Carol Isaac

The effect of an intervention to break the gender bias habit for faculty at one institution: a cluster randomized, controlled trial.

Purpose Despite sincere commitment to egalitarian, meritocratic principles, subtle gender bias persists, constraining women’s opportunities for academic advancement. The authors implemented a pair-matched, single-blind, cluster randomized, controlled study of a gender-bias-habit-changing intervention at a large public university. Method Participants were faculty in 92 departments or divisions at the University of Wisconsin–Madison. Between September 2010 and March 2012, experimental departments were offered a gender-bias-habit-changing intervention as a 2.5-hour workshop. Surveys measured gender bias awareness; motivation, self-efficacy, and outcome expectations to reduce bias; and gender equity action. A timed word categorization task measured implicit gender/leadership bias. Faculty completed a work–life survey before and after all experimental departments received the intervention. Control departments were offered workshops after data were collected. Results Linear mixed-effects models showed significantly greater changes post intervention for faculty in experimental versus control departments on several outcome measures, including self-efficacy to engage in gender-equity-promoting behaviors (P = .013). When ≥ 25% of a department’s faculty attended the workshop (26 of 46 departments), significant increases in self-reported action to promote gender equity occurred at three months (P = .007). Post intervention, faculty in experimental departments expressed greater perceptions of fit (P = .024), valuing of their research (P = .019), and comfort in raising personal and professional conflicts (P = .025). Conclusions An intervention that facilitates intentional behavioral change can help faculty break the gender bias habit and change department climate in ways that should support the career advancement of women in academic medicine, science, and engineering.

Interventions That Affect Gender Bias in Hiring: A Systematic Review

Purpose To systematically review experimental evidence for interventions mitigating gender bias in employment. Unconscious endorsement of gender stereotypes can undermine academic medicines commitment to gender equity. Method The authors performed electronic and hand searches for randomized controlled studies since 1973 of interventions that affect gender differences in evaluation of job applicants. Twenty-seven studies met all inclusion criteria. Interventions fell into three categories: application information, applicant features, and rating conditions. Results The studies identified gender bias as the difference in ratings or perceptions of men and women with identical qualifications. Studies reaffirmed negative bias against women being evaluated for positions traditionally or predominantly held by men (male sex-typed jobs). The assessments of male and female raters rarely differed. Interventions that provided raters with clear evidence of job-relevant competencies were effective. However, clearly competent women were rated lower than equivalent men for male sex-typed jobs unless evidence of communal qualities was also provided. A commitment to the value of credentials before review of applicants and womens presence at above 25% of the applicant pool eliminated bias against women. Two studies found unconscious resistance to “antibias” training, which could be overcome with distraction or an intervening task. Explicit employment equity policies and an attractive appearance benefited men more than women, whereas repeated employment gaps were more detrimental to men. Masculine-scented perfume favored the hiring of both sexes. Negative bias occurred against women who expressed anger or who were perceived as self-promoting. Conclusions High-level evidence exists for strategies to mitigate gender bias in hiring.

EBM: evidence to practice and practice to evidence.

RATIONALE The purpose of this paper is to explore new perspectives about difficulties academicians may have communicating with clinicians, obtaining subjects, and gaining compliance for their research. AIMS AND OBJECTIVES Evidence-based medicine (EBM) has been defined as an integration of best research evidence, clinical expertise, and patient values; however, clinical observation and experience are placed last in the evidence hierarchy with the randomized controlled trial held as the standard for clinical intervention. This paper describes how the hierarchical model of power in the research community obstructs new areas of knowledge, and how clinicians create resistance. Methods Foucault gave new perspectives describing how power circulates through individuals within organizational discourse. Drawing on literature and experience, and using a framework based on postmodern theoretical concepts, this paper examines patterns of discourse, subjectivity, resistance, and power/knowledge within the physical therapy profession. RESULTS The hierarchical discourse of medical knowledge produces opposition rather than collaboration between researcher, clinician, and patient. Alleviating perceptions of dominance and creating connections produces cohesion within medical communities. CONCLUSIONS Evidence to practice and practice to evidence redefines EBM as a circular integration of best research evidence, clinical expertise, and patient values.

An Educational Intervention Designed to Increase Women's Leadership Self-Efficacy

Women are sparsely represented in leadership in academic science, technology, engineering, mathematics, and medicine (STEMM). Cultural stereotypes about men, women, and leaders influence the attitudes, judgments, and decisions that others make about women and the choices women make for themselves. Multilevel interventions are needed to counteract the impact of these pervasive and easily activated stereotypes, which conspire in multiple ways to constrain womens entry, persistence, and advancement in academic STEMM. We describe an individual-level educational intervention. Using the transtheoretical model of behavioral change as a framework, we assessed the success of a semester course on increasing womens leadership self-efficacy for the first three cohorts of course participants (n = 30). Pre/post questionnaires showed gains in leadership self-efficacy, personal mastery, and self-esteem, and decreases in perceived constraints. Qualitative text analysis of weekly journals indicated increasing leadership self-efficacy as course participants applied course information and integrated strategies to mitigate the impact of societal stereotypes into their own leadership practices. Follow-up queries of the first two cohorts supported the enduring value of course participation. We conclude that providing strategies to recognize and mitigate the impact of gender stereotypes is effective in increasing leadership self-efficacy in women at early stages of academic STEMM careers.

