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Venezia L, Labarile N, Maselli R, Benedetti A, Annibale B, Parodi MC, Soncini M, Zingone F. Women in Gastroenterology: What Is the Current Situation? Results of an Italian National Survey. Dig Dis Sci 2024:10.1007/s10620-024-08407-8. [PMID: 38637458 DOI: 10.1007/s10620-024-08407-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 03/26/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Many women grow up dreaming of becoming doctors, preferring specialties that allow more focus on time outside the hospital and on family life. Nowadays, specialties, like gastroenterology, have still a significant gender gap. METHODS Based on this known discrepancy, a web-based questionnaire was designed by the Young Component of the Scientific Committee of the Federation of Italian Scientific Societies of Digestive Diseases 2023 (FISMAD) to examine the current situation of female gastroenterologists in Italy. The survey, designed specifically for this study, was sent by email to all female gastroenterologists and residents gastroenterologists, members of the three major Italian societies of Gastroenterology. RESULTS A total of 423 female physicians responded to the survey: 325 (76.8%) had full-time employment, and only a few had an academic career (7.2%). The main occupations were outpatient clinics (n = 288, 68%) and diagnostic endoscopy (n = 289, 68.3%); only 175 (41.3%) performed interventional endoscopy. One hundred and forty-seven (34.7%) had the chance to attend a master in advanced or interventional endoscopy, while 133 (31.4%) faced disadvantages that enabled them to attend. Of the 244 (58%) who reported feeling underappreciated, 194 (79.5%) said it was due to gender bias. We found that women doctors considered themselves disadvantaged compared with men doctors due to career opportunities (n = 338), salary negotiations (n = 64), and training opportunities (n = 144). CONCLUSIONS In conclusion, gastroenterology still has a long way to go before approaching greater gender parity.
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Affiliation(s)
- Ludovica Venezia
- Gastroenterology Unit, Department of Oncological and Specialty Medicine, Azienda Ospedaliero-Universitaria 'Maggiore Della Carità', Novara, Italy
| | - Nunzia Labarile
- National Institute of Gastroenterology - IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Roberta Maselli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, Milan, Italy
| | - Antonio Benedetti
- Department of Clinic and Molecular Sciences, Polytechnic University of Marche, Via Tronto 10, Ancona, Italy
| | - Bruno Annibale
- Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Teaching Hospital, Sapienza University of Rome, Rome, Italy
| | - Maria Caterina Parodi
- Department of Gastroenterology and Digestive Endoscopy, IRCCS Teaching Hospital San Martino, Genoa, Italy
| | - Marco Soncini
- Department of Internal Medicine, A. Manzoni Hospital, Lecco, Italy
| | - Fabiana Zingone
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
- Gastroenterology Unit, Azienda Ospedale - Università Padova, Via Giustiniani 2, Padua, Italy.
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Authorship by gender in anesthesiology journals: a retrospective cross-sectional study for Japan. J Anesth 2023; 37:364-370. [PMID: 36688988 PMCID: PMC9868495 DOI: 10.1007/s00540-023-03165-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/10/2023] [Indexed: 01/24/2023]
Abstract
PURPOSE Although it is important to recognize gender disparities in publishing to achieve gender diversity, women's authorship in Japan remains unclear. Therefore, this study aimed to investigate the percentage and analyze the trends of articles authored and published in anesthesiology journals by Japanese female authors. METHODS The genders of the first and last authors affiliated with Japanese institutions were surveyed in the Journal of Anesthesia (JA) (1990, 1995, and 2000-2022) and 11 international anesthesiology journals (2010-2022). RESULTS We included 845 and 819 original research articles from JA in the analyses of the first and last authors, respectively. The proportion of female first authors significantly increased from 41 (11.7%) out of 351 before 2009 to 119 (24.1%) out of 494 after 2010 (p < 0.001). The proportion of female last authors was 11 (3.3%) out of 335 before 2009 and 22 (4.5%) out of 484 after 2010, respectively, with no significant difference (p = 0.470). We included 624 and 572 original research articles from international anesthesiology journals in the analyses of first and last authors, respectively. Among these, there were 134 (21.5%) and 23 (4.0%) female first and last authors, respectively. These proportions in international anesthesiology journals did not significantly differ from those in JA (p = 0.334, p = 0.789, respectively). CONCLUSION The percentage of female first authors has increased, commensurate with the percentage of female anesthesiologists. However, the percentage of female last authors has not increased and remains low in Japan.
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Mousa M, Skouteris H, Boyle JA, Currie G, Riach K, Teede HJ. Factors that influence the implementation of organisational interventions for advancing women in healthcare leadership: A meta-ethnographic study. EClinicalMedicine 2022; 51:101514. [PMID: 35856039 PMCID: PMC9287475 DOI: 10.1016/j.eclinm.2022.101514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Gender inequity in healthcare leadership persists and progress is slow, with the focus firmly on problems, barriers and on requiring women themselves to adapt and compete in a system not designed for them. Women are individually burdened to advance their careers, with little effort given to addressing systemic barriers in the health sector. A recent systematic review prioritised organisational-level approaches and demonstrated effective interventions. In this meta-ethnographic study, we further this work by examining factors in implementation of organisational interventions for advancing women in leadership. METHODS The meta-ethnographic framework applied here follows the Noblit and Hare approach for synthesising findings and applying interpretive analysis to original research. We generated a new line-of-argument with insights for the healthcare sector. The protocol is registered (CRD42020162115) on the International Prospective Register of Systematic Reviews. Three academic databases (MEDLINE, PsycINFO, SCOPUS) were searched systematically between 2000 and 2021. Studies were analysed if they included organisational-level interventions that sought to measurably advance women in leadership. Study characteristics were extracted using a standard template for intervention details. Quality appraisal was conducted using the Critical Appraisal Skills Program tool. Data synthesis was conducted across 19 criteria of the Meta-Ethnography Reporting Guide (eMERGe). FINDINGS Fifteen qualitative studies were included. Analysis revealed three meta-themes that are central to successful implementation of organisational interventions that advance women in healthcare leadership: (1) leadership commitment and accountability, influenced by internal and external organisational settings, salient for long term outcomes and for developing an inclusive leadership culture; (2) intervention fit with individuals with consideration given to personal beliefs, preferences, experiences, capabilities or life circumstances, including capacity for leadership roles in their broader life context; balanced against maintaining interventional fidelity, and (3) cultural climate and organisational readiness for change, addressing traditional, conservative and constrictive perspectives on gender and leadership in health, highlighting the facilitating role of male colleagues. INTERPRETATION This meta-ethnographic research extends past work by integrating empirical evidence from a systematic literature review of effective organisational level interventions, with the identification of pragmatic themes to generate, implement, evaluate and embed evidence-based organisational interventions to advance women in healthcare leadership. This work can inform initiatives and policymakers to generate and implement new knowledge to advance women in healthcare leadership. FUNDING Epworth Health and Monash University provided scholarships for MM. HT is funded by an NHMRC / MRFF Practitioner Fellowship, JB by an NHMRC fellowship and HS by a Monash Warwick University Professorship.
