Centering Matrices of Domination: Steps Toward a More Intersectional Vocational Psychology

2021 ◽  
pp. 106907272110291
Author(s):  
Melanie Elyse Brewster ◽  
David Alejandro López Molina
Keyword(s):  
White Supremacy ◽  
Research Training ◽  
Clinical Work ◽  
Vocational Psychology ◽  
Protestant Work Ethic ◽  
Diverse Populations ◽  
Prosperity Gospel ◽  
Working Lives ◽  
Close Analysis ◽  
The Impact

The present paper responds to calls to integrate a more explicitly intersectional framework and agenda to vocational psychology. We elucidate how several matrices of domination (i.e., interlocking systems of oppression) may shape the working lives of Americans. Although vocational psychology has made limited progress in exploring two such matrices—the impact of White supremacy and Patriarchy—and expanding research, theory, and clinical work to increasingly diverse populations, we argue that other oppressive systemic forces have been largely overlooked. In response to this gap, a close analysis of how our economic system (i.e., late-stage capitalism, neoliberalism) and Christian hegemony (i.e., protestant work ethic, the prosperity gospel) have impacted the workforce is provided. Finally, to center intersectional perspectives on change, we argue that vocational psychology must pivot to a more activist stance and provide recommendations for research, training, and clinical work.

scholarly journals Measuring the Impact of COVID-19 on Hematology-Oncology Trainees: A Quantitative and Qualitative Assessment

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 20-21
Author(s):  
Urshila Durani ◽  
Ana I. Velazquez Manana ◽  
Jori May ◽  
Marquita Nelson ◽  
Ze Zheng ◽  
...  
Keyword(s):  
Mental Health ◽  
Family Member ◽  
Research Training ◽  
Health Resources ◽  
Clinical Work ◽  
Well Being ◽  
Learning Opportunities ◽  
Stock Ownership ◽  
American Society ◽  
The Impact

Introduction: While the COVID-19 pandemic has affected many aspects of clinical care, research, and medical training, its impact on hematology-oncology trainees and professional development has not been described. The American Society of Hematology (ASH) and the American Society of Clinical Oncology (ASCO) sought to assess the impact of COVID-19 on fellows enrolled in hematology-oncology programs. Methods: In spring 2020, ASH and ASCO developed and administered a survey by e-mail to active hematology-oncology fellow members. Response formats used both a semi-Likert scale and open-ended text. Questions focused on fellow experiences and how changes in their programs have impacted their personal and professional lives across several domains. Multiple-choice responses were analyzed using descriptive statistics, and NVivo software was used for qualitative analysis of open-ended questions. Results: Respondent demographics are described in Table 1. Of 2,306 trainees, 620 (27%) responded to the survey. Most respondents continued patient care responsibilities during the pandemic (80%). Almost half of all trainees (47%) reported that they felt less productive than usual. Stress and/or anxiety about the current situation was the most cited factor affecting productivity in the overall cohort (Figure 1). One-third (33%) of respondents had volunteered or were assigned to clinical/non-clinical COVID-19-related efforts. Of the 90 visa holders in our cohort, 30% (N=27) reported experiencing issues with their visa/immigration status. Eight percent of respondents stated their career plans had changed due to COVID-19. Of those who said their plans had changed, 30 respondents were considering careers in academia pre-pandemic and 11 were considering private practice. However, only 14 respondents were considering academia post-pandemic while 19 were interested in private practice. Overall, most respondents had concerns about at least one of the following: salary reductions, availability of networking events, family well-being, mental health and obtaining a job (Figure 2). The prevalence of burnout increased from 22% (N=105) before the pandemic to 33% (N=161) during (p<.001). Of the respondents who did not report burnout before COVID-19, 22% noted new-onset burnout during the pandemic. New-onset burnout prevalence varied based on the type of work respondents performed: no COVID-related work (17%), COVID-related non-clinical work (26%), and COVID-related clinical work (34%) (p<0.01). The open-ended responses yielded several consistent themes. Clinical and educational constraints were enumerated: lost learning opportunities due to low patient volumes, unavailability of colleagues to discuss cases, and overall low perceived quality of virtual learning. Trainees also reported reduced motivation to complete work within a stipulated time frame due to lack of robust discussions in the virtual environment and technological challenges in navigating educational resources. Trainee research was also severely impacted as laboratories closed, experimental animal colonies were lost, and many research activities ceased. Respondents also expressed concern that cuts in research training initiatives and budgets would jeopardize faculty positions for graduating fellows and that funding for travel and conferences was suspended. Fellows' recommendations for ASH and ASCO included improved online education, virtual research training and networking opportunities, practical guidance on caring for immune-compromised patients during the pandemic, increased funding resources for trainees, mental health resources, and advocating on behalf of trainee visa holders. Conclusions: Hematology-oncology trainees reported their training experiences have been deeply impacted by the COVID-19 pandemic. A majority of trainees are concerned about the negative impact on career opportunities, research funding, financial well-being, and mental health. Burnout increased during COVID-19, especially in trainees who were assigned to specific COVID-related efforts. Training programs and professional societies can support trainees by increasing trainee research funding, online networking and learning opportunities, mental health resources and, support for international trainees. Disclosures Velazquez Manana: Corbus Pharmaceuticals: Other: Immediate family member stock ownership; Portola Pharmaceuticals: Other: Immediate family member stock ownership; Midatech: Other: Immediate family member stock ownership. Wun:Glycomimetics, Inc.: Consultancy.

