender and status contribute to these biases and reinforce occupational gender segregation. The clustering of women in certain specialties means these specialties will be disproportionately affected by gender bias. Recognizing the consequences of gender demographics within physician specialties is important to maintain the strong and diverse physician workforce needed to support the health care needs of the populations who depend on these specialties for care.
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Affiliation(s)
- Elaine Pelley
- E. Pelley is associate professor, Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Molly Carnes
- M. Carnes is professor, Departments of Medicine, Psychiatry, and Industrial & Systems Engineering and director, Center for Women's Health Research, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
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Udawatta M, Ong V, Duong C, Alkhalid Y, Nguyen T, Woodard J, Yang I. In Reply: Patient Satisfaction Ratings of Male and Female Residents Across Subspecialties. Neurosurgery 2020; 87:E530-E532. [PMID: 32735674 DOI: 10.1093/neuros/nyaa324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/23/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Methma Udawatta
- Departments of Neurosurgery Ronald Reagan UCLA Medical Center Los Angeles, California
| | - Vera Ong
- Departments of Neurosurgery Ronald Reagan UCLA Medical Center Los Angeles, California
| | - Courtney Duong
- Departments of Neurosurgery Ronald Reagan UCLA Medical Center Los Angeles, California
| | - Yasmine Alkhalid
- Department of Neurosurgery University of Chicago Medical Center Chicago, Illinois
| | - Thien Nguyen
- Departments of Neurosurgery Ronald Reagan UCLA Medical Center Los Angeles, California
- Department of Pediatrics UCSF San Francisco, California
| | - Jos'lyn Woodard
- Departments of Neurosurgery Ronald Reagan UCLA Medical Center Los Angeles, California
| | - Isaac Yang
- Departments of Neurosurgery Ronald Reagan UCLA Medical Center Los Angeles, California
- Office of the Patient Experience Ronald Reagan UCLA Medical Center Los Angeles, California
- Radiation Oncology Ronald Reagan UCLA Medical Center Los Angeles, California
- Head and Neck Surgery Ronald Reagan UCLA Medical Center Los Angeles, California
- UCLA Jonsson Comprehensive Cancer Center Ronald Reagan UCLA Medical Center Los Angeles, California
- Department of Surgery Harbor-UCLA Medical Center Torrance, California
- Los Angeles Biomedical Research Institute (LA BioMed) Harbor-UCLA Medical Center Torrance, California
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Klein R, Ufere NN, Rao SR, Koch J, Volerman A, Snyder ED, Schaeffer S, Thompson V, Warner AS, Julian KA, Palamara K. Association of Gender With Learner Assessment in Graduate Medical Education. JAMA Netw Open 2020; 3:e2010888. [PMID: 32672831 PMCID: PMC7366188 DOI: 10.1001/jamanetworkopen.2020.10888] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Gender bias may affect assessment in competency-based medical education. OBJECTIVE To evaluate the association of gender with assessment of internal medicine residents. DESIGN, SETTING, AND PARTICIPANTS This multisite, retrospective, cross-sectional study included 6 internal medicine residency programs in the United States. Data were collected from July 1, 2016, to June 30, 2017, and analyzed from June 7 to November 6, 2019. EXPOSURES Faculty assessments of resident performance during general medicine inpatient rotations. MAIN OUTCOMES AND MEASURES Standardized scores were calculated based on rating distributions for the Accreditation Council for Graduate Medical Education's core competencies and internal medicine Milestones at each site. Standardized scores are expressed as SDs from the mean. The interaction of gender and postgraduate year (PGY) with standardized scores was assessed, adjusting for site, time of year, resident In-Training Examination percentile rank, and faculty rank and specialty. RESULTS Data included 3600 evaluations for 703 residents (387 male [55.0%]) by 605 faculty (318 male [52.6%]). Interaction between resident gender and PGY was significant in 6 core competencies. In PGY2, female residents scored significantly higher than male residents in 4 of 6 competencies, including patient care (mean standardized score [SE], 0.10 [0.04] vs 0.22 [0.05]; P = .04), systems-based practice (mean standardized score [SE], -0.06 [0.05] vs 0.13 [0.05]; P = .003), professionalism (mean standardized score [SE], -0.04 [0.06] vs 0.21 [0.06]; P = .001), and interpersonal and communication skills (mean standardized score [SE], 0.06 [0.05] vs 0.32 [0.06]; P < .001). In PGY3, male residents scored significantly higher than female patients in 5 of 6 competencies, including patient care (mean standardized score [SE], 0.47 [0.05] vs 0.32 [0.05]; P = .03), medical knowledge (mean standardized score [SE], 0.47 [0.05] vs 0.24 [0.06]; P = .003), systems-based practice (mean standardized score [SE], 0.30 [0.05] vs 0.12 [0.06]; P = .02), practice-based learning (mean standardized score [SE], 0.39 [0.05] vs 0.16 [0.06]; P = .004), and professionalism (mean standardized score [SE], 0.35 [0.05] vs 0.18 [0.06]; P = .03). There was a significant increase in male residents' competency scores between PGY2 and PGY3 (range of difference in mean adjusted standardized scores between PGY2 and PGY3, 0.208-0.391; P ≤ .002) that was not seen in female residents' scores (range of difference in mean adjusted standardized scores between PGY2 and PGY3, -0.117 to 0.101; P ≥ .14). There was a significant increase in male residents' scores between PGY2 and PGY3 cohorts in 6 competencies with female faculty and in 4 competencies with male faculty. There was no significant change in female residents' competency scores between PGY2 to PGY3 cohorts with male or female faculty. Interaction between faculty-resident gender dyad and PGY was significant in the patient care competency (β estimate [SE] for female vs male dyad in PGY1 vs PGY3, 0.184 [0.158]; β estimate [SE] for female vs male dyad in PGY2 vs PGY3, 0.457 [0.181]; P = .04). CONCLUSIONS AND RELEVANCE In this study, resident gender was associated with differences in faculty assessments of resident performance, and differences were linked to PGY. In contrast to male residents' scores, female residents' scores displayed a peak-and-plateau pattern whereby assessment scores peaked in PGY2. Notably, the peak-and-plateau pattern was seen in assessments by male and female faculty. Further study of factors that influence gender-based differences in assessment is needed.