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Affiliation(s)
- Mariam Mousa
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Melbourne, Australia
- Epworth Healthcare, Melbourne, Victoria, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Australia
- Warwick Business School, Warwick University, Coventry, UK
| | - Jacqueline A. Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Melbourne, Australia
- Epworth Healthcare, Melbourne, Victoria, Australia
- Monash Partners Academic Health Science Centre, Melbourne, Australia
- Health Systems and Equity, Eastern Health Clinical School, Monash University
| | - Graeme Currie
- Warwick Business School, Warwick University, Coventry, UK
| | - Kathleen Riach
- Adam Smith Business School, University of Glasgow, Scotland, UK
| | - Helena J. Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Melbourne, Australia
- Monash Partners Academic Health Science Centre, Melbourne, Australia
- Endocrine and Diabetes Units, Monash Health, Melbourne, Australia
- Warwick Business School, Warwick University, Coventry, UK
- Corresponding author at: Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia.
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Meyer-Frießem C, Enax-Krumova E, Kruppa C. Between clinical practice, teaching and research - a project report on the development and implementation of a career mentoring curriculum for female clinician scientists. GMS JOURNAL FOR MEDICAL EDUCATION 2022; 39:Doc35. [PMID: 36119149 PMCID: PMC9469568 DOI: 10.3205/zma001556] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 02/16/2022] [Accepted: 04/21/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Despite the high proportion of female medical students, the leading positions in almost all medical departments are still considerably less often held by female clinicians than by male. The aim of this project report is to introduce a career mentoring curriculum for female clinician scientists at Ruhr-University of Bochum in Germany. METHODS The career mentoring program was developed for young female clinician scientists who aim for a leading position in academic medicine. We describe and discuss herein its planning and implementation over two years (11/2020-11/2022) focusing on the needs of the target group. RESULTS The mentoring program is based on an agile twin-track strategy. It includes peer mentoring, content-related input and interdisciplinary three-to-one mentoring by the coordinators. Additionally, the mentees develop and conduct a scientific project to practice their acquired skills in a protected environment. The quality assurance system of the mentoring program includes a continuous evaluation of the mentees' satisfaction with the content and organisation of the program, whose results serve as the basis of the prompt adjustment of the latter. It also includes an evaluation of the sustainable impact of the program on the mentees' career development based on an adapted role matrix. The role matrix addresses the mentees to acquire the competencies required for them to become a successful clinician, scientist and academic teacher. CONCLUSIONS A 2-year innovative and unique career mentoring program for female clinician scientists was developed and already successfully launched. Making use of different mentoring strategies, the program has the potential to promote gender equality and encourage female physicians to pursue a career in academic medicine.
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Affiliation(s)
- Christine Meyer-Frießem
- Ruhr-University Bochum, BG University Hospital Bergmannsheil gGmbH Bochum, Department of Anaesthesiology, Intensive Care and Pain Medicine, Bochum, Germany
| | - Elena Enax-Krumova
- Ruhr-University Bochum, BG University Hospital Bergmannsheil gGmbH Bochum, Department of Anaesthesiology, Department of Neurology, Bochum, Germany
| | - Christiane Kruppa
- Ruhr-University Bochum, BG University Hospital Bergmannsheil gGmbH Bochum, Department of General and Trauma Surgery, Bochum, Germany
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Noronha B, Fuchs A, Zdravkovic M, Berger-Estilita J. Gender balance in the medical workplace – A snapshot into anesthesia. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2022. [DOI: 10.1016/j.tacc.2022.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Burkinshaw P, Bryant LD, Magee C, Thompson P, Cotterill LA, Mulvey MR, Hewison J. Ten years of NIHR research training: perceptions of the programmes: a qualitative interview study. BMJ Open 2022; 12:e046410. [PMID: 35027413 PMCID: PMC8762125 DOI: 10.1136/bmjopen-2020-046410] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 11/25/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES The UK National Institute for Health Research (NIHR) training programmes were created to build and sustain research capacity in healthcare. Following the training programme 10-year strategic review, this qualitative study aimed to deepen understanding of facilitators and barriers for those progressing through NIHR-supported research careers. DESIGN Semistructured qualitative study. DATA COLLECTION AND ANALYSIS Telephone interviews conducted between May and August 2017 were digitally recorded, transcribed and analysed using Framework Approach. SETTING UK National Health Service (NHS) Trusts, university medical schools, District General Hospitals, Integrated Academic Training Programme centres and Research Design Services across the North East, North West, South East and South West of England, London and the Midlands. PARTICIPANTS Fourteen women and eight men, of whom, 14 were previous or current NIHR personal awardees (seven doctors and seven allied health professionals (AHPs) or nurses) and eight were managers (staff within clinical or university training-related roles). RESULTS (1) NIHR awards were viewed as transformative for research careers; (2) however, there were perceptions of a biased 'playing field'. (3) Inequalities were perceived for AHPs and nurses, those outside of established research institutes and those in 'unfashionable' specialisms. (4) While support for NIHR awards contributed to a healthy research culture, (5) short-term awards were perceived as a barrier to continuing an independent research career. CONCLUSIONS Participants perceived many strengths of the NIHR training programmes in terms of developing individual careers and research capacity. Areas in which improvement could enhance the ability to attract, develop and retain researcher were identified. Our findings are of relevance to schemes in other countries, where healthcare researchers experience similar challenges. Further work is needed to overcome barriers and ensure equity of access to, and success within, clinical research training schemes to sustain the research workforce needed to address future global health challenges.