scholarly journals How does the outcome of research training fellowships funded via the NHS compare with that from competitively funded fellowships from the MRC and other charities: a cross-sectional retrospective survey of trainees undertaking research training in the West Midlands

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019630
Author(s):  
Charlotte Maybury ◽  
Matthew David Morgan ◽  
Russell Smith ◽  
Lorraine Harper
Keyword(s):  
Clinical Training ◽  
Online Survey ◽  
Research Training ◽  
Clinical Care ◽  
Clinical Work ◽  
Research Experience ◽  
The West ◽  
Cross Sectional ◽  
West Midlands ◽  
The Impact

ObjectivesThis study aimed to investigate the impact of research training funded via the National Health Service (NHS) on medical trainees compared with traditional clinical research training fellowships (CRTFs).Design, setting and participantsOnline survey of 221 clinical trainees who had completed a period of research during their clinical training between 2009 and 2015 in the West Midlands.Main outcome measuresResearch outcomes.ResultsOverall response rate was 59%, of whom 72 participants were funded by CRTFs and 51 funded by the NHS. Although participants with CRTFs were more likely to be awarded a higher degree compared with those on NHS-administered funding (66/72 CRTFs and 37/51 NHS, P=0.005), similar proportions of NHS-funded and CRTF-funded participants entered clinical lecturer posts on completing initial research training (8/51 NHS and 16/72 CRTF, P=0.37). 77% of participants had three or more publications (CRTF 57 and NHS 39, P=0.72). 57 participants had completed clinical training; similar proportions of CRTF-funded and NHS-funded trainees had research included in their consultant contract (12/22 NHS and 14/26 CRTF, P=0.96) or were appointed to academic posts (3 of 25 NHS funded and 6 of 32 CRTF, P>0.05). 95% of participants would recommend to colleagues and 82% of participants felt the research experience improved their provision of clinical care with no difference between CRTF-funded and NHS-funded participants (P=0.49). Continuing to participate in clinical work during the research reduced reports of trainee difficulty on returning to clinical work (23/108 continued clinical work vs 12/22 no clinical work, P=0.001).ConclusionResearch training funded by the NHS provides a quality experience and contributes to the clinical academic capacity within the UK. More needs to be done to support NHS participants to successfully achieve a higher degree.

