scholarly journals Gender Effects in Assessment of Clinical Teaching: Does Concordance Matter?

2020 ◽  
Vol 12 (6) ◽  
pp. 710-716
Author(s):  
Lynfa Stroud ◽  
Risa Freeman ◽  
Kulamakan Kulasegaram ◽  
Tulin D. Cil ◽  
Shiphra Ginsburg
Keyword(s):  
Internal Medicine ◽  
Family Medicine ◽  
Gender Bias ◽  
Clinical Teaching ◽  
Linear Regression Analysis ◽  
Gender Effects ◽  
Female Faculty ◽  
Global Rating ◽  
Gender Concordance ◽  
Male Faculty

ABSTRACT Background Gender bias is thought to exist in the assessment of clinical teachers, yet its extent in different specialties is not well-documented nor has it been studied at the individual-dyadic level. Objective The authors sought to determine whether gender bias exists in residents' assessments of faculty teaching in 3 clinical departments, and if present, whether this is influenced by gender concordance or discordance between the faculty and resident. Methods Residents' ratings of faculty in internal medicine (800 faculty, 5753 ratings), surgery (377, 2249), and family medicine (672, 3438) at the University of Toronto from 2016–2017 were analyzed using the overall global rating on a 5-point scale. A mixed-effects linear regression analysis accounted for nesting of ratings within each faculty member. Results Overall scores of teaching effectiveness showed a strong skew to favorable ratings for all faculty and a ceiling effect. However, gender effects differed across departments. In internal medicine (38.5% female faculty), no significant gender effects were detected. In surgery (16.2% female) and family medicine (53.0% female), male faculty received significantly higher scores than female faculty. In surgery this was driven by male residents giving male faculty higher ratings (4.46 vs 4.26, P < .001). In family medicine this was driven by male faculty receiving higher ratings regardless of resident gender (4.65 to 4.57, P < .001). Conclusions Although effects were very small and inconsistent, with gender concordance mattering only for one department, it suggests that gender is a meaningful source of variance in teaching assessments.

52. Simulation based training improves resident competence in the performance of critical resuscitation procedures

2007 ◽  
Vol 30 (4) ◽  
pp. 56
Author(s):  
I. Rigby ◽  
I. Walker ◽  
T. Donnon ◽  
D. Howes ◽  
J. Lord
Keyword(s):  
Internal Medicine ◽  
Emergency Medicine ◽  
Medical Education ◽  
Family Medicine ◽  
Training Program ◽  
Correlation Coefficient ◽  
Training Programs ◽  
Self Assessment ◽  
Procedural Skills ◽  
Simulation Based

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.

scholarly journals A collective case study of supervision and competence judgments on the inpatient internal medicine ward

2021 ◽  
Author(s):  
Tristen Gilchrist ◽  
Rose Hatala ◽  
Andrea Gingerich
Keyword(s):  
Internal Medicine ◽  
Clinical Supervision ◽  
Clinical Teaching ◽  
Senior Resident ◽  
Structured Interviews ◽  
Collective Case Study ◽  
Teaching Unit ◽  
Competency Based ◽  
Trainee Competence

Abstract Introduction Workplace-based assessment in competency-based medical education employs entrustment-supervision scales to suggest trainee competence. However, clinical supervision involves many factors and entrustment decision-making likely reflects more than trainee competence. We do not fully understand how a supervisor’s impression of trainee competence is reflected in their provision of clinical support. We must better understand this relationship to know whether documenting level of supervision truly reflects trainee competence. Methods We undertook a collective case study of supervisor-trainee dyads consisting of attending internal medicine physicians and senior residents working on clinical teaching unit inpatient wards. We conducted field observations of typical daily activities and semi-structured interviews. Data was analysed within each dyad and compared across dyads to identify supervisory behaviours, what triggered the behaviours, and how they related to judgments of trainee competence. Results Ten attending physician-senior resident dyads participated in the study. We identified eight distinct supervisory behaviours. The behaviours were enacted in response to trainee and non-trainee factors. Supervisory behaviours corresponded with varying assessments of trainee competence, even within a dyad. A change in the attending’s judgment of the resident’s competence did not always correspond with a change in subsequent observable supervisory behaviours. Discussion There was no consistent relationship between a trigger for supervision, the judgment of trainee competence, and subsequent supervisory behaviour. This has direct implications for entrustment assessments tying competence to supervisory behaviours, because supervision is complex. Workplace-based assessments that capture narrative data including the rationale for supervisory behaviours may lead to deeper insights than numeric entrustment ratings.