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Affiliation(s)
- Paula Burkinshaw
- Leeds University Business School, University of Leeds, Leeds, UK
| | - Louise D Bryant
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | | | | | - Matthew R Mulvey
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Jenny Hewison
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Mousa M, Boyle J, Skouteris H, Mullins AK, Currie G, Riach K, Teede HJ. Advancing women in healthcare leadership: A systematic review and meta-synthesis of multi-sector evidence on organisational interventions. EClinicalMedicine 2021; 39:101084. [PMID: 34430838 PMCID: PMC8365436 DOI: 10.1016/j.eclinm.2021.101084] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/16/2021] [Accepted: 07/22/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Women are underrepresented in healthcare leadership, yet evidence on impactful organisational strategies, practices and policies that advance women's careers are limited. We aimed to explore these across sectors to gain insight into measurably advancing women in leadership in healthcare. METHODS A systematic review was performed across Medline via OVID; Medline in-process and other non-indexed citations via OVID; PsycINFO and SCOPUS from January 2000 to March 2021. Methods are outlined in a published protocol registered a priori on PROSPERO (CRD42020162115). Eligible studies reported on organisational interventions for advancing women in leadership with at least one measurable outcome. Studies were assessed independently by two reviewers. Identified interventions were organised into categories and meta-synthesis was completed following the 'ENhancing Transparency in REporting the synthesis of Qualitative research' (ENTREQ) statement. FINDINGS There were 91 eligible studies from 6 continents with 40 quantitative, 38 qualitative and 13 mixed methods studies. These spanned academia, health, government, sports, hospitality, finance and information technology sectors, with around half of studies in health and academia. Sample size, career stage and outcomes ranged broadly. Potentially effective interventions consistently reported that organisational leadership, commitment and accountability were key drivers of organisational change. Organisational intervention categories included i) organisational processes; ii) awareness and engagement; iii) mentoring and networking; iv) leadership development; and v) support tools. A descriptive meta-synthesis of detailed strategies, policies and practices within these categories was completed. INTERPRETATION This review provides an evidence base on organisational interventions for advancing women in leadership across diverse settings, with lessons for healthcare. It transcends the focus on the individual to target organisational change, capturing measurable change across intervention categories. This work directly informs a national initiative with international links, to enable women to achieve their career goals in healthcare and moves beyond the focus on barriers to solutions.
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Affiliation(s)
- Mariam Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Melbourne, VIC 3168, Australia
- Epworth Healthcare, Melbourne, VIC, Australia
| | - Jacqueline Boyle
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Melbourne, VIC 3168, Australia
- Epworth Healthcare, Melbourne, VIC, Australia
- Department of Gynaecology, Monash Medical Centre, Melbourne, VIC, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Melbourne, VIC 3168, Australia
| | - Alexandra K Mullins
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Melbourne, VIC 3168, Australia
| | - Graeme Currie
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Melbourne, VIC 3168, Australia
- Warwick Business School, Warwick University, United Kingdom
| | - Kathleen Riach
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Melbourne, VIC 3168, Australia
- Adam Smith Business School, University of Glasgow, United Kingdom
| | - Helena J Teede
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Melbourne, VIC 3168, Australia
- Endocrine and Diabetes Units, Monash Medical Centre, Melbourne, VIC, Australia
- Corresponding author at: Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Melbourne, VIC 3168, Australia.
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Lydon S, O'Dowd E, Walsh C, O'Dea A, Byrne D, Murphy AW, O'Connor P. Systematic review of interventions to improve gender equity in graduate medicine. Postgrad Med J 2021; 98:300-307. [PMID: 33637640 DOI: 10.1136/postgradmedj-2020-138864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 01/21/2021] [Accepted: 01/28/2021] [Indexed: 11/03/2022]
Abstract
Women are substantially underrepresented in senior and leadership positions in medicine and experience gendered challenges in their work settings. This systematic review aimed to synthesise research that has evaluated interventions for improving gender equity in medicine. English language electronic searches were conducted across MEDLINE, CINAHL, Academic Search Complete, PsycINFO and Web of Science. Reference list screening was also undertaken. Peer-reviewed studies published between 2000 and March 2020 that evaluated interventions to improve gender equity, or the experiences of women, in academic or clinical medicine were reviewed. Dual reviewer data extraction on setting, participants, type of intervention, measurement and outcomes was completed. Methodological rigour and strength of findings were evaluated. In total, 34 studies were included. Interventions were typically focused on equipping the woman (82.4%), that is, delivering professional development activities for women. Fewer focused on changing cultures (20.6%), ensuring equal opportunities (23.5%) or increasing the visibility or valuing of women (23.5%). Outcomes were largely positive (87.3%) but measurement typically relied on subjective, self-report data (69.1%). Few interventions were implemented in clinical settings (17.6%). Weak methodological rigour and a low strength of findings was observed. There has been a focus to-date on interventions which Equip the Woman Interventions addressing systems and culture change require further research consideration. However, institutions cannot wait on high quality research evidence to emerge to take action on gender equity. Data collated suggest a number of recommendations pertaining to research on, and the implementation of, interventions to improve gender equity in academic and clinical settings.