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Affiliation(s)
- Robin Klein
- Division of General Internal Medicine and Geriatrics, Department of Internal Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Nneka N. Ufere
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston
| | - Sowmya R. Rao
- Massachusetts General Hospital Biostatistics Center, Boston, Massachusetts
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
| | - Jennifer Koch
- Department of Medicine, University of Louisville, Louisville, Kentucky
| | - Anna Volerman
- Department of Medicine, University of Chicago, Chicago, Illinois
- Department of Pediatrics, University of Chicago, Chicago, Illinois
| | - Erin D. Snyder
- Division of General Internal Medicine, Department of Medicine, University of Alabama at Birmingham School of Medicine
| | - Sarah Schaeffer
- Division of Hospital Medicine, Department of Medicine, University of California, San Francisco
| | - Vanessa Thompson
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
| | - Ana Sofia Warner
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston
| | - Katherine A. Julian
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
| | - Kerri Palamara
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston
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Spruit E, Mol MF, Bos PK, Bierma-Zeinstra SM, Krastman P, Runhaar J. Self-Assessment of Competence and Referral Behavior for Musculoskeletal Injections among Dutch General Practitioners. J Clin Med 2020; 9:jcm9061880. [PMID: 32560156 PMCID: PMC7356219 DOI: 10.3390/jcm9061880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 11/16/2022] Open
Abstract
General practitioners (GPs) are qualified and trained to administer therapeutic musculoskeletal injections when indicated. However, it is unknown to what extend Dutch GPs feel competent to administer these injections in clinical practice. Reluctance among GPs to inject might lead to unnecessary and costly referral to secondary care. An online and offline questionnaire was spread among Dutch GPs, querying demographics, GPs' self-assessment of injection competence, the number of administered/referred injections and management strategy for musculoskeletal injections. A total of 355 GPs responded. In total, 81% of the GPs considered themselves competent in administering musculoskeletal injections. Self-assessed incompetent GPs performed less injections the last month than self-assessed competent GPs (1.2 ± 1.4 vs 4.8 ± 4.6 injections, P < 0.001). Additionally, they referred four times more often to a colleague GP (0.4 ± 1.0 vs 0.1 ± 0.6 injections per month, P < 0.001) and twice as often to secondary care (1.0 ± 1.3 vs 0.5 ± 0.9 injections per month, P = 0.001). Self-assessed incompetence was associated with female sex (OR [95% CI] = 4.94 [2.39, 10.21]) and part-time work (OR [95% CI] = 2.58 [1.43, 4.66]). The most frequently addressed barriers were a lack of confidence in injection skills, lack of practical training, and uncertainty about the effectiveness and diagnosis of musculoskeletal injections. Although most GPs considered themselves competent to administer musculoskeletal injections, the referral rate to secondary care for several injections was strikingly high. To decrease secondary care referrals, addressing some of the most frequently indicated barriers is highly recommended.
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Affiliation(s)
- Emely Spruit
- Department of General Practice, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.S.); (M.F.M.); (S.M.A.B.-Z.); (P.K.)
| | - Marianne F. Mol
- Department of General Practice, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.S.); (M.F.M.); (S.M.A.B.-Z.); (P.K.)
| | - P. Koen Bos
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands;
| | - Sita M.A. Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.S.); (M.F.M.); (S.M.A.B.-Z.); (P.K.)
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands;
| | - Patrick Krastman
- Department of General Practice, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.S.); (M.F.M.); (S.M.A.B.-Z.); (P.K.)
| | - Jos Runhaar
- Department of General Practice, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.S.); (M.F.M.); (S.M.A.B.-Z.); (P.K.)
- Correspondence:
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Miller BL, Azari D, Gerber RC, Radwin R, Le BV. Evidence That Female Urologists and Urology Trainees Tend to Underrate Surgical Skills on Self-Assessment. J Surg Res 2020; 254:255-260. [PMID: 32480069 DOI: 10.1016/j.jss.2020.04.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/02/2020] [Accepted: 04/11/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Historically low, the proportion of female urology residents now exceeds 25% in recent years. Self-assessment is a widely used tool to track progress in medical education. However, the validity of its results and gender differences may influence interpretation. Simulation of surgical skills is increasingly common in modern residency training and standardizes certain objective tasks and skills. The objective of this study was to identify gender differences in self-assessment of surgeons and trainees when using simulation of surgical skills. METHODS Medical students, residents, and attending and retired surgeons completed simple interrupted suturing. Assessment was self-rated using previously tested visual analog motion scales. Tasks were video recorded and rated by blinded expert surgeons using identical motion scales. Computer vision motion tracking software was used to objectively analyze the kinematics of surgical tasks. RESULTS Proportion of female (n = 17) and male (n = 20) participants did not differ significantly by the level of training, P = 0.76. Five expert surgeons evaluated 84 video segments of simple interrupted suturing tasks (mean 3.0 segments per task per participant). Self-assessment correlated well overall with expert rating for motion economy (Pearson correlation coefficient 0.61, P < 0.001) and motion fluidity (0.55, P = 0.002). Women underrated their performance in accordance with mean individual difference of self-assessment and expert assessment scores (Δ SAS-EAS) for both economy of motion (mean ± SEM -1.1 ± 0.38, P = 0.01) and fluidity of motion (-1.3 ± 0.39, P < 0.01). On the same measures, men tended to rate themselves in accordance with experts (-0.16 ± 0.36, P = 0.63; -0.09 ± 0.41, P = 0.82, respectively). Δ SAS-EAS did not differ significantly on any rating scale across levels of training. Expert ratings did not differ significantly by gender for any domain. CONCLUSIONS Female surgeons and trainees underrate some technical skills on self-assessment when compared with expert ratings, whereas male surgeon and trainee self-ratings and expert ratings were similar. Further work is needed to determine if these differences are accentuated across increasingly difficult tasks.
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Affiliation(s)
- Brady L Miller
- Department of Urology, University of Wisconsin, Madison, Wisconsin.
| | - David Azari
- University of Wisconsin, Industrial and Systems Engineering, Madison, Wisconsin
| | - Rebecca C Gerber
- Department of Urology, University of Wisconsin, Madison, Wisconsin
| | - Robert Radwin
- University of Wisconsin, Industrial and Systems Engineering, Madison, Wisconsin; Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin
| | - Brian V Le
- Department of Urology, University of Wisconsin, Madison, Wisconsin
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Udawatta M, Alkhalid Y, Nguyen T, Ong V, Woodard J, Sheppard JP, Duong C, Iyengar S, Migdal CW, Mosley V, Yang I. Patient Satisfaction Ratings of Male and Female Residents Across Subspecialties. Neurosurgery 2020; 86:697-704. [PMID: 31432073 DOI: 10.1093/neuros/nyz281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 04/18/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Females currently comprise approximately 50% of incoming medical students yet continue to be underrepresented in certain medical subspecialties. OBJECTIVE To assess whether gender plays a role in patients' perception of physician competency among different specialties. METHODS We administered surveys at 2 academic medical centers to patients who were stable, cognitively aware, and indicated English as their primary language. Survey questions evaluated communication, medical expertise, and quality of care. RESULTS A total of 4222 surveys were collected. Females comprised around half (n = 2133, 50.7%) of evaluated residents. First-year (n = 1647, 39%) and second-year (n = 1416, 33.5%) residents were assessed most frequently. Internal medicine conducted the most surveys (n = 1111, 23.6%), whereas head and neck surgery conducted the least (n = 137, 3.24%). There was no statistically significant difference between patients' perception of male and female residents of the same year in overall communication skills, medical expertise, and quality of medical care. Female residents outperformed their male counterparts on specific questions evaluating the communication of treatment plans, patient education, and patient satisfaction (P < .001, P = .03, P = .04, respectively). Unsurprisingly, patients' perceptions of residents' overall communication skills, medical expertise, and quality of medical care significantly improved when comparing more experienced residents to newer residents. CONCLUSION There is no difference between overall communication, medical expertise, and quality of care between sexes, and across subspecialties. Though gender inequalities currently exist most starkly in practitioners in surgical subspecialties, women in surgical residencies were much better communicators than their male counterparts, but still perceived to have similar levels of medical expertise and quality of care.