Psychosocial Beliefs of Medical Students Planning to Specialize in Family Medicine

1997 ◽  
Vol 80 (3) ◽  
pp. 987-992 ◽  
Author(s):  
Fred W. Markham ◽  
James J. Diamond
Keyword(s):  
Internal Medicine ◽  
Medical Students ◽  
Family Medicine ◽  
Family Physicians ◽  
Female Students ◽  
Further Training ◽  
Senior Year ◽  
Family Doctors ◽  
Fourth Year Medical Students ◽  
Belief Scale

The psychosocial orientation of fourth-year medical students planning careers in family medicine was compared to those selecting other specialities using the Physician Belief Scale. This scale has shown that practicing family physicians have a greater psychosocial orientation than those in other specialities such as internal medicine. The current study was done to see whether students choosing family medicine already have this greater orientation before they begin training as residents. 664 fourth-year medical students received surveys during their senior year and 378 (57%) returned completed surveys. Female students had a significantly greater psychosocial orientation than their male peers, but there were no significant differences between students planning residencies in family medicine and those selecting other residencies. The greater orientation of family doctors would appear to be a product of further training and experience either during residency or later during the actual practice of family medicine.

Contradicting findings of gender bias in teaching evaluations: Evidence from two experiments in Denmark

2021 ◽  
Author(s):  
Anne Skorkjær Binderkrantz ◽  
Mette Bisgaard ◽  
Berit Lassesen
Keyword(s):  
Gender Bias ◽  
Observational Studies ◽  
Experimental Studies ◽  
Gender Effects ◽  
Performance Evaluations ◽  
Student Evaluations Of Teaching ◽  
Teaching Evaluations ◽  
Public Sector Employees ◽  
Evaluation Of Teaching

The role of gender in the interaction between citizens and public sector employees attracts increasing attention. Notably, gender effects have been described in performance evaluations across different contexts. With respect to student evaluations of teaching, a series of observational studies as well as experimental studies have found that women are evaluated lower than men. In this paper, we conduct two experiments in Denmark to test whether a similar gender bias is present in a national context that is generally considered among the most gender equal. Study 1 investigates differences in the evaluation of two similar presentations by teachers reported to be either male or female. Study 2 focuses on the evaluation of teaching material prepared by men and women respectively. The two studies arrive at similar conclusions: There is no gender bias in favor of men in the evaluations made by students. The paper discusses the implications of these findings.

scholarly journals Out-of-Match Residency Offers: The Possible Extent and Implications of Prematching in Graduate Medical Education

2010 ◽  
Vol 2 (3) ◽  
pp. 327-333 ◽  
Author(s):  
Robert V. Wetz ◽  
Charles B. Seelig ◽  
Georges Khoueiry ◽  
Kera F. Weiserbs
Keyword(s):  
Internal Medicine ◽  
United States ◽  
Primary Care ◽  
Medical Education ◽  
Family Medicine ◽  
Rank Order ◽  
Medical Doctors ◽  
Spearman Rank ◽  
Fellowship Programs ◽  
Career Preferences