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Affiliation(s)
- Sinéad Lydon
- School of Medicine, National University of Ireland, Galway, Ireland .,Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
| | - Emily O'Dowd
- Department of General Practice, National University of Ireland, Galway, Ireland
| | - Chloe Walsh
- Department of General Practice, National University of Ireland, Galway, Ireland
| | - Angela O'Dea
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Dara Byrne
- School of Medicine, National University of Ireland, Galway, Ireland.,Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
| | - Andrew W Murphy
- Department of General Practice, National University of Ireland, Galway, Ireland
| | - Paul O'Connor
- School of Medicine, National University of Ireland, Galway, Ireland.,Department of General Practice, National University of Ireland, Galway, Ireland
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House A, Dracup N, Burkinshaw P, Ward V, Bryant LD. Mentoring as an intervention to promote gender equality in academic medicine: a systematic review. BMJ Open 2021; 11:e040355. [PMID: 33500280 PMCID: PMC7839843 DOI: 10.1136/bmjopen-2020-040355] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Mentoring is frequently suggested as an intervention to address gender inequalities in the workplace. OBJECTIVES To systematically review evidence published since a definitive review in 2006 on the effectiveness of mentoring interventions aimed at achieving gender equality in academic medicine. DESIGN Systematic Review, using the Template for Intervention Description and Replication as a template for data extraction and synthesis. SAMPLE Studies were included if they described a specific mentoring intervention in a medical school or analogous academic healthcare organisation and included results from an evaluation of the intervention. ELIGIBILITY CRITERIA Mentoring was defined as (1) a formally organised intervention entailing a supportive relationship between a mentor, defined as a more senior/experienced person and a mentee defined as a more junior/inexperienced person; (2) mentoring intervention involved academic career support (3) the mentoring relationship was outside line management or supervision of performance and was defined by contact over an extended period of time. OUTCOMES The impact of mentoring was usually reported at the level of individual participants, for example, satisfaction and well-being or self-reported career progression. We sought evidence of impact on gender equality via reports of organisation-level effectiveness, of promotion or retention, pay and academic performance of female staff. RESULTS We identified 32 publications: 8 review articles, 20 primary observational studies and 4 randomised controlled trials. A further 19 discussed mentoring in relation to gender but did not meet our eligibility criteria. The terminology used, and the structures and processes reported as constituting mentoring, varied greatly. We identified that mentoring is popular with many who receive it; however, we found no robust evidence of effectiveness in reducing gender inequalities. Primary research used weak evaluation designs. CONCLUSIONS Mentoring is a complex intervention. Future evaluations should adopt standardised approaches used in applied health research to the design and evaluation of effectiveness and cost-effectiveness.
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Affiliation(s)
- Allan House
- Leeds Institute of Health Sciences, University of Leeds School of Medicine, Leeds, UK
| | - Naila Dracup
- Library (Allied Health and Social Care), University of Derby, Derby, UK
| | - Paula Burkinshaw
- Leeds University Business School, University of Leeds, Leeds, West Yorkshire, UK
| | - Vicky Ward
- School of Management, University of St Andrews, St Andrews, UK
| | - Louise D Bryant
- Leeds Institute of Health Sciences, University of Leeds School of Medicine, Leeds, UK
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Farrell L, Petzel ZW, McCormack T, Turner RN, Rafferty K, Latu IM. When You Put It that Way: Framing Gender Equality Initiatives to Improve Engagement among STEM Academics. Bioscience 2020. [DOI: 10.1093/biosci/biaa136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
A number of high-profile gender equality initiatives (GEIs) are intended to address women's underrepresentation in science. However, attitudes toward such initiatives can be negative. In two experiments with STEM academics, we examined how GEIs can be best framed to improve attitudes toward them. In study 1 (N = 113), we manipulated the framing of GEI leadership (led by a man or woman) and GEI focus (benefitting men and women or benefitting women only). The men were more supportive of GEIs benefitting both men and women because of fewer concerns of unfair treatment and more internal motivations to engage with GEIs. The women's level of support was unaffected by framing. In study 2 (N = 151), we framed GEIs as either supported by university management or not and either internally or externally driven. Support was greater for internally driven GEIs. The impact of management support depended on the academics’ experience with GEIs. This research makes evidence-based recommendations for the implementation of GEIs to improve their effectiveness.
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Affiliation(s)
- Lynn Farrell
- School of Psychology, School of Electronics, Electrical Engineering, and Computer Science, Queen's University Belfast, Northern Ireland
| | - Zachary W Petzel
- School of Psychology, School of Electronics, Electrical Engineering, and Computer Science, Queen's University Belfast, Northern Ireland
| | - Teresa McCormack
- School of Psychology, School of Electronics, Electrical Engineering, and Computer Science, Queen's University Belfast, Northern Ireland
| | - Rhiannon N Turner
- School of Psychology, School of Electronics, Electrical Engineering, and Computer Science, Queen's University Belfast, Northern Ireland
| | - Karen Rafferty
- School of Psychology, School of Electronics, Electrical Engineering, and Computer Science, Queen's University Belfast, Northern Ireland
| | - Ioana M Latu
- School of Psychology, School of Electronics, Electrical Engineering, and Computer Science, Queen's University Belfast, Northern Ireland
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Henderson LR, Shah SGS, Ovseiko PV, Dam R, Buchan AM, McShane H, Kiparoglou V. Markers of achievement for assessing and monitoring gender equity in a UK National Institute for Health Research Biomedical Research Centre: A two-factor model. PLoS One 2020; 15:e0239589. [PMID: 33052933 PMCID: PMC7556494 DOI: 10.1371/journal.pone.0239589] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 09/09/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The underrepresentation of women in academic medicine at senior level and in leadership positions is well documented. Biomedical Research Centres (BRC), partnerships between leading National Health Service (NHS) organisations and universities, conduct world class translational research funded by the National Institute for Health Research (NIHR) in the UK. Since 2011 BRCs are required to demonstrate significant progress in gender equity (GE) to be eligible to apply for funding. However, the evidence base for monitoring GE specifically in BRC settings is underdeveloped. This is the first survey tool designed to rank and identify new GE markers specific to the NIHR BRCs. METHODS An online survey distributed to senior leadership, clinical and non-clinical researchers, trainees, administrative and other professionals affiliated to the NIHR Oxford BRC (N = 683). Participants ranked 13 markers of GE on a five point Likert scale by importance. Data were summarised using frequencies and descriptive statistics. Interrelationships between markers and underlying latent dimensions (factors) were determined by exploratory and confirmatory factor analyses. RESULTS The response rate was 36% (243 respondents). Respondents were more frequently female (55%, n = 133), aged 41-50 years (33%, n = 81), investigators (33%, n = 81) affiliated to the BRC for 2-7 years (39.5%, n = 96). Overall participants ranked 'BRC senior leadership roles' and 'organisational policies on gender equity', to be the most important markers of GE. 58% (n = 141) and 57% (n = 139) respectively. Female participants ranked 'organisational policies' (64.7%, n = 86/133) and 'recruitment and retention' (60.9%, n = 81/133) most highly, whereas male participants ranked 'leadership development' (52.1%, n = 50/96) and 'BRC senior leadership roles' (50%, n = 48/96) as most important. Factor analyses identified two distinct latent dimensions: "organisational markers" and "individual markers" of GE in BRCs. CONCLUSIONS A two-factor model of markers of achievement for GE with "organisational" and "individual" dimensions was identified. Implementation and sustainability of gender equity requires commitment at senior leadership and organisational policy level.