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Affiliation(s)
- Methma Udawatta
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Yasmine Alkhalid
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Thien Nguyen
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Vera Ong
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Jos'lyn Woodard
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - John P Sheppard
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Courtney Duong
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Sonia Iyengar
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Christopher W Migdal
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Virgie Mosley
- Office of the Patient Experience, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Isaac Yang
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California.,Office of the Patient Experience, Ronald Reagan UCLA Medical Center, Los Angeles, California.,Department of Radiation Oncology, Ronald Reagan UCLA Medical Center, Los Angeles, California.,Department of Head and Neck Surgery, Ronald Reagan UCLA Medical Center, Los Angeles, California.,UCLA Jonsson Comprehensive Cancer Center, Ronald Reagan UCLA Medical Center, Los Angeles, California.,Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, California.,Los Angeles Biomedical Research Institute (LA BioMed), Harbor-UCLA Medical Center, Torrance, California
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Flaegel K, Brandt B, Goetz K, Steinhaeuser J. Which procedures are performed by general internists practicing primary care in Germany? - a cross-sectional study. BMC FAMILY PRACTICE 2020; 21:73. [PMID: 32349681 PMCID: PMC7191754 DOI: 10.1186/s12875-020-01136-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 04/02/2020] [Indexed: 11/25/2022]
Abstract
Background Due to differences of residency training programs’ emphases – inpatient vs office-based – internal medicine and family medicine residents consistently reported differences in preparedness to care for common adult conditions. Study’s aim was to add knowledge about procedures that a) are performed by general internists working in primary care and b) should be learned during residency in general internists’ appraisal. Methods A cross-sectional postal survey was carried out by using a questionnaire that comprised 90 procedures relevant in primary care. Each procedure implied the two questions “Do you perform this procedure in your own practice?” and “How important do you think it is to learn this procedure during residency?” The final questionnaire was sent to 1002 general internists working in primary care in Germany in May 2015. Data analysis was performed using SPSS Version 24.0 (SPSS inc., IBM). Next to descriptive statistics subgroup analyses were performed using cross tabulation and Chi-square tests for evaluation of differences in the performance of most frequently performed procedures in urban or rural areas as well as by male or female physicians. Results Twenty-eight percent of sent questionnaires (276/1002) could be included in analysis. Mean age of participants was 52 years with 13 years of practice experience; 40% were female. Twenty-nine (32%) of 90 given procedures were performed by at least half of the participants, foremost technical diagnostics, punctures, procedures of the integument and resuscitation. After Bonferroni correction, five of those procedures were performed by more male than female physicians and two procedures by more physicians working in a rural practice than physicians practicing in an urban location. Moreover, 46 (51%) procedures were assessed as important to learn during residency by at least 50% of participants. Conclusions General internists working in German primary care perform a narrow scope of procedures offered by primary care physicians. In order to provide best ambulatory care for patients, residency training programs must ensure training in procedures that are necessary for providing high quality care. Therefore, a consensus aligned with patients’ and health-systems’ needs on procedures required for working as a general internist in primary care is necessary.
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Affiliation(s)
- Kristina Flaegel
- Institute of Family Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
| | - Bettina Brandt
- Department of General Practice/Primary Care, Hamburg University Medical School, Martinistraße 52, 20246, Hamburg, Germany
| | - Katja Goetz
- Institute of Family Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Jost Steinhaeuser
- Institute of Family Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
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26
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Cooney CM, Aravind P, Lifchez SD, Hultman CS, Weber RA, Brooke S, Cooney DS. Differences in operative self-assessment between male and female plastic surgery residents: A survey of 8,149 cases. Am J Surg 2020; 221:799-803. [PMID: 32414498 DOI: 10.1016/j.amjsurg.2020.04.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 12/20/2019] [Accepted: 04/09/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous studies show female residents tend to underrate and male residents to overrate their own performance. We sought to determine if plastic surgery resident trainee self-evaluations differ by resident sex. METHODS We extracted Operative Entrustability Assessment (OEA) data for plastic surgery programs from MileMarker™, a program capable of storing assessment data for CPT-coded procedures. Complete OEAs contain a trainee self-assessment and attending surgeon assessment. We used simple statistics and linear regression to assess differences, stratifying by trainee sex and post-graduate year (PGY). RESULTS We analyzed 8149 OEAs from 3 training programs representing 64 residents (25% female) and 51 attendings. Compared to attending assessments, both male and female residents significantly underrated their performance during PGY1. However, during PGY2-6 male residents' self-evaluations were significantly higher and female residents' self-evaluations significantly lower than their attending evaluations. CONCLUSIONS Results demonstrated female plastic surgery residents underestimated and male residents overestimated their performance. Further studies are needed to determine reasons for these differences.
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Affiliation(s)
- Carisa M Cooney
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pathik Aravind
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Scott D Lifchez
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - C Scott Hultman
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Plastic and Reconstructive Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Robert A Weber
- Division of Plastic and Reconstructive Surgery, Baylor Scott & White Medical Center, Temple, TX, USA
| | - Sebastian Brooke
- Division of Plastic and Reconstructive Surgery, Baylor Scott & White Medical Center, Temple, TX, USA
| | - Damon S Cooney
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Rowell TR, Redd RA, Neuberg DS, Walensky LD. Mind the gap: Expediting gender parity in MD-PhD admissions. JCI Insight 2020; 5:136037. [PMID: 32102982 DOI: 10.1172/jci.insight.136037] [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] Open
Abstract
The 2018 National MD-PhD Program Outcomes Study highlighted the critical need to increase MD-PhD trainee diversity and close the gender gap in MD-PhD enrollment. This Association of American Medical Colleges imperative prompted us to evaluate trends in female matriculation from our institutional MD-PhD program compared with national data. Based on a 10-year review of Harvard/MIT Medical Scientist Training Program admissions, we observed a sharp and sustained increase in female matriculants for the past 5 years that is well above the national average. We report our experience with achieving gender parity among matriculants of our MD-PhD program, identify the specific stage of the admissions process where the gender balance acutely shifted, and attribute the increase in female matriculation to concrete administrative changes that were put into place just prior to the observed gender balance shift. These changes included increasing the number of faculty participants in application screening and awardee selection and establishing gender balance among faculty decision makers. We believe that adopting basic administrative practices geared toward increasing the diversity of perspectives among admissions faculty has the potential to expedite gender parity of MD-PhD matriculants nationwide and could eventually help achieve gender balance in the national physician-scientist workforce.