“Scrap-Heap Storiesˮ: Oral Narratives of Labour and Loss in Scottish Mining and Manufacturing

2020 ◽  
Vol 31 (2-2018) ◽  
pp. 8-21
Author(s):  
Arthur McIvor
Keyword(s):  
Working Class ◽  
Lived Experience ◽  
Oral History ◽  
Job Loss ◽  
Sense Of Self ◽  
Oral Narratives ◽  
Industrial Work ◽  
Working Lives ◽  
Plant Closures ◽  
The Impact

This article is an attempt to comprehend deindustrialisation and the impact of plant downsizing and closures in Scotland since the 1970s through listening to the voices of workers and reflecting on their ways of telling, whilst making some observations on how an oral history methodology can add to our understanding. It draws upon a rich bounty of oral history projects and collections undertaken in Scotland over recent decades. The lush description and often intense articulated emotion help us as academic “outsidersˮ to better understand how lives were profoundly affected by plant closures, getting us beyond statistical body counts and overly sentimentalised and nostalgic representations of industrial work to more nuanced understandings of the meanings and impacts of job loss. In recalling their lived experience of plant run-downs and closures, narrators are informing and interpreting; projecting a sense of self in the process and drawing meaning from their working lives. My argument here is that we need to listen attentively and learn from those who bore witness and try to make sense of these diverse, different and sometimes contradictory stories. We should take cognisance of silences and transgressing voices as well as dominant, hegemonic narratives if we are to deepen the conversation and understand the complex but profound impacts that deindustrialisation had on traditional working-class communities in Scotland, as well as elsewhere.

scholarly journals AB0142 SOCIOECONOMIC STATUS (SES) AND MEDICATION USE IN RHEUMATOID ARTHRITIS (RA): A SCOPING REVIEW

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1098.2-1099
Author(s):  
O. Russell ◽  
S. Lester ◽  
R. Black ◽  
C. Hill
Keyword(s):  
Rheumatoid Arthritis ◽  
Socioeconomic Status ◽  
Scoping Review ◽  
Research Training ◽  
Medication Use ◽  
Study Group ◽  
Knowledge Gaps ◽  
Coverage Area ◽  
Race Ethnicity ◽  
The Impact

Background:Socioeconomic status (SES) influences disease outcomes in rheumatoid arthritis (RA) patients. (1, 2) Differences in medication use could partly explain this association. (3) A scoping review was used to identify research conducted on this topic and determine what knowledge gaps remain.Objectives:To determine what research has been conducted on this topic, how this research has defined SES and medication use, and establish what knowledge gaps remain.Methods:MEDLINE, EMBASE and PsychInfo were searched from their inception until May 2019 for studies which assessed SES and medication use as outcome variables. Studies were included if they measured medication use and incorporated an SES measure as a comparator variable.SES was defined using any of the “PROGRESS” framework variables (4) including patients’ stated gender, age, educational attainment, employment, occupational class, personal income, marital status, health insurance coverage, area- (neighbourhood) level SES, or patients’ stated race and/or ethnicity. Medication use was broadly defined as either prescription or dispensation of a medicine, medication adherence, or delays in treatment. Data was extracted on studies’ primary objectives, measurement of specific SES measures, patients’ medication use, and whether studies assessed for differences in patients’ medication use according to SES variables.Results:1464 studies were identified by this search from which 74 studies were selected for inclusion, including 52 published articles. Studies’ publication year ranged from 1994-2019, and originated from 20 countries; most commonly from the USA.Studies measured a median of 4 SES variables (IQR 3-6), with educational achievement, area level SES and race/ethnicity the most frequently recorded.Likelihood of disease modifying antirheumatic drug (DMARD) prescription was the most frequent primary objective recorded.96% of studies reported on patients’ use of DMARDs, with glucocorticoids and analgesics being reported in fewer studies (51% and 23% respectively.)Most included studies found at least one SES measure to be significantly associated with differences in patients’ medication use. In some studies, however, this result was not necessarily drawn from the primary outcome and therefore may not have been adjusted for covariates.70% of published studies measuring patients’ income (n=14 of 20) and 58% of those that measured race/ethnicity (n=14 of 24) documented significant differences in patients’ medication use according to these SES variables, although the direction of this effect – whether it led to ‘greater’ or ‘lesser’ medication use – varied between studies.Conclusion:Multiple definitions of SES are used in studies of medication use in RA patients. Despite this, most identified studies found evidence of a difference in medication use by patient groups that differed by an SES variable, although how medication use differed was found to vary between studies. This latter observation may relate to contextual factors pertaining to differences in countries’ healthcare systems. Further prospective studies with clearly defined SES and medication use measures may help confirm the apparent association between SES and differences in medication use.References:[1]Jacobi CE, Mol GD, Boshuizen HC, Rupp I, Dinant HJ, Van Den Bos GA. Impact of socioeconomic status on the course of rheumatoid arthritis and on related use of health care services. Arthritis Rheum. 2003;49(4):567-73.[2]ERAS Study Group. Socioeconomic deprivation and rheumatoid disease: what lessons for the health service? ERAS Study Group. Early Rheumatoid Arthritis Study. Annals of the rheumatic diseases. 2000;59(10):794-9.[3]Verstappen SMM. The impact of socio-economic status in rheumatoid arthritis. Rheumatology (Oxford). 2017;56(7):1051-2.[4]O’Neill J, Tabish H, Welch V, Petticrew M, Pottie K, Clarke M, et al. Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health. J Clin Epidemiol. 2014;67(1):56-64.Acknowledgements:This research was supported by an Australian Government Research Training Program Scholarship.Disclosure of Interests:None declared