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Affiliation(s)
- Lorna R. Henderson
- National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom
- Radcliffe Department of Medicine, University of Oxford, Oxford, Oxford, United Kingdom
- * E-mail:
| | - Syed Ghulam Sarwar Shah
- National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom
- Radcliffe Department of Medicine, University of Oxford, Oxford, Oxford, United Kingdom
| | - Pavel V. Ovseiko
- Radcliffe Department of Medicine, University of Oxford, Oxford, Oxford, United Kingdom
| | - Rinita Dam
- Radcliffe Department of Medicine, University of Oxford, Oxford, Oxford, United Kingdom
| | - Alastair M. Buchan
- Radcliffe Department of Medicine, University of Oxford, Oxford, Oxford, United Kingdom
| | - Helen McShane
- National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom
- Nuffield Department of Medicine, University of Oxford, Oxford, Oxford, United Kingdom
| | - Vasiliki Kiparoglou
- National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom
- Nuffield Department of Primary Health Care Sciences University of Oxford, Oxford, United Kingdom
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Kurdi MS, Katikar MD, Ahuja V, Sharma R. Striding towards the pinnacles of professional growth, scientific epitome, and leadership: India's women anaesthesiologists. Indian J Anaesth 2020; 64:739-742. [PMID: 33162566 PMCID: PMC7641080 DOI: 10.4103/ija.ija_1116_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 08/21/2020] [Accepted: 08/21/2020] [Indexed: 11/07/2022] Open
Affiliation(s)
- Madhuri S Kurdi
- Department of Anaesthesiology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India. E-mail:
| | - Manisha D Katikar
- Department of Anaesthesiology and Critical Care, Balwant Institute of Neurosurgery and Intensive trauma Unit, Solapur, Maharashtra, India
| | - Vanita Ahuja
- Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India
| | - Ridhima Sharma
- Department of Anaesthesiology, Superspeciality Paediatric hospital and Postgraduate teaching Institute, Noida, Uttar Pradesh, India
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Brown MEL, Hunt GEG, Hughes F, Finn GM. 'Too male, too pale, too stale': a qualitative exploration of student experiences of gender bias within medical education. BMJ Open 2020; 10:e039092. [PMID: 32792453 PMCID: PMC7430333 DOI: 10.1136/bmjopen-2020-039092] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To explore medical student perceptions and experiences of gender bias within medical education. SETTING Gender bias-'prejudiced actions or thoughts based on the perception that women are not equal to men'-is a widespread issue. Within medicine, the pay gap, under-representation of women in senior roles and sexual harassment are among the most concerning issues demonstrating its presence and impact. While research investigating experiences of clinicians is gaining traction, investigation of medical students' experiences is lacking. This qualitative study analyses medical students' experiences of gender bias within their education to discern any patterns to this bias. Illuminating the current state of medical education gender bias will hopefully highlight areas in which student experience could be improved. Constructivist thematic analysis was used to analyse data, informed by William's patterns of gender bias, intersectional feminism and communities of practice theory. PARTICIPANTS Thirty-two medical students from multiple UK medical schools participated in individual interviews. Nine faculty members were also interviewed to triangulate data. RESULTS Gender bias has an overt presence during medical student education, manifesting in line with William's patterns of bias, impacting career aspirations. Physical environments serve to manifest organisational values, sending implicit messages regarding who is most welcome-currently, this imagery remains 'too male, too pale…too stale'. Existing gender initiatives require careful scrutiny, as this work identifies the superficial application of positive action, and a failure to affect meaningful change. CONCLUSIONS Despite progress having been made regarding overt gender discrimination, implicit bias persists, with existing positive action inadequate in promoting the advancement of women. Institutions should mandate participation in implicit bias education programmes for all staff and must strive to revise the imagery within physical environments to better represent society. Gender initiatives, like Athena Scientific Women's Academic Network, also require large-scale evaluation regarding their impact, which this work found to be lacking.
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Affiliation(s)
- Megan E L Brown
- Health Professions Education Unit, Hull York Medical School, York, UK
| | - George E G Hunt
- Health Professions Education Unit, Hull York Medical School, York, UK
| | - Ffion Hughes
- Health Professions Education Unit, Hull York Medical School, York, UK
| | - Gabrielle M Finn
- Health Professions Education Unit, Hull York Medical School, York, UK
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Clark M, Adams D. Listening to parents to understand their priorities for autism research. PLoS One 2020; 15:e0237376. [PMID: 32790720 PMCID: PMC7425861 DOI: 10.1371/journal.pone.0237376] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/24/2020] [Indexed: 12/28/2022] Open
Abstract
Involving the autism community in research increases the real-world translation and impact of findings. The current study explored the research priorities of parents of school-aged children on the autism spectrum across the home, school, and community settings. A combination of content analysis of an online questionnaire (n = 134) and Q-sort methodology (n = 9) was used. The most commonly identified research priorities in the online questionnaire were child health and well-being (home setting), socialisation and social support (school), and community awareness and understanding of autism (community). The Q-sort method highlighted different top priorities, with understanding the parent, sibling, child and family impact and stress the highest ranked priority for home, teacher/staff education and support for the school, and recognizing and supporting anxiety for the community. The implications of the findings are discussed in relation to shifting the framework of autism research to align research agendas with parental priorities.