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Affiliation(s)
- Temperance R Rowell
- Harvard/MIT MD-PhD Program and.,Curriculum Fellows Program, Harvard Medical School, Boston, Massachusetts, USA
| | - Robert A Redd
- Department of Biostatistics and Computational Biology and
| | | | - Loren D Walensky
- Harvard/MIT MD-PhD Program and.,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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Miller KA, Monuteaux MC, Roussin C, Nagler J. Self-Confidence in Endotracheal Intubation Among Pediatric Interns: Associations With Gender, Experience, and Performance. Acad Pediatr 2019; 19:822-827. [PMID: 31229695 DOI: 10.1016/j.acap.2019.06.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 06/12/2019] [Accepted: 06/17/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Supervisors' decisions regarding procedural readiness are influenced by resident confidence. Confidence is a valuable metric if we understand how it correlates with trainee characteristics and procedural competence. Our objective was to evaluate the relationship between self-reported confidence in endotracheal intubation (ETI) and pediatric interns' characteristics (gender, prior intubation experience) and performance (airway management knowledge, demonstrated skills on airway trainers). METHODS This was a secondary analysis of a randomized, controlled trial of an airway management curriculum. Gender and prior intubation experience were reported on a preparticipation questionnaire. Interns' performance was measured 1) using a 14-item knowledge-based assessment of airway management and 2) as time to successful intubation across 4 simulated intubation scenarios. After completing the curriculum and assessment, interns reported retrospective precurriculum and current postcurriculum confidence with ETI using a 10-point Likert scale. RESULTS Forty-nine interns participated, of whom 16 (33%) were male. Eleven (22%) had ≥1 previous successful intubation. Median [interquartile range] pre- and postcurriculum confidence scores were 3 [2, 5] and 6 [5, 8], respectively. Male interns reported higher precurriculum confidence than females (median difference: 2.0; 95% confidence interval: 0.1, 3.9); postcurriculum confidence among males was also higher but not statistically significant. There was no correlation between self-reported precurriculum confidence and prior experience. There was no correlation between pre- or postcurriculum self-reported confidence and performance on the knowledge-based assessment or time to successful intubation on airway trainers. CONCLUSIONS Male pediatric interns self-report higher initial confidence in ETI compared to females. Self-reported confidence did not correlate with prior experience, airway management knowledge, or intubation performance on airway trainers.
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Affiliation(s)
- Kelsey A Miller
- Division of Emergency Medicine, Department of Medicine (KA Miller, MC Monuteaux, and J Nagler), Boston Children's Hospital, Boston, Mass.
| | - Michael C Monuteaux
- Division of Emergency Medicine, Department of Medicine (KA Miller, MC Monuteaux, and J Nagler), Boston Children's Hospital, Boston, Mass
| | - Christopher Roussin
- Boston Children's Hospital Simulator Program, Center for Life Sciences Building (C Roussin), Boston, Mass
| | - Joshua Nagler
- Division of Emergency Medicine, Department of Medicine (KA Miller, MC Monuteaux, and J Nagler), Boston Children's Hospital, Boston, Mass
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Cronin C, Lucas M, McCarthy A, Boland F, Varadarajan R, Premnath N, Gillen P. Are we reaping what we sow? Gender diversity in surgery: a survey of medical students. Postgrad Med J 2019; 95:119-124. [DOI: 10.1136/postgradmedj-2018-136136] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/17/2019] [Accepted: 03/04/2019] [Indexed: 11/04/2022]
Abstract
BackgroundA survey of medical students from the Royal College of Surgeons in Ireland (RCSI) at Dublin, Perdana and Penang in Malaysia was undertaken in an attempt to explore attitudes towards a career in surgery and document potential differences between male and female students’ perceptions of a surgical career.MethodA hyperlink to an online, anonymised questionnaire was distributed to medical students in 3rd, 4th and final year at three RCSI campuses. Basic descriptive statistics were used to describe the responses to individual questions and appropriate statistical tests used to compare male and female responses to questions.ResultsA total of 464 completed questionnaires were analysed. Almost 40% (n=185) were male and 60% (n=279) were female. Males were significantly more influenced by remuneration than females (p<0.001) towards a choice of surgical career. Females were significantly more influenced in their choice of surgical career by part-time work (p<0.001), parental leave (p<0.001), working hours (p<0.001) and length of residency (p=0.003). During surgical attachments, females were significantly more likely to admit feeling intimidated than males (p=0.002) and males more likely to report feeling confident (p<0.001). Ninety-six per cent of students felt they would be more likely to pursue a career in which they had identified a positive role model, with female medical students three times more likely to have identified a female role model than males.ConclusionAccording to our study, preference for a career in surgery declines with advancing years in medical school for both males and females. Medical students report high levels of feeling intimidated or ignored during their surgical placements, and enthusiasm for surgery reduces during medical school with exposure to this. These findings, along with the importance of role modelling, add further urgency to the need to address factors which make surgery less appealing to female medical graduates.
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Aldahmashi T, Almanea A, Alsaad A, Mohamud M, Anjum I. Attitudes towards depression among non-psychiatric physicians in four tertiary centres in Riyadh. Health Psychol Open 2019; 6:2055102918820640. [PMID: 30729020 PMCID: PMC6350145 DOI: 10.1177/2055102918820640] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Depression is a common mental illness that has a profound impact on an estimated
number of 300 million people worldwide. Depression is stigmatised in communities
and even physicians, especially, non-psychiatric physicians, which affects
depressed patients’ care. This study aims to investigate non-psychiatric
physicians’ attitudes towards depression in Riyadh, Saudi Arabia. The study
surveyed 380 participants using Revised Depression Attitude Questionnaire.
Non-psychiatric physicians in Riyadh are optimistic and have a positive
perspective towards depression. Yet, the majority preferred dealing with
physical rather than mental illness. Understanding the attitudes of medical
practitioners is important to shape service delivery and assess training
needs.
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Affiliation(s)
- Thamir Aldahmashi
- King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | | | - Abdulaziz Alsaad
- King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Mohamud Mohamud
- King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Irfan Anjum
- King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
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Kobayasi R, Tempski PZ, Arantes-Costa FM, Martins MA. Gender differences in the perception of quality of life during internal medicine training: a qualitative and quantitative analysis. BMC MEDICAL EDUCATION 2018; 18:281. [PMID: 30477504 PMCID: PMC6260562 DOI: 10.1186/s12909-018-1378-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 11/02/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The higher level of participation by women in medicine may impact this profession's evolution due to gender differences perceived during medical school, after graduation and during residency. Gender differences regarding quality of life are associated with higher states of anxiety and depression among female physicians. We aimed to assess gender differences in the perception of quality of life with quantitative methods and to understand further, from the female residents´ point of view, the reasons that may influence the perception of quality of life using qualitative method. Resilience, empathy and daytime sleepiness were also scored. METHODS We performed a cross-sectional study with first-year internal medicine residents to evaluate self-reported quality of life factors specific to medical residents (VERAS-Q), including empathy (Jefferson Scale of Empathy), resilience (Wagnild and Young Brief Resilience Scale) and daytime sleepiness (Epworth Scale). We explored, from the female residents´ view which factors may influence the perception of quality of life using a focus group method. RESULTS In our study, one hundred and nine residents completed the survey: 31 (28.4%) were female and 78 (71.6%) were male. Female residents exhibited significantly lower scores than those of male residents for quality of life in the domains of time management (30.3, females vs 41.1, males; p < 0.001), psychology (48.1, females vs 56.7, males; p < 0.01) and physical health (42.8, females vs 53.6, males; p < 0.05). Female residents also scored higher for daytime sleepiness (13.0, females vs 9.0, males; p < 0.001), with pathological scores for daytime sleepiness. No significant gender differences were found in the resilience or empathy scores. The focus group assessment revealed difficulty in concentration and knowledge acquisition, insecurity, feelings of loss, greater critical perception, self-doubt and difficulty in creating effective bonds to support the training period as the main factors involved in the lower perception of quality of life among the women. CONCLUSIONS In conclusion, female residents had lower scores for quality of life and higher scores for daytime sleepiness. Measures to improve quality of life among female residents during this critical period of medical training might include investing in mentoring to help them better manage their time and encouraging activities that facilitate relationship development.