Abstract Background When the data from the National Resident Matching Program (NRMP) are used to analyze trends in medical students' career preferences, positions offered outside the match are omitted. The purpose of the study was to evaluate the extent and nature of out-of-match residency offers. Methods We obtained total resident complements and postgraduate year-1 positions offered in 7 specialties in 2007 and compared these with the 2007 NRMP match data. We compared the percentage of positions offered outside the match to “success” in matching United States medical doctors (USMDs) and to the availability of fellowship positions, using the Spearman rank order test (SROT). Results A total of 18 030 postgraduate year-1 positions were offered in 9 specialty areas. Of 15 205 positions offered in the match, 54% were taken by USMDs. The percentage of outside-the-match offers was found to vary by specialty, from 7% in obstetrics-gynecology to 23% in internal medicine, and was inversely correlated with the specialty's “success” in matching USMDs (SROT  =  −0.87). The 3 nonprocedural primary care specialties (internal medicine, family medicine, and pediatrics) accounted for 10 091 (46.2%) of the 21 845 total positions offered in the match, with 4401 (43.6%) offered almost entirely to non-USMDs. Another 2467 positions were offered outside the match, resulting in 6868 positions offered to non-USMDs (55% of all primary care positions). In internal medicine, the percentage of outside-the-match offers was significantly and inversely associated with the availability of intrainstitutional fellowship programs (P &lt; .0001). Prematching of independent applicants was significantly higher in primary care than in procedural-lifestyle programs (P &lt; .0001). Conclusion The NRMP's match data do not account for positions filled outside the match, a finding that appears to be significant. In 2007, 1 in 5 positions in primary care was offered outside the match.

scholarly journals Identifying and Remediating Quality Issues at Clinical Teaching Sites: A CERA Clerkship Directors Survey

2019 ◽  
Vol 51 (10) ◽  
pp. 811-816
Author(s):  
Joanna Drowos ◽  
Tomoko Sairenji ◽  
Kristen Hood Watson ◽  
Vanessa A. Diaz ◽  
Jasmine Pinckney ◽  
...  
Keyword(s):  
Family Medicine ◽  
Clinical Teaching ◽  
Medical Schools ◽  
Teaching Quality ◽  
Additional Time ◽  
Community Based ◽  
Medicine Clerkship ◽  
Education Leaders ◽  
Performance Challenges ◽  
Research Alliance

Background and Objectives: Family medicine clerkship directors must secure an adequate number of teaching sites while maintaining or improving the quality of teaching. This survey details how family medicine clerkship directors identify community-based clinical sites with performance challenges, types of challenges, and whether a remediation option exists for struggling clinical sites or preceptors. This study also investigates the relationship between clerkship structure and problems with maintaining high-quality teaching sites. Methods: Data were gathered and analyzed as part of the 2018 Council of Academic Family Medicine’s (CAFM) Educational Research Alliance (CERA) survey of family medicine clerkship directors. Results: There was a significant relationship between ease/difficulty of identifying clinical sites and paying preceptors (P=.032). A lower proportion of sites where a system is in place for remediation reported it being difficult to identify clinical sites (70.0% vs 92.2%, respectively, P=.011). Having a remediation system in place was also associated with less removal of sites (2.5% removed three or more sites vs 25% removed three or more sites, respectively, P=.005). Conclusions: Medical education leaders can explore payment to incentivize community-based preceptors in schools where identifying clinical sites is a challenge. Offering centralized preceptor development activities from medical schools, geared toward the importance of evaluations, balancing learners and opportunities for student engagement, may overcome some of the identified challenges. Medical schools may also consider providing additional time and support for clerkship directors to assist with tracking teaching quality at sites, and to assist struggling preceptors prior to removing them from teaching.