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Affiliation(s)
- Megan Clark
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Australia
- Griffith Institute for Educational Research, Griffith University, Brisbane, Australia
| | - Dawn Adams
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Australia
- Griffith Institute for Educational Research, Griffith University, Brisbane, Australia
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Kalpazidou Schmidt E, Ovseiko PV, Henderson LR, Kiparoglou V. Understanding the Athena SWAN award scheme for gender equality as a complex social intervention in a complex system: analysis of Silver award action plans in a comparative European perspective. Health Res Policy Syst 2020; 18:19. [PMID: 32059678 PMCID: PMC7023775 DOI: 10.1186/s12961-020-0527-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 01/15/2020] [Indexed: 12/24/2022] Open
Abstract
Background Given the complex mix of structural, cultural and institutional factors that produce barriers for women in science, an equally complex intervention is required to understand and address them. The Athena SWAN Award Scheme for Gender Equality has become a widespread means to address barriers for women’s advancement and leadership in the United Kingdom, Ireland, Australia, the United States of America and Canada, while the European Commission is exploring the introduction of a similar award scheme across Europe. Methods This study analyses the design and implementation of 16 departmental Athena SWAN Silver Action Plans in Medical Sciences at one of the world’s leading universities in Oxford, United Kingdom. Data pertaining to the design and implementation of gender equality interventions were extracted from the action plans, analysed thematically, coded using categories from the 2015 Athena SWAN Charter Awards Handbook and synthesised against a typology of gender equality interventions in the European Research Area. The results were further analysed against the complexity research literature framework, where research organisations are perceived as dynamic systems that adapt, interact and co-evolve with other systems. Results Athena SWAN is a complex contextually embedded system of action planning within the context of universities. It depends on a multitude of contextual variables that relate in complex, non-linear ways and dynamically adapt to constantly moving targets and new emergent conditions. Athena SWAN Silver Action Plans conform to the key considerations of complexity – (1) multiple actions and areas of intervention with a focus on the complex system being embedded in local dynamics, (2) the non-linearity of interventions and the constantly emerging conditions, and (3) impact in terms of contribution to change, improved conditions to foster change and the increased probability that change can occur. Conclusions To enact effective sustainable structural and cultural change for gender equality, it is necessary to acknowledge and operationalise complexity as a frame of reference. Athena SWAN is the single most comprehensive and systemic gender equality scheme in Europe. It can be further strengthened by promoting the integration of sex and gender analysis in research and education. Gender equality policies in the wider European Research Area can benefit from exploring Athena SWAN’s contextually embedded systemic approach to dynamic action planning and inclusive focus on all genders and categories of staff and students.
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Affiliation(s)
| | - Pavel V Ovseiko
- Radcliffe Department of Medicine, Medical Science Division, University of Oxford, Oxford, United Kingdom
| | - Lorna R Henderson
- Radcliffe Department of Medicine, Medical Science Division, University of Oxford, Oxford, United Kingdom.,NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - Vasiliki Kiparoglou
- NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom.,Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
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16
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Abstract
OBJECTIVES To promote gender diversity and equity in higher education, Athena Scientific Women's Academic Network (SWAN) supports and recognises higher education institutions (HEI) in advancing the careers of women through charter commitment, awards, training and advocacy since 2005. Most evaluation studies, however, are based on qualitative assessments. This study sought to (1) examine the relationship between Athena SWAN accreditation/awards in the UK and gender diversity of leaders and senior academics using quantitative data from 2012/2013 to 2016/2017, and (2) explore the associations between Athena SWAN awards and university performance as measured by overall scores in global ranking systems. DESIGN Retrospective cohort study based on the UK HEIs. SETTING Higher education sector in the UK provided by the Higher Education Statistics Agency. PARTICIPANTS 148 HEIs who provided employment data on female-to-male ratios (55% complete data) for each academic year between 2012/2013 and 2016/2017. PRIMARY AND SECONDARY OUTCOME MEASURES Gender diversity, defined as female representation rates of positions in managerial leadership (eg, heads of institutions, department heads) and professors. The Quacquarelli Symonds (QS) World University Rankings scores, an indicator of research, teaching, employability and internationalisation, were collected to measure university performance. RESULTS Gender diversity of managerial leaders and non-managerial professors at all levels of Athena SWAN status has improved over the 5 years. Linear mixed effects models identified that Athena SWAN awardees had lower female representation than non-awardees in managerial leadership positions (p<0.05), while the gap was narrowed among Silver awardees over time. Athena SWAN Charter members had increasingly higher female representation than those not in the Charter (p<0.05). Silver-award institutions ranked higher in QS rankings than Bronze-award institutions (β=11.80, p<0.05). CONCLUSIONS There are overall rising trends in gender diversity from 2012/2013 to 2016/2017. Athena SWAN members showed greater and faster growth in female representations. Silver awardees had greater university performance than Bronze awardees.