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Affiliation(s)
- Renata Kobayasi
- Faculty Development Center (CEDEM), School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Experimental Therapeutics (LIM 20), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Patricia Zen Tempski
- Faculty Development Center (CEDEM), School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Experimental Therapeutics (LIM 20), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Fernanda Magalhâes Arantes-Costa
- Faculty Development Center (CEDEM), School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Experimental Therapeutics (LIM 20), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Mílton Arruda Martins
- Faculty Development Center (CEDEM), School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Experimental Therapeutics (LIM 20), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Backhus LM, Fann BE, Hui DS, Cooke DT, Berfield KS, Moffatt-Bruce SD. Culture of Safety and Gender Inclusion in Cardiothoracic Surgery. Ann Thorac Surg 2018; 106:951-958. [DOI: 10.1016/j.athoracsur.2018.07.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 01/31/2023]
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Bowen CJ, Kersbergen CJ, Tang O, Cox A, Beach MC. Medical school research ranking is associated with gender inequality in MSTP application rates. BMC MEDICAL EDUCATION 2018; 18:187. [PMID: 30081928 PMCID: PMC6080404 DOI: 10.1186/s12909-018-1306-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 07/30/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The number of female trainees in MD and biomedical PhD programs has reached near parity with their male counterparts for several years. However, a gender disparity persists for enrollment in Medical Scientist Research Programs (MSTPs). Several studies suggest women underestimate their abilities compared with male colleagues. If this phenomenon applies, we might expect there to be a gender disparity in applicants to MSTPs, which are typically considered more competitive compared to MD or PhD programs. In this report, we explored this hypothesis by evaluating whether female applicants who do apply to MSTP programs disproportionately apply to lower ranking programs when compared to male applicants. METHODS For each institution, we identified their 2016 U.S. News and World Report "Best Medical Schools: Research" ranking and examined trends across rankings using linear regression models, such as relationships between the percentage of female applicants and other factors that may influence where applicants apply. RESULTS The female applicants who do apply to MSTP programs apply disproportionately to lower ranking programs. Despite this, women seem to have the same success rate for gaining admission to MSTPs, as indicated by matriculation rates across programs, regardless of program rank. CONCLUSIONS Our findings of gender disparity in applications to high-ranking but not low-ranking programs support prior hypotheses that under-confidence or lack of encouragement may drive this inequality. This analysis highlights the need for further systematic studies of gender differences in MSTP applicants and the relationship to career trajectories in order to improve the gender disparity that exists in academic medicine.
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Affiliation(s)
- Caitlin J. Bowen
- Medical Scientist Training Program, Johns Hopkins University, 1830 East Monument Street, Suite 2-300, Baltimore, MD 21205 USA
| | - Calvin J. Kersbergen
- Medical Scientist Training Program, Johns Hopkins University, 1830 East Monument Street, Suite 2-300, Baltimore, MD 21205 USA
| | - Olive Tang
- Medical Scientist Training Program, Johns Hopkins University, 1830 East Monument Street, Suite 2-300, Baltimore, MD 21205 USA
| | - Andrea Cox
- Oncology, Medicine, and Medical Scientist Training Program, Johns Hopkins University, 1830 East Monument Street, Suite 2-300, Baltimore, MD 21205 USA
| | - Mary Catherine Beach
- General Internal Medicine and Berman Bioethics Institute, Johns Hopkins University, 2024 East Monument Street, Baltimore, MD 21287 USA
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Wolgin M, Grabowski S, Elhadad S, Frank W, Kielbassa AM. Comparison of a prepCheck-supported self-assessment concept with conventional faculty supervision in a pre-clinical simulation environment. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2018; 22:e522-e529. [PMID: 29575669 DOI: 10.1111/eje.12337] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/25/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES This study aimed to evaluate the educational outcome of a digitally based self-assessment concept (prepCheck; DentsplySirona, Wals, Austria) for pre-clinical undergraduates in the context of a regular phantom-laboratory course. MATERIALS AND METHODS A sample of 47 third-year dental students participated in the course. Students were randomly divided into a prepCheck-supervised (self-assessment) intervention group (IG; n = 24); conventionally supervised students constituted the control group (CG; n = 23). During the preparation of three-surface (MOD) class II amalgam cavities, each IG participant could analyse a superimposed 3D image of his/her preparation against the "master preparation" using the prepCheck software. In the CG, several course instructors performed the evaluations according to pre-defined assessment criteria. After completing the course, a mandatory (blinded) practical examination was taken by all course participants (both IG and CG students), and this assessment involved the preparation of a MOD amalgam cavity. Then, optical impressions by means of a CEREC-Omnicam were taken to digitalize all examination preparations, followed by surveying and assessing the latter using prepCheck. RESULTS The statistical analysis of the digitalized samples (Mann-Whitney U test) revealed no significant differences between the cavity dimensions achieved in the IG and CG (P = .406). Additionally, the sum score of the degree of conformity with the "master preparation" (maximum permissible 10% of plus or minus deviation) was comparable in both groups (P = .259). CONCLUSION The implemented interactive digitally based, self-assessment learning tool for undergraduates appears to be equivalent to the conventional form of supervision. Therefore, such digital learning tools could significantly address the ever-increasing student to faculty ratio.
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Affiliation(s)
- M Wolgin
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University (DPU), Krems, Austria
| | - S Grabowski
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University (DPU), Krems, Austria
| | - S Elhadad
- DentSim Lab NYC, New York, NY, USA
- School of Dentistry, University of Baltimore, Baltimore, MD, USA
| | - W Frank
- Centre for Preclinical Education, Department of Biostatistics, University of Dental Medicine and Oral Health, Danube Private University (DPU), Krems, Austria
| | - A M Kielbassa
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University (DPU), Krems, Austria
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Oh SL, Liberman L, Mishler O. Faculty calibration and students' self-assessments using an instructional rubric in preparation for a practical examination. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2018; 22:e400-e407. [PMID: 29266593 DOI: 10.1111/eje.12318] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/27/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE The purpose of this study was to investigate the effect of faculty calibration and students' self-assessments on students' performances in a periodontal practical examination. METHODS Before a new instructional rubric was implemented in the second-year periodontics course, faculty calibration was conducted with a pilot group of 32 third-year dental students. Afterwards, the new rubric was implemented in the second-year periodontics course. Second-year students used the rubric for their self-assessments before the practical examination. An intraclass correlation coefficient was used to test the reliability of the faculty members. A paired t test was used to compare scores between self-assessments of the pilot group (third-year students) and faculty evaluation. A two-way analysis of variance was performed to compare scores between self-assessments of second-year students and faculty evaluations. Chi-square tests were used to compare overall failure rates amongst four different classes. RESULTS The reliability amongst the faculty members was strong (the ICC = 0.75 at the first and 0.97 at the second calibration). The mean self-assessment score from the pilot group was significantly higher than the faculty evaluation. However, the mean self-assessment score of second-year students was significantly lower than the faculty evaluation. The class that practiced self-assessments with the validated instructional rubric exhibited the lowest overall failure rate compared to three past classes. CONCLUSIONS Using an instructional rubric and conducting faculty calibration improved the process of the periodontal practical examination. Improving the examination process and practicing self-assessments with feedback from faculty may have a positive impact on students' performances in the examination.