Optimism and Myths

PEDIATRICS ◽  
1983 ◽  
Vol 72 (4) ◽  
pp. 578-578
Author(s):  
JOSEPH W.ST. GEME
Keyword(s):  
Internal Medicine ◽  
Family Medicine ◽  
Family Physician ◽  
Clinical Competence ◽  
Educational Program ◽  
Clinical Performance ◽  
Point Of View

In Reply.— Klein expresses his point of view with clarity and intensity. That is important. I am optimistic about pediatrics and its future. That is important to me. I also believe that the optimism is reasonable. There is an increasing sense of competition between pediatrics and family medicine. The same seems to be true for internal medicine and family medicine. The competition in the spheres of educational program and clinical performance is healthy. We will continue to learn from each other and the roles of the pediatrician, internist, and family physician will evolve as a function of our knowledge, our clinical competence, the desires of our patients, and, perhaps, our enthusiasm about what we do.

scholarly journals Gender gap in medical research: a bibliometric study in Swiss university hospitals

2020 ◽  
Author(s):  
Paul Sebo ◽  
Sylvain de Lucia ◽  
Nathalie Vernaz
Keyword(s):  
Internal Medicine ◽  
Family Medicine ◽  
Medical Research ◽  
Gender Gap ◽  
Female Gender ◽  
Bibliometric Study ◽  
Gender Inequalities ◽  
University Hospitals ◽  
Female Physicians ◽  
Number Of Citations

Abstract Several studies explored gender inequalities in research, but only limited data are available concerning general internal medicine and family medicine. We aimed to assess the level of gender inequalities in Swiss academic medical research. In this bibliometric study conducted in March 2020, we selected all senior hospital physicians practicing internal medicine or family medicine in the six Swiss university hospitals. The list of these physicians was extracted from the hospitals’ websites. We recorded their socio-demographic characteristics. Then, using Web of Science, we retrieved the number of publications (overall, as first author, per year, per year as first author), the proportion of publications as first author, the number of citations (overall, per year, per publication) and the h-index, and we compared the data by gender. 367 senior physicians were included in the study [female physicians: 172 (47%), internal medicine: 187 (51%)]. Female physicians were four times less likely to be a professor (5% vs. 20%, p value < 0.001) and half as often heads of division or staff physicians (19% vs. 40%, p value < 0.001). The proportion of physicians having published at least one article was lower among women than men (79% vs. 90%, p value 0.003). Finally, all bibliometric indices were associated with male gender (incident rate ratios ranging from 1.9 [(95% CI 1.3–2.8), p value 0.001] for number of citations per publication to 9.3 [(95% CI 5.3–16.2), p value < 0.001] for number of citations), except the proportion of publications as first author that was associated with female gender [odds ratio 1.7 (95% CI 1.2–2.3), p value 0.003). Our data suggest a “leaky pipeline” phenomenon (a lower proportion of women moving up the academic ladder). In addition, with the exception of the proportion of publications as first author, all bibliometric indices were lower for female than male physicians.

Undergraduate Students’ Perceptions of Professors Concerning Academic Rules and Relations: Does Sex Matter?

2020 ◽  
Vol 201 (1) ◽  
pp. 28-33
Author(s):  
Ahmad Daghigh ◽  
Vahid Daghigh ◽  
Mohsen Niazi ◽  
David T. Morse
Keyword(s):  
Undergraduate Students ◽  
Middle Eastern ◽  
Educational Experience ◽  
Student Ratings ◽  
Complete Data ◽  
Female Faculty ◽  
Policy Communication ◽  
Main Effect ◽  
Male Faculty

A common metric in appraising the classroom and educational experience is student ratings of courses and faculty. Our purpose in this study was to investigate whether the ratings of faculty in a co-educational Middle Eastern university concerning observation of university rules and policy, communication with colleagues, and communication with students differ based on sex—both that of the faculty and that of the student furnishing the ratings. Data were collected from 847 undergraduate students at Kashan University, of whom 626 had complete data. Statistically significant, though small, differences were observed for the main effect of student sex (females>males on following rules) and female faculty were rated more highly than male faculty on following rules and relationships with students. No differences by student sex or faculty sex on relationships with colleagues were noted, nor was there an interaction of student sex and faculty sex on the ratings.

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