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Affiliation(s)
- Yunyu Xiao
- Silver School of Social Work, New York University, New York, New York, USA
| | - Edward Pinkney
- Centre for Suicide Research and Prevention, University of Hong Kong, Pokfulam, Hong Kong
| | - Terry Kit Fong Au
- Department of Psychology, University of Hong Kong, Pokfulam, Hong Kong
- President's Office, University of Hong Kong, Pokfulam, Hong Kong
| | - Paul Siu Fai Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Pokfulam, Hong Kong
- Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong
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Zdravkovic M, Osinova D, Brull SJ, Prielipp RC, Simões CM, Berger-Estilita J. Perceptions of gender equity in departmental leadership, research opportunities, and clinical work attitudes: an international survey of 11 781 anaesthesiologists. Br J Anaesth 2020; 124:e160-e170. [PMID: 32005515 DOI: 10.1016/j.bja.2019.12.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/08/2019] [Accepted: 12/20/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Women make up an increasing proportion of the physician workforce in anaesthesia, but they are consistently under-represented in leadership and governance. METHODS We performed an internet-based survey to investigate career opportunities in leadership and research amongst anaesthesiologists. We also explored gender bias attributable to workplace attitudes and economic factors. The survey instrument was piloted, translated into seven languages, and uploaded to the SurveyMonkey® platform. We aimed to collect between 7800 and 13 700 responses from at least 100 countries. Participant consent and ethical approval were obtained. A quantitative analysis was done with χ2 and Cramer's V as a measure of strength of associations. We used an inductive approach and a thematic content analysis for qualitative data on current barriers to leadership and research. RESULTS The 11 746 respondents, 51.3% women and 48.7% men, represented 148 countries; 35 respondents identified their gender as non-binary. Women were less driven to achieve leadership positions (P<0.001; Cramer's V: 0.11). Being a woman was reported as a disadvantage for leadership and research (P<0.001 for both; Cramer's V: 0.47 and 0.34, respectively). Women were also more likely to be mistreated in the workplace (odds ratio: 10.6; 95% confidence interval: 9.4-11.9; P<0.001), most commonly by surgeons. Several personal, departmental, institutional, and societal barriers in leadership and research were identified, and strategies to overcome them were suggested. Lower-income countries were associated with a significantly smaller gender gap (P<0.001). CONCLUSIONS Whilst certain trends suggest improvements in the workplace, barriers to promotion of women in key leadership and research positions continue within anaesthesiology internationally.
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Affiliation(s)
- Marko Zdravkovic
- Department of Anaesthesiology, Intensive Care and Pain Management, University Medical Centre Maribor, Maribor, Slovenia; Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Denisa Osinova
- Department of Anaesthesiology and Intensive Care, Jessenius Faculty of Medicine in Martin, Comenius University Bratislava, University Hospital Martin, Martin, Slovak Republic
| | - Sorin J Brull
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA
| | | | - Claudia M Simões
- Department of Anaesthesiology, Instituto Do Câncer Do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, Hospital Sírio Libanês, São Paulo, Brazil
| | - Joana Berger-Estilita
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
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Raj A, Kumra T, Darmstadt GL, Freund KM. Achieving Gender and Social Equality: More Than Gender Parity Is Needed. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:1658-1664. [PMID: 31335818 DOI: 10.1097/acm.0000000000002877] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In this Perspective, the authors review Association of American Medical Colleges data on gender parity and intersectionality, consider the literature on gender parity in academic medicine and the underlying gender norms that explain these statistics, and offer recommendations for moving past indicators of parity to achieve gender and social equality.Improvements in gender parity among medical school graduates have not translated to gender parity among practicing physicians or medical school faculty, particularly for racial/ethnic minorities. Further, gender parity does not correspond to gender equality, such that gender-based disparities in salaries and advancement persist. In addition, social norms related to traditional gender role expectations reinforce existing biases and lead to sexual harassment and discrimination against women in the workplace.Building on their analysis of existing data and the literature, the authors offer concrete recommendations to achieve gender equality in academic medicine that not only improve parity but also support policies and practices to address the norms that further bias and discrimination. These recommendations include the collection, monitoring, and open reporting of data on salaries as well as on sex and race/ethnicity; stronger policies related to family leave and sexual discrimination and harassment; and accountability structures to ensure that policies are enforced. While these efforts alone cannot eliminate gender inequalities, academic medicine should be at the forefront of creating a climate in medicine that is supportive of gender equality as part of their larger goal of promoting social equality.
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Affiliation(s)
- Anita Raj
- A. Raj is Tata Chancellor Professor of Society and Health, professor of education studies, and director, Center on Gender Equity and Health, University of California, San Diego School of Medicine, San Diego, California. T. Kumra is assistant professor of pediatrics, codirector, Longitudinal Ambulatory Clerkship, and medical director, Remington Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland. G.L. Darmstadt is associate dean for maternal and child health and professor of neonatal and developmental medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California. K.M. Freund is professor of medicine and vice chair for faculty affairs and quality improvement, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts
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Truijens D, van Exel J. Views on deceased organ donation in the Netherlands: A q-methodology study. PLoS One 2019; 14:e0216479. [PMID: 31125339 PMCID: PMC6534345 DOI: 10.1371/journal.pone.0216479] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 04/22/2019] [Indexed: 11/19/2022] Open
Abstract
In many countries, such as the US, Germany, France, and the Netherlands, governments are dealing with a great shortage of organ donors. Even though people generally show positive attitudes towards organ donation, they often do not actually register as organ donors themselves. This study's objective was to explore prevailing viewpoints among the Dutch population on deceased organ donation and the relation between aspects of the viewpoints potentially influencing the decision to register as an organ donor. Although substantive research about attitudes on organ donation has been conducted, this is the first study investigating people's viewpoints focusing on the relation between beliefs, tastes, preferences, motives, goals and other constituents underlying people's viewpoints on organ donation, such as the role of the media and public policies. This Q-methodology study revealed four viewpoints: "not donating your organs is a waste", "it does not go with my religion", "my family should decide"; and "it's a good deed, but I'm doubtful". These viewpoints convey information on potential reasons for the gap between people's favourable attitudes towards organ donation and the low number of actual registrations, and opportunities for policy makers to address certain target groups more adequately.