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Affiliation(s)
- S-L Oh
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - L Liberman
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - O Mishler
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
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Acosta D, Castillo-Angeles M, Garces-Descovich A, Watkins AA, Gupta A, Critchlow JF, Kent TS. Surgical Practical Skills Learning Curriculum: Implementation and Interns' Confidence Perceptions. JOURNAL OF SURGICAL EDUCATION 2018; 75:263-270. [PMID: 28827182 DOI: 10.1016/j.jsurg.2017.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 07/08/2017] [Accepted: 07/10/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To provide an overview of the practical skills learning curriculum and assess its effects over time on the surgical interns' perceptions of their technical skills, patient management, administrative tasks, and knowledge. DESIGN An 84-hour practical skills curriculum composed of didactic, simulation, and practical sessions was implemented during the 2015 to 2016 academic year for general surgery interns. Totally, 40% of the sessions were held during orientation, whereas the remainder sessions were held throughout the academic year. Interns' perceptions of their technical skills, administrative tasks, patient management, and knowledge were assessed by the practical skills curriculum residents' perception survey at various time points during their intern year (baseline, midpoint, and final). Interns were also asked to fill out an evaluation survey at the completion of each session to obtain feedback on the curriculum. SETTING General Surgery Residency program at a tertiary care academic institution. PARTICIPANTS 20 General Surgery categorical and preliminary interns. RESULTS Significant differences were found over time in interns' perceptions on their technical skills, patient management, administrative tasks, and knowledge (p < 0.001 for all). The results were also statistically significant when accounting for a prior boot camp course in medical school, intern status (categorical or preliminary), and gender (p < 0.05 for all). Differences in interns' perceptions occurred both from baseline to midpoint, and from midpoint to final time point evaluations (p < 0.001 for all). Prior surgical boot camp in medical school status, intern status (categorical vs. preliminary), and gender did not differ in the interns' baseline perceptions of their technical skills, patient management, administrative tasks, and knowledge (p > 0.05 for all). CONCLUSIONS Implementation of a Practical Skills Curriculum in surgical internships can improve interns' confidence perception on their technical skills, patient management skills, administrative tasks, and knowledge.
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Affiliation(s)
- Danilo Acosta
- Department of Obstetrics & Gynecology, Maimonides Medical Center, Brooklyn, New York
| | | | | | - Ammara A Watkins
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Alok Gupta
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Jonathan F Critchlow
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Tara S Kent
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
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Watson RS, Borgert AJ, O Heron CT, Kallies KJ, Sidwell RA, Mellinger JD, Joshi AR, Galante JM, Chambers LW, Morris JB, Josloff RK, Melcher ML, Fuhrman GM, Terhune KP, Chang L, Ferguson EM, Auyang ED, Patel KR, Jarman BT. A Multicenter Prospective Comparison of the Accreditation Council for Graduate Medical Education Milestones: Clinical Competency Committee vs. Resident Self-Assessment. JOURNAL OF SURGICAL EDUCATION 2017; 74:e8-e14. [PMID: 28666959 DOI: 10.1016/j.jsurg.2017.06.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/07/2017] [Accepted: 06/10/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The Accreditation Council for Graduate Medical Education requires accredited residency programs to implement competency-based assessments of medical trainees based upon nationally established Milestones. Clinical competency committees (CCC) are required to prepare biannual reports using the Milestones and ensure reporting to the Accreditation Council for Graduate Medical Education. Previous research demonstrated a strong correlation between CCC and resident scores on the Milestones at 1 institution. We sought to evaluate a national sampling of general surgery residency programs and hypothesized that CCC and resident assessments are similar. DESIGN Details regarding the makeup and process of each CCC were obtained. Major disparities were defined as an absolute mean difference of ≥0.5 on the 4-point scale. A negative assessment disparity indicated that the residents evaluated themselves at a lower level than did the CCC. Statistical analysis included Wilcoxon rank sum and Sign tests. SETTING CCCs and categorical general surgery residents from 15 residency programs completed the Milestones document independently during the spring of 2016. RESULTS Overall, 334 residents were included; 44 (13%) and 43 (13%) residents scored themselves ≥0.5 points higher and lower than the CCC, respectively. Female residents scored themselves a mean of 0.08 points lower, and male residents scored themselves a mean of 0.03 points higher than the CCC. Median assessment differences for postgraduate year (PGY) 1-5 were 0.03 (range: -0.94 to 1.28), -0.11 (range: -1.22 to 1.22), -0.08 (range: -1.28 to 0.81), 0.02 (range: -0.91 to 1.00), and -0.19 (range: -1.16 to 0.50), respectively. Residents in university vs. independent programs had higher rates of negative assessment differences in medical knowledge (15% vs. 6%; P = 0.015), patient care (17% vs. 5%; P = 0.002), professionalism (23% vs. 14%; P = 0.013), and system-based practice (18% vs. 9%; P = 0.031) competencies. Major assessment disparities by sex or PGY were similar among individual competencies. CONCLUSIONS Surgery residents in this national cohort demonstrated self-awareness when compared to assessments by their respective CCCs. This was independent of program type, sex, or level of training. PGY 5 residents, female residents, and those from university programs consistently rated themselves lower than the CCC, but these were not major disparities and the significance of this is unclear.
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Affiliation(s)
- Ryan S Watson
- Department of Medical Education, General Surgery Residency, Gundersen Medical Foundation, La Crosse, Wisconsin
| | - Andrew J Borgert
- Department of Medical Research, Gundersen Medical Foundation, La Crosse, Wisconsin
| | - Colette T O Heron
- Department of Medical Education, General Surgery Residency, Gundersen Medical Foundation, La Crosse, Wisconsin
| | - Kara J Kallies
- Department of Medical Research, Gundersen Medical Foundation, La Crosse, Wisconsin
| | - Richard A Sidwell
- General Surgery Residency Program, Iowa Methodist Medical Center, Des Moines, Iowa
| | - John D Mellinger
- Department of Surgery, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Amit R Joshi
- Department of Surgery, Einstein Healthcare Network, Philadelphia, Pennsylvania
| | - Joseph M Galante
- General Surgery Residency, University of California-Davis Health System, Sacramento, California
| | | | - Jon B Morris
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert K Josloff
- Department of Surgery, Abington Memorial Hospital, Abington, Pennsylvania
| | - Marc L Melcher
- Department of Surgery, Stanford University Medical Center, Palo Alto, California
| | | | - Kyla P Terhune
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Lily Chang
- Department of Surgery, Virginia Mason Medical Center, Seattle, Washington
| | | | - Edward D Auyang
- Department of Surgery, University of New Mexico, Albuquerque, New Mexico
| | - Kevin R Patel
- Department of General Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - Benjamin T Jarman
- Department of Medical Education, General Surgery Residency, Gundersen Medical Foundation, La Crosse, Wisconsin; Department of General Surgery, Gundersen Health System, La Crosse, Wisconsin.
