Merlynn R. Bergen

Career advancement for women faculty in a U.S. school of medicine: perceived needs.

Purpose. The percentage of women faculty at the professor level has remained at approximately 11%. The medical community could benefit from knowing what is required to attract, retain, and advance women in the academy. Method. The Committee on Women in Medicine and Science at Stanford University School of Medicine was charged with improving career success and well-being of women faculty. In 2001–02, a survey instrument including both needs and perceived school climate was sent to 309 women faculty. Responses were analyzed using one-way analyses of variance with Tukey follow-up tests. Results. A total of 163 (53%) faculty responded. The highest ranked needs were a flexible work environment without negative consequences for women with young children (mean = 4.37 on a five-point scale); a three-month sabbatical from clinical and administrative duties (mean = 4.15); departmental mentoring for academic career development (mean = 4.13); and school/departmental administrative secretarial support for grant and manuscript preparation (mean = 4.11). Climate data obtained in 2002, compared to data from similar surveys in 1994 and 1995, showed a nonsignificant decrease in mean ratings for sexual harassment, gender discrimination, and gender insensitivity in the intervening years. Mean ratings for positive climate and cohesion increased between 1994 and 1995 but remained stable from 1995 to 2002. Results of the survey were presented to the dean, faculty, and staff of the medical school. Conclusion. Women faculty members were able to clearly indicate specific interventions that would improve their career success and sense of well-being. Since administrators are committed to serious consideration of these recommendations, this was a key step in advancing womens careers in academic medicine at Stanford.

The Stanford faculty development program: A dissemination approach to faculty development for medical teachers

The Stanford Faculty Development Program, designed to improve the instructional skills of clinical teachers, uses a dissemination model to provide faculty development activities for medical schools across the country. Selected clinical faculty attend a month‐long training program at Stanford University Medical Center and then return to their home institutions to conduct seminars for their fellow faculty and for residents in one of three content areas: (a) principles and skills of clinical teaching, (b) the teaching of medical decision making, or (c) the teaching of clinical preventive medicine. Faculty from institutions affiliated with over one quarter of U.S. medical schools have participated in the program. From 1986 through 1991, the program has trained 67 seminar facilitators from 47 institutions who have then conducted training for over 500 faculty and 200 residents. The extent of dissemination indicates that this approach provides a feasible mechanism for delivering faculty development in a wide var...

Impact of a program to diminish gender insensitivity and sexual harassment at a medical school.

Purpose To measure the effect of an intervention to reduce gender insensitivity and sexual harassment at one medical school. Method Stanford University School of Medicine undertook a multifaceted program to educate faculty and students regarding gender issues and to diminish sexual harassment. The authors developed a survey instrument to assess the facultys perceptions regarding environment (five scales) and incidences of sexual harassment. Faculty were surveyed twice during the interventions (1994 and 1995). Results Between the two years, the authors measured significant improvements in mean ratings for positive climate (p =.004) and cohesion (p =.006) and decreases in the facultys perceptions of sexual harassment (p = 0006), gender insensitivity (p =.001), and gender discrimination (p =.004). The faculty also reported fewer observations of harassing behavior during the study period. Conclusions An intervention program to diminish gender insensitivity and sexual harassment can measurably improve a medical schools environment.

Impact of a clinical preventive medicine curriculum for primary care faculty: Results of a dissemination model

BACKGROUND This study was designed to test a dissemination model for providing clinical preventive medicine (CPM) training to general internal medicine faculty across the United States. METHODS The model incorporated direct instruction of a few faculty as seminar facilitators who, in turn, taught a CPM curriculum to their faculty colleagues, who then could teach it to housestaff and students. The CPM curriculum consisted of six seminars that focused primarily on the risk factors for chronic diseases and on behavior change methods for modifying smoking, diet, and exercise. RESULTS Faculty who participated in the seminars had significant pre- to post-test increase in knowledge and reported self-efficacy to implement CPM strategies with patients, as well as changes in CPM clinical practices. These faculty, in turn, successfully disseminated CPM information to their housestaff, who also had increases in self-efficacy and changed clinical practices regarding CPM topics. CONCLUSIONS The successful implementation of the dissemination model attests to its viability as a mechanism for disseminating CPM curricula and increasing the emphasis on CMP issues in both clinical teaching and clinical encounters with patients.