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Affiliation(s)
- Daphne Truijens
- Erasmus University Rotterdam, Institute for Philosophy & Economics (EIPE), Rotterdam, the Netherlands
- Erasmus University Rotterdam, Erasmus School of Economics, Rotterdam, the Netherlands
| | - Job van Exel
- Erasmus University Rotterdam, Erasmus School of Economics, Rotterdam, the Netherlands
- Erasmus University Rotterdam, Erasmus School of Health Policy & Management, Rotterdam, the Netherlands
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21
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Truong DB, Doan HP, Doan Tran VK, Nguyen VC, Bach TK, Rueanghiran C, Binot A, Goutard FL, Thwaites G, Carrique-Mas J, Rushton J. Assessment of Drivers of Antimicrobial Usage in Poultry Farms in the Mekong Delta of Vietnam: A Combined Participatory Epidemiology and Q-Sorting Approach. Front Vet Sci 2019; 6:84. [PMID: 30968033 PMCID: PMC6442645 DOI: 10.3389/fvets.2019.00084] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 02/28/2019] [Indexed: 12/19/2022] Open
Abstract
In the Mekong Delta of Vietnam, poultry farmers use high amounts of antimicrobials, but little is known about the drivers that influence this usage. We aimed to identify these drivers using a novel approach that combined participatory epidemiology (PE) and Q-sorting (a methodology that allows the analysis of the subjectivity of individuals facing a common phenomenon). A total of 26 semi-structured collective interviews were conducted with 125 farmers representative of the most common farming systems in the area (chickens, meat ducks, and mobile grazing ducks), as well as with 73 farmers' advisors [veterinarians, veterinary drug shop owners, and government veterinarians/commune animal health workers (CAHWs)] in five districts of Dong Thap province (Mekong Delta). Through these interviews, 46 statements related to the antimicrobials' perceived reliability, costs, and impact on flock health were created. These statements were then investigated on 54 individuals (28 farmers and 26 farmers' advisors) using Q-sorting interviews. Farmers generally indicated a higher propensity for antimicrobial usage (AMU) should their flocks encounter bacterial infections (75.0-78.6%) compared with viral infections (8.3-66.7%). The most trusted sources of advice to farmers were, in decreasing order: government veterinarian/CAHWs, their own knowledge/experience, veterinary drug shop owners, and sales persons from pharmaceutical and feed companies. The highest peak of AMU took place in the early phase of the production cycle. Farmers and their advisors showed considerable heterogeneity of attitudes with regards to AMU, with, respectively, four and three discourses representing their views on AMU. Overall, farmers regarded the cost of AMU cheaper than other disease management practices implemented on their farms. However, they also believed that even though these measures were more expensive, they would also lead to more effective disease prevention. A key recommendation from this finding would be for the veterinary authorities to implement long-term sustainable training programs aiming at reducing farmers' reliance on antimicrobials.
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Affiliation(s)
- Dinh Bao Truong
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam.,Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Ho Chi Minh, Vietnam
| | - Hoang Phu Doan
- Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Ho Chi Minh, Vietnam.,Faculty Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - Vinh Khanh Doan Tran
- Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Ho Chi Minh, Vietnam
| | | | - Tuan Kiet Bach
- Sub Department of Animal Health and Production, Cao Lãnh, Vietnam
| | - Chalalai Rueanghiran
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - Aurélie Binot
- ASTRE, CIRAD, INRA, University Montpellier, Montpellier, France
| | - Flavie L Goutard
- Faculty Veterinary Medicine, Kasetsart University, Bangkok, Thailand.,ASTRE, CIRAD, INRA, University Montpellier, Montpellier, France
| | - Guy Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam.,Centre for Tropical Medicine and Global Health, Oxford University, Oxford, United Kingdom
| | - Juan Carrique-Mas
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam.,Centre for Tropical Medicine and Global Health, Oxford University, Oxford, United Kingdom
| | - Jonathan Rushton
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
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Mustafa K, Murray CC, Nicklin E, Glaser A, Andrews J. Understanding barriers for research involvement among paediatric trainees: a mixed methods study. BMC MEDICAL EDUCATION 2018; 18:165. [PMID: 30005649 PMCID: PMC6044020 DOI: 10.1186/s12909-018-1263-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 06/20/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Child Health research is reported to be at worryingly low level by the Royal College of Paediatrics and Child Health. Recent survey showed that 54.5% of paediatric consultants in the United Kingdom do not do any research at all. We conducted a mixed methods study to understand barriers and facilitators for research involvement among paediatric trainees who are going to fill these consultant posts in the future. METHODS A questionnaire based on a validated index for research and development was completed by 136 paediatric trainees within a region in the North of England (Yorkshire and Humber). Twelve semi-structured interviews were conducted with stratified purposive sampling. Descriptive statistics and Chi-Square test for independence were used for quantitative analysis. Thematic content analysis was done for interviews based on analysis method framework. RESULTS 136 out of 396 trainees responded to the survey. There was a significant relationship between confidence in using research in practice and ability to understand research terminology. This was not related to research experience or training. Males were significantly more likely to have presented a research paper, know how research influences practice and have more confidence in using research in practice than females. There was no significant relationship between gender and research training or highest qualification. Time constraints and lack of academic culture were the most frequently mentioned barriers in the survey. Over-arching themes identified from the interviews were related to lack of academic culture, opportunities provided in current training scheme and constraints related to time availability along with workforce management. CONCLUSION Paediatric research requires a supportive academic culture with more flexibility in training scheme and immediate attention to a pressing staffing crisis.
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Affiliation(s)
| | | | - Emma Nicklin
- Leeds Institute of Cancer and Pathology, Leeds, UK
| | - Adam Glaser
- University of Leeds, Leeds Institute of Cancer and Pathology,, Leeds, UK
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Ciacci C, Leandro G, Testoni PA. Gender equality in medicine: What do gastroenterologists from Italy think of it? Dig Liver Dis 2018; 50:725-727. [PMID: 29866629 DOI: 10.1016/j.dld.2018.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/06/2018] [Accepted: 04/10/2018] [Indexed: 12/11/2022]
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Alderson S, Foy R, Bryant L, Ahmed S, House A. Using Q-methodology to guide the implementation of new healthcare policies. BMJ Qual Saf 2018; 27:737-742. [DOI: 10.1136/bmjqs-2017-007380] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 02/28/2018] [Accepted: 03/15/2018] [Indexed: 11/04/2022]
Abstract
There are many challenges in the development, implementation and evaluation of healthcare policy. One challenge is understanding how different stakeholders view a particular policy and what impact these views may have during implementation. Q-methodology is one approach that can be used to help policy makers and researchers actively engage with those who are important in policy implementation, and anticipate their responses. Q-methodology combines qualitative and quantitative research methods to systematically explore and describe the range of viewpoints about a topic. Participants are required to rank a set of predefined statements relating to the topic, according to their own viewpoint. Factor analytic techniques then identify people who are like-minded in the way they view the topic and enable areas of consensus and divergence in viewpoint to be clearly defined. This mapping of viewpoints allows those working in policy implementation to anticipate likely barriers and levers in implementing new policies.
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