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Hadid S. Factors Influencing Nursing Student Self-Assessment in Relation to Instructor Assessment. J Nurs Educ 2017; 56:70-76. [DOI: 10.3928/01484834-20170123-03] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 09/27/2016] [Indexed: 11/20/2022]
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The Use of Laparoscopy Simulation to Explore Gender Differences in Resident Surgical Confidence. Obstet Gynecol Int 2017; 2017:1945801. [PMID: 28203253 PMCID: PMC5288545 DOI: 10.1155/2017/1945801] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 11/11/2016] [Accepted: 11/16/2016] [Indexed: 02/03/2023] Open
Abstract
Background. The objective of this study was to determine whether female surgical residents underestimate their surgical abilities relative to males on a standardized test of laparoscopic skill. Methods. Twenty-six male and female general surgery residents and 25 female obstetrics and gynecology residents at two academic centers were asked to predict their score prior to undergoing the Fundamentals of Laparoscopic Surgery standardized skills exam. Actual and predicted score as well as delta values (predicted score minus actual score) were compared between residents. Multivariate linear regression was used to determine variables associated with predicted score, actual score, and delta scores. Results. There was no difference in actual score based on residency or gender. Predicted scores, however, were significantly lower in female versus male general surgery residents (25.8 ± 13.3 versus 56.0 ± 16.0; p < 0.01) and in female obstetrics and gynecology residents versus male general surgery residents (mean difference 20.9, 95% CI 11.6–34.8; p < 0.01). Male residents more accurately predicted their scores while female residents significantly underestimated their scores. Conclusion. Gender differences in estimating surgical ability exist that do not reflect actual differences in performance. This finding needs to be considered when structuring mentorship in surgical training programs.
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Confidence in Procedural Skills before and after a Two-Year Master's Programme in Family Medicine in Gezira State, Sudan. Adv Med 2017; 2017:6267015. [PMID: 29318182 PMCID: PMC5727659 DOI: 10.1155/2017/6267015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/20/2017] [Accepted: 10/30/2017] [Indexed: 11/18/2022] Open
Abstract
Many postgraduate family medicine training programmes have been developed to meet the worldwide dire need for practicing family physicians. This study was conducted in Gezira state of Sudan in a "before-and-after" design in the period of 2010-2012 with the aim to assess improvements in candidates' confidence in performing certain clinical skills. A self-evaluation questionnaire was used with a five-grade scale (1-5) to assess candidates' confidence in performing 46 clinical skills. A group of 108 participants responded for both the "before" and the "after" questionnaire: the response rate was 91% (before) and 90% (after). In general, a positive progress trend was detected. The mean skill value for all skills was 3.23 (before) and 3.93 (after) with a mean increase of 21.7% (P < 0.001). Male students scored constantly higher than females both before and after completing the master's programme, while females showed a higher percentage in progress. Scores in certain medical disciplines were higher than others. However, disciplines with low scores in the beginning, such as psychiatry and ophthalmology, showed the highest progress percentage. The results show a significant increase in confidence in performing procedural skills designed in the curriculum of the GFMP master's programme.
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Hall SR, Stephens JR, Seaby EG, Andrade MG, Lowry AF, Parton WJC, Smith CF, Border S. Can medical students accurately predict their learning? A study comparing perceived and actual performance in neuroanatomy. ANATOMICAL SCIENCES EDUCATION 2016; 9:488-495. [PMID: 27037749 DOI: 10.1002/ase.1601] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 12/11/2015] [Accepted: 01/18/2016] [Indexed: 06/05/2023]
Abstract
It is important that clinicians are able to adequately assess their level of knowledge and competence in order to be safe practitioners of medicine. The medical literature contains numerous examples of poor self-assessment accuracy amongst medical students over a range of subjects however this ability in neuroanatomy has yet to be observed. Second year medical students attending neuroanatomy revision sessions at the University of Southampton and the competitors of the National Undergraduate Neuroanatomy Competition were asked to rate their level of knowledge in neuroanatomy. The responses from the former group were compared to performance on a ten item multiple choice question examination and the latter group were compared to their performance within the competition. In both cohorts, self-assessments of perceived level of knowledge correlated weakly to their performance in their respective objective knowledge assessments (r = 0.30 and r = 0.44). Within the NUNC, this correlation improved when students were instead asked to rate their performance on a specific examination within the competition (spotter, rS = 0.68; MCQ, rS = 0.58). Despite its inherent difficulty, medical student self-assessment accuracy in neuroanatomy is comparable to other subjects within the medical curriculum. Anat Sci Educ 9: 488-495. © 2016 American Association of Anatomists.
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Affiliation(s)
- Samuel R Hall
- Centre for Learning Anatomical Sciences, University of Southampton, Southampton, United Kingdom
- Department of Neurosurgery, University Hospitals Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Jonny R Stephens
- Centre for Learning Anatomical Sciences, University of Southampton, Southampton, United Kingdom
- Department of Orthopedic Surgery, St Mary's Hospital London, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Eleanor G Seaby
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | | | - Andrew F Lowry
- Department of Neurology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trusts, Sheffield, United Kingdom
| | - Will J C Parton
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Claire F Smith
- Department of Anatomy, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Scott Border
- Centre for Learning Anatomical Sciences, University of Southampton, Southampton, United Kingdom
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Accuracy and content of medical student midclerkship self-evaluations. Am J Surg 2016; 211:1153-7. [DOI: 10.1016/j.amjsurg.2015.11.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/20/2015] [Accepted: 11/06/2015] [Indexed: 11/20/2022]
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Wynn R, Rosenfeld RM, Lucente FE. Satisfaction and gender issues in otolaryngology residency. Otolaryngol Head Neck Surg 2016; 132:823-7. [PMID: 15944548 DOI: 10.1016/j.otohns.2005.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE: To evaluate the otolaryngology residency experience with attention to operative experience, career guidance, and gender. STUDY DESIGN AND SETTING: Otolaryngology residents were anonymously surveyed by mail about their residency experience. The 22-item survey was scored on a 5-point ordinal Likert scale. Responses were analyzed with respect to gender and postgraduate year (PGY) level. RESULTS: Complete surveys were returned by 261 otolaryngology residents (24% female). PGY level correlated with confidence that surgical skills were appropriate ( P = 0.003), establishment of solid career network ( P = 0.003), and confidence that surgical abilities are adequate for practice ( P = 0.028). Female residents reported less confidence that surgical skills were appropriate ( P = 0.050) and that surgical abilities were adequate for postresidency practice ( P = 0.035). Women were encouraged to enter private practice more often ( P = 0.012), were less likely to have a solid career network ( P = 0.025), and were less confident about being able to run their own practice ( P = 0.036) CONCLUSIONS: Significant differences exist for several questions regarding surgical confidence and career issues, even after correction for PGY level.
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Affiliation(s)
- Rhoda Wynn
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA.