scholarly journals The use of text mining to detect key shifts in Japanese first-year medical student professional identity formation through early exposure to non-healthcare hospital staff

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yayoi Shikama ◽  
Yasuko Chiba ◽  
Megumi Yasuda ◽  
Maham Stanyon ◽  
Koji Otani
Keyword(s):  
Text Mining ◽  
Professional Identity ◽  
Identity Formation ◽  
Role Models ◽  
Healthcare Professionals ◽  
Clinical Work ◽  
Working Environment ◽  
First Year ◽  
Professional Identity Formation ◽  
The Impact

Abstract Background Professional identity formation is nurtured through socialization, driven by interaction with role models, and supported through early clinical exposure (ECE) programmes. Non-healthcare professionals form part of the hospital community but are external to the culture of medicine, with their potential as role models unexplored. We employed text mining of student reflective assignments to explore the impact of socialization with non-healthcare professionals during ECE. Methods Assignments from 259 first-year medical students at Fukushima Medical University, Japan, underwent hierarchical cluster analysis. Interrelationships between the most-frequently-occurring words were analysed to create coding rules, which were applied to elucidate underlying themes. Results A shift in terms describing professional characteristics was detected, from “knowledge/skill” towards “pride [in one’s work]” and “responsibility”. Seven themes emerged: contribution of non-healthcare professionals, diversity of occupation, pride, responsibility, teamwork, patient care and gratitude. Students mentioning ‘contribution of non-healthcare professionals’ spoke of altruistic dedication and strong sense of purpose. These students expressed gratitude towards non-healthcare professionals for supporting clinical work, from a doctor’s perspective. Conclusion Socialization with non-healthcare professionals provides important insights into the hospital working environment and cultural working norms. Through role modelling altruism and responsibility, non-healthcare professionals positively influenced student professional identity formation, promoting self-conceptualisation as a doctor.

Native language identification and writing proficiency

2015 ◽  
Vol 1 (2) ◽  
pp. 187-209 ◽  
Author(s):  
Kristopher Kyle ◽  
Scott A. Crossley ◽  
YouJin Kim
Keyword(s):  
Group Membership ◽  
Native Language ◽  
Multinomial Logistic Regression ◽  
First Language ◽  
Language Identification ◽  
Writing Proficiency ◽  
Proficiency Levels ◽  
Close Analysis ◽  
The Impact ◽  
The Relationship

This study evaluates the impact of writing proficiency on native language identification (NLI), a topic that has important implications for the generalizability of NLI models and detection-based arguments for cross-linguistic influence (Jarvis 2010, 2012; CLI). The study uses multinomial logistic regression to classify the first language (L1) group membership of essays at two proficiency levels based on systematic lexical and phrasal choices made by members of five L1 groups. The results indicate that lower proficiency essays are significantly easier to classify than higher proficiency essays, suggesting that lower proficiency writers make lexical and phrasal choices that are more similar to other lower proficiency writers that share an L1 than higher proficiency writers that share an L1. A close analysis of the findings also indicates that the relationship between NLI accuracy and proficiency differed across L1 groups.