Embedding Faculty Development in Teaching Hospitals

In this issue of the Journal of General Internal Medicine, Clark et al. present valuable data on the spread of faculty development (FD) programs in U.S. teaching hospitals.1 Their findings indicate moderate diffusion, with 39% of hospitals having “ongoing” programs. The results also show significant institutional barriers to FD. Current FD efforts can be largely attributed to the internal motivation and dedication of faculty to the FD mission. However admirable, individual motivation will not be sufficient in the current academic environment to spur greater efforts to improve teaching excellence.2 For FD on teaching to become integral to departments of medicine, we must both increase awareness of the potential for FD to benefit faculty and their institutions, and establish a research agenda to guide FD policy and practice. Teaching improvement appears inconsistently valued by schools and departments. From interviews with the facilitators we have trained at the Stanford Faculty Development Center, we know that the participants and content of FD activities can remain under-recognized, if not invisible, to key administrators. It is incumbent upon faculty developers to more effectively publicize their programs’ potential benefits and outcomes. From an historical point of view, the time may be right for institutions to implement FD on teaching—gaining benefits directly relevant to their patient care and research missions. With national attention focused on physician professionalism, patient safety, and even new approaches to training medical scientists, the success of prior medical education methods must be brought into question.3–5 The need for more effective teaching is clear. In our own experience, we have seen FD participants show greater commitment to specific areas of clinical care (e.g., geriatrics and palliative care), stronger dedication to institutional improvement, and increased involvement in scholarly activities (e.g., research, publication, and self-directed learning). We also have seen FD participants acquire more positive attitudes toward their role as clinician-educators. Further demonstration of such benefits in todays climate can lead to increased recognition of the utility of FD, and thereby, greater institutional support. This survey also provides a stimulus for continued research on faculty development. A broad-based FD research agenda for contemporary academic medicine is needed to understand the effects of context, process, topics, and types of participating faculty on FD outcomes. New research is needed because the current depth and rate of institutional change may yield results that differ from prior research.

A Climate Survey for Medical Students A Means to Assess Change

An instrument was developed to assess the perceptions of students regarding six aspects of school climate and their experience of and attitudes toward sexual harassment and gender insensitivity. During clerkship orientation, 77 students (92% return rate), half female, were given the survey. Cronbach alpha reliabilities for the six scales ranged from .71 to .85. One significant female/male difference among the three scales of general school climate was observed; two signizfcantfemale/ male differences occurred among the three scales relating to gender concerns. Seventy percent of both males and females reported having observed sexually harassing behavior during the previous year; 46% offemales and 15% of males reported experiencing sexually harassing behavior during the year Observing and/or personally experiencing sexual harassment was associated with a decrease in positive climate ratings and an increase in negative climate ratings.

Feasibility of Incorporating Alternative Teaching Methods into Clinical Clerkships.

Current pressures on medical education mandate a search for more efficient, effective methods of clinical teaching. Most clinical clerkships rely on teaching through patient‐based experience. In this study, we investigated the feasibility of using alternative methods, such as computer‐assisted instruction, videodisc, and videotape, to complement patient‐based experience in outpatient clerkships. Seventeen medical students completed modules on diabetes and hypertension using such alternative methods during clinical rotations. Results of a preintervention‐postintervention evaluation included (a) increased interest among students in a more balanced distribution of clerkship time between patients and alternative teaching methods, (b) significantly increased self‐assessments of knowledge, and (c) significant gains on knowledge test. In‐depth interviews with 13 participants revealed positive attitudes toward the alternative curriculum, particularly its capacity to augment teaching by attending physicians and pr...

Comparison of clinical teaching by residents and attending physicians in inpatient and lecture settings

We examined the differences between the clinical teaching of 21 residents and 19 attending physicians in one of two settings. Participants completed self‐assessments and were videotaped in either inpatient rounds or lectures. The videotapes were rated using the Clinical Teaching Observational Rating Scale. Teacher (Resident, Attending Physician) x Setting (Inpatient, Lecture) between‐subjects analyses of variance of videotape ratings showed that (a) attending physicians and residents generally received similar ratings; (b) when ratings were significantly different, faculty ratings were higher than residents’ ratings; and (c) setting was a significant source of variance for five of seven educational categories. There were no significant differences between residents’ and attending physicians’ self‐assessments of their clinical teaching. We concluded that (a) teaching improvement methods should acknowledge the influence of teaching experience and setting on teaching performance, and (b) residents and facult...

A sexual harassment workshop for medical students.

No abstract available.