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Al-Amri S, Ali Z. Systematic Review of Computer Based Assessments in Medical Education. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2016; 4:79-88. [PMID: 30787703 PMCID: PMC6298330 DOI: 10.4103/1658-631x.178288] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Medical schools, postgraduate training institutes, licensing and certification bodies have developed and implemented many new methods for accurate, reliable, and timely assessments of the competence of medical professionals and practicing physicians. The underlying objective of all these assessments is to not only evaluate the students' learning and educational goals but also to establish the graduating individual's skills and professionalism. Computer based assessment (CBA) has emerged in recent years as a viable alternative to traditional assessment techniques. It has also infiltrated and influenced the medical curriculum where it has been employed for assessment tasks. This study presents how CBA offers pedagogical opportunities and analyzes its usage pattern over the past three decades. We examined 47 CBAs in medical education and analyzed several assessment components, including application area, assessment purpose, assessment type, assessment format, student level, and emphasized the interplay among these components. Our analysis determined that formative assessment is the most frequently used type and 75% of all assessment types employed used the multiple choice questions format.
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Affiliation(s)
- Saad Al-Amri
- Deanship of Information and Communications Technology, University of Dammam, Dammam, Saudi Arabia
| | - Zahid Ali
- Deanship of Information and Communications Technology, University of Dammam, Dammam, Saudi Arabia
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Gase KA, Leone C, Khoury R, Babcock HM. Advancing the competency of infection preventionists. Am J Infect Control 2015; 43:370-9. [PMID: 25721061 DOI: 10.1016/j.ajic.2015.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 12/24/2014] [Accepted: 01/05/2015] [Indexed: 11/28/2022]
Abstract
The Association of Professionals in Infection Control and Epidemiology (APIC) has identified advancing infection prevention competency as a core goal in their Strategic Plan 2020. To achieve this goal, APIC has published a self-assessment tool to help infection preventionists identify where they are on a predefined scale. This project trialed APIC's self-assessment tool along with an internally developed objective assessment. The objective was to determine if the tools help identify areas for improvement to advance overall group competency at BJC HealthCare, a large Midwestern health care system with nearly 30 infection preventionists.
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Affiliation(s)
- Kathleen A Gase
- Center for Clinical Excellence, BJC HealthCare, St Louis, MO.
| | - Carole Leone
- Center for Clinical Excellence, BJC HealthCare, St Louis, MO
| | - Raya Khoury
- Center for Clinical Excellence, BJC HealthCare, St Louis, MO
| | - Hilary M Babcock
- Division of Infectious Diseases, Washington University School of Medicine, St Louis, MO
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Brinkman DJ, Tichelaar J, van Agtmael MA, de Vries TPGM, Richir MC. Self-reported confidence in prescribing skills correlates poorly with assessed competence in fourth-year medical students. J Clin Pharmacol 2015; 55:825-30. [PMID: 25650568 DOI: 10.1002/jcph.474] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 01/29/2015] [Indexed: 11/08/2022]
Abstract
The objective of this study was to investigate the relationship between students' self-reported confidence and their objectively assessed competence in prescribing. We assessed the competence in several prescribing skills of 403 fourth-year medical students at the VU University Medical Center, the Netherlands, in a formative simulated examination on a 10-point scale (1 = very low; 10 = very high). Afterwards, the students were asked to rate their confidence in performing each of the prescribing skills on a 5-point Likert scale (1 = very unsure; 5 = very confident). Their assessments were then compared with their self-confidence ratings. Students' overall prescribing performance was adequate (7.0 ± 0.8), but they lacked confidence in 2 essential prescribing skills. Overall, there was a weak positive correlation (r = 0.2, P < .01, 95%CI 0.1-0.3) between reported confidence and actual competence. Therefore, this study suggests that self-reported confidence is not an accurate measure of prescribing competence, and that students lack insight into their own strengths and weaknesses in prescribing. Future studies should focus on developing validated and reliable instruments so that students can assess their prescribing skills.
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Affiliation(s)
- David J Brinkman
- Research and Expertise Center in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands.,Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam, The Netherlands
| | - Jelle Tichelaar
- Research and Expertise Center in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands
| | - Michiel A van Agtmael
- Research and Expertise Center in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands.,Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam, The Netherlands
| | - Theo P G M de Vries
- Research and Expertise Center in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands.,Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam, The Netherlands
| | - Milan C Richir
- Research and Expertise Center in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands.,Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam, The Netherlands
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48
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Isenberg GA, Roy V, Veloski J, Berg K, Yeo CJ. Evaluation of the validity of medical students' self-assessments of proficiency in clinical simulations. J Surg Res 2014; 193:554-9. [PMID: 25450601 DOI: 10.1016/j.jss.2014.09.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 09/12/2014] [Accepted: 09/25/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND The accuracy of self-assessments has not been well supported in the literature. This study was undertaken to examine the validity of medical students' ratings of their proficiency during encounters with simulated patients and simulation devices. METHODS Confidential self-assessments for 10 skills were collected from 195 students during a formal clinical skills assessment related to 3 cases at the end of a surgery clerkship. The cases required students to gather data from simulated patients and perform procedures such as rectal examinations, nasogastric tube insertions, and suturing on bench simulation models. The patients were trained to assess student performance. RESULTS There were significant differences between student self-assessments and simulated patient scores for general clinical skills as opposed to procedural skills. Students' mean self-assessments in the data gathering and interpersonal skills were 2-6 % points higher than ratings of their proficiency by simulated patients. However, self-assessments on procedures were 5-8 points lower than patient ratings. The median correlation between self-assessments and patient ratings for general clinical skills such as data gathering and interpersonal skills was 0.08 (not significant), whereas the median correlation between student and patient ratings in procedures was 0.22 (P < 0.01). CONCLUSIONS Third-year medical students' self-assessments for specific procedures are more valid than self-assessments of general clinical skills. Students are less confident in their procedural skills compared with general clinical skills. Although self-assessments should not be used as the sole measure of performance in clinical simulations, self-assessments for specific procedures can provide supplemental information on proficiency.
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Affiliation(s)
- Gerald A Isenberg
- Department of Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.
| | - Vibin Roy
- Department of Family and Community Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jon Veloski
- Department of Psychiatry and Human Behavior, and the Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Katherine Berg
- Department of Medicine, and the University Clinical Skills and Simulation Center, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Charles J Yeo
- Department of Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
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49
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Chadwick KA, Dodson KM, Wan W, Reiter ER. Attainment of surgical competence in otolaryngology training. Laryngoscope 2014; 125:331-6. [DOI: 10.1002/lary.24771] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/12/2014] [Accepted: 05/14/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Keith A. Chadwick
- Department of Surgery; Virginia Commonwealth University; Richmond Virginia U.S.A
| | - Kelley M. Dodson
- Department of Otolaryngology-Head and Neck Surgery; Virginia Commonwealth University; Richmond Virginia U.S.A
| | - Wen Wan
- Department of Biostatistics; Virginia Commonwealth University; Richmond Virginia U.S.A
| | - Evan R. Reiter
- Department of Otolaryngology-Head and Neck Surgery; Virginia Commonwealth University; Richmond Virginia U.S.A
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50
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Fonseca AL, Reddy V, Longo WE, Udelsman R, Gusberg RJ. Operative confidence of graduating surgery residents: a training challenge in a changing environment. Am J Surg 2014; 207:797-805. [DOI: 10.1016/j.amjsurg.2013.09.033] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 08/29/2013] [Accepted: 09/09/2013] [Indexed: 11/17/2022]
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