scholarly journals Impact of COVID-19 on post graduate medical education and training

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sharon C. Enujioke ◽  
Kimberly McBrayer ◽  
Katherine C. Soe ◽  
Teresa M. Imburgia ◽  
Cynthia Robbins
Keyword(s):  
Mental Health ◽  
Clinical Work ◽  
Well Being ◽  
Training Experience ◽  
Equal Distribution ◽  
Institutional Review ◽  
Medical Education And Training ◽  
Home Work ◽  
Novel Coronavirus ◽  
The Impact

Abstract Purpose The novel Coronavirus Disease 19 (COVID-19) has had a significant impact worldwide that led to changes in healthcare. The purpose of this study was to evaluate the effect of the COVID-19 pandemic on trainee’s mental health and educational preparedness. Methods Trainees at the Indiana University School of Medicine were surveyed regarding the impact of the COVID-19 pandemic on their training. Using a Likert scale, participants were asked questions pertaining to educational preparedness, mental health, and clinical work during the pandemic. Data was analyzed using SPSS version 27. The study was approved as exempt by the Institutional review Board (IRB). Results 324 of the 1204 trainees responded to the survey. The respondents were 76% white with an equal distribution of males and females. A majority of the respondents were first year residents with an equal distribution of second, third, and fourth year residents. Twenty-three percent of respondents were in a procedural residency or fellowship program. Better perceived educational preparedness was associated with an improved home-work balance during COVID-19 (β = 0.506, p < 0.0001) and having a department that advocated/supported focus on mental health during COVID-19 (β = 0.177, p < 0.0001). Worse perceived educational preparedness was associated with being in procedural vs. non-procedural dominant training program (β = − 0.122, p = 0.01). Conclusion COVID-19 has had a significant impact on the training experience of residents and fellows. Departmental support increased mental well-being and perceived education preparedness in trainees. Trainees that felt they had a better home-work life balance had better educational preparedness compared to their peers. Also, trainees in procedural programs had less educational preparedness compared to their peers in non-procedural programs. This study highlights the importance for programs to find avenues to increase educational preparedness in their trainees while being attuned to the mental health of their trainees.

scholarly journals ‘Stressed, uncomfortable, vulnerable, neglected’: a qualitative study of the psychological and social impact of the COVID-19 pandemic on UK frontline keyworkers.

2021 ◽  
Author(s):  
Tom May ◽  
Henry Aughterson ◽  
Daisy Fancourt ◽  
Alexandra Burton
Keyword(s):  
Social Impact ◽  
Work Conditions ◽  
Structured Interviews ◽  
Work Related ◽  
Health And Wellbeing ◽  
Working Lives ◽  
Psychosocial Concerns ◽  
Postal Services ◽  
Exposure Risks ◽  
The Impact

Aims: Non-healthcare keyworkers face distinct occupational vulnerabilities that have received little consideration within broader debates about ‘essential’ work and psychological distress during the COVID-19 pandemic. The aim of this study was therefore to explore the impact of the pandemic on the working lives and mental health and wellbeing of non-healthcare keyworkers in the UK.Methods: In-depth, semi-structured interviews were conducted with 23 participants employed in a range of non-healthcare keyworker occupations, including transport, retail, education, postal services and the police force. Interviews were audio-recorded and transcribed verbatim. Data were analysed using a reflexive thematic approach. Results: Keyworkers experienced adverse psychological effects during the COVID-19 pandemic, including fears of COVID-19 exposure, contagion and subsequent transmission to others, especially their families. These concerns were often experienced in the context of multiple exposure risks, including insufficient PPE and a lack of workplace mitigation practices. Keyworkers also described multiple work-related challenges, including increased workload, a lack of public and organisational recognition and feelings of disempowerment. Conclusion: In efforts to reduce psychosocial concerns among non-healthcare keyworkers, there is a need for appropriate support during the COVID-19 pandemic and in preparation for other infections (e.g. seasonal influenza) in the future. This includes the provision of psychological and workplace measures attending to the intersections of personal vulnerability and work conditions that cause unique risks and challenges among those in frontline keyworker occupations.

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