Women Deans: Leadership Becoming.

The term ‘leadership’ metaphorically embodies a gendered hierarchy of labour. In this study women deans’ values were found to be incongruent with the masculine discourse creating inner conflicts and alternative discourses. Data collected from 10 women deans from both male‐dominated and female‐dominated colleges were used to deconstruct leadership using a feminist poststructuralist perspective. Unlike a critical perspective, poststructuralism questions hierarchical relationships between knowledge and power, thus enabling us to understand leadership in differently shaded terms. The data portrays the multidimensional qualities of power and how women use power consciously and unconsciously to move within academic discourses.

Afraid of being "witchy with a 'b'": a qualitative study of how gender influences residents' experiences leading cardiopulmonary resuscitation.

Purpose Ineffective leadership during cardiopulmonary resuscitation (“code”) can negatively affect a patient’s likelihood of survival. In most teaching hospitals, internal medicine residents lead codes. In this study, the authors explored internal medicine residents’ experiences leading codes, with a particular focus on how gender influences the code leadership experience. Method The authors conducted individual, semistructured telephone or in-person interviews with 25 residents (May 2012 to February 2013) from 9 U.S. internal medicine residency programs. They audio recorded and transcribed the interviews and then thematically analyzed the transcribed text. Results Participants viewed a successful code as one with effective leadership. They agreed that the ideal code leader was an authoritative presence; spoke with a deep, loud voice; used clear, direct communication; and appeared calm. Although equally able to lead codes as their male colleagues, female participants described feeling stress from having to violate gender behavioral norms in the role of code leader. In response, some female participants adopted rituals to signal the suspension of gender norms while leading a code. Others apologized afterwards for their counternormative behavior. Conclusions Ideal code leadership embodies highly agentic, stereotypical male behaviors. Female residents employed strategies to better integrate the competing identities of code leader and female gender. In the future, residency training should acknowledge how female gender stereotypes may conflict with the behaviors required to enact code leadership and offer some strategies, such as those used by the female residents in this study, to help women integrate these dual identities.

By Their Own Hand: Irreconcilable Silence

The word suicide takes on a life of its own. People are both repulsed and intrigued by the word and the silence it brings. Those who survive a loved ones suicide face the inherent contradictions that exist in society: a mixture of sympathy and disgust, spectacle and removal. The authors sister was a clinical neurologist working at a well-known, top-tier medical institution who committed suicide in reaction to thwarted efforts to obtain a tenured position. As a result, the author faced within herself a mixture of horror and wonder, isolation and community, and anger and stillness. A survivors grief has no structure, and feelings and thoughts meander without rhyme or reason like the primitive rhizome as an uncovered memory constantly stops in the middle and unfolds to another. This autoethnographic article explores Deleuze and Guattaris oppositional binaries and the authors compelling need to search the silence.

A Poetic Representation: Women in Medicine Are “Able to”

The purpose of letters of recommendation is to accentuate the positive attributes of candidates. An archival study examined 291 medical students’ performance evaluations (MSPEs) for male and female medical students written by male and female associate deans of medicine for a highly competitive radiology residency in the Northeast United States. This poetic representation illustrates the author’s emotion to the audience after grappling with disturbing results from the data analysis (Richardson, 2003). Interpretations of the data through a poststructural feminist lens draw on the complexity of the language that remains a constitutive force illustrating reality. “Competent,” part of the Merriam-Webster’s definition of “able,” has a gendered masculine nuance. Even though women physicians represent almost 50% of medical school graduates, there remains questions of what they are “able to” do.

Hospital safety: perceptual paradox

Abstract Objective This purpose of this case study was to assess how a medicine/surgery unit patients and nursing staff in the southeast United States perceived patient safety in comparison with US federal patient safety goals. Method Researchers verbally administered 3 rating scales (0–10) and 21 open-ended questions to 45 patients. Their responses were recorded verbatim and inductively analysed. Ten unit RNs filled out a survey with 18 open-ended questions with 1 rating scale (0-10). Results Using a 10-point scale, patients rated the average degree of control over their care as 7.29 and facility safety as 8.74 while nurses rated their degree of control as 6.6 and facility safety at 7.2. 80% of patients but only 20% of nurses described their response time to call lights in a specific number of minutes with 20% of patients reporting a wait time of greater than 30 minutes. Patient themes included medical errors, concerns about not being heard, lack of knowledge regarding safety, and passivity. Nursing staff themes included reporting errors, call light response, and expectations for patient participation. Conclusions This exploratory study supports previous research and depicts how hospital patients and nurses perceive care and safety differently. Of importance, patients possess little understanding of hospital safety creating a paradox of patient dependency.