{"id":11206,"date":"2018-07-12T07:00:59","date_gmt":"2018-07-12T12:00:59","guid":{"rendered":"https:\/\/feminem.org\/?p=11206"},"modified":"2018-07-02T17:55:22","modified_gmt":"2018-07-02T22:55:22","slug":"gender-medical-education-part-3","status":"publish","type":"post","link":"https:\/\/feminem.org\/2018\/07\/12\/gender-medical-education-part-3\/","title":{"rendered":"Gender & Medical Education – Part 3"},"content":{"rendered":"

Editor’s Note: This is the third in a three part series.<\/em><\/p>\n

Evaluations show conflict related to gender, but do those conflicts occur in our clinical practice?\u00a0Decidedly YES!\u00a0 As a resident running a code, I learned to swaddle my commands for epinephrine or resuming CPR with please and thank you.\u00a0 I delivered them gingerly, without any angst in my voice, despite the person DYING in front of me.\u00a0 When I became an attending, I watched one of my strongest female residents run a resuscitation.\u00a0 I noticed her voice changed.\u00a0 Her normally faint southern accent became thick and syrupy.\u00a0 I pulled her aside after and asked her if it was intentional.\u00a0It was.\u00a0 She had learned to thicken her accent to make her commands sound \u201csweeter\u201d to the nurses.\u00a0 Recently, a study of internal medicine residents confirmed what I had been witnessing in my own medical education and the education of my female residents.\u00a0Gender stereotypes can influence how we run a code, how we save lives.\u00a0 This study, titled \u201cAfraid of being witchy with a \u2018B\u2019\u201d by Kolehmainen et al. looked at the character traits associated with ideal code leadership, finding them to be decidedly \u201cagentic\u201d.\u00a0 Code leaders were assertive and authoritative, standing tall at the foot of the bed while calmly and emotionlessly orchestrating the room7.\u00a0<\/sup>The female residents discussed their difficulties in using directive language and the increased stress they faced when violating prescriptive gender norms7<\/sup>. These residents were expressing a fear of \u201cbacklash,\u201d the social censure that women receive from acting in ways that counter stereotypical behavior7<\/sup>. \u00a0We, as women in medicine may suffer that same \u201clikeability penalty\u201d5<\/sup>when running a resuscitation to save a life.\u00a0\u00a0 This \u201clikeability penalty\u201d can affect our evaluations as residents, our future job opportunities and promotions, and potentially even our salary2<\/sup>.\u00a0In her commentary piece entitled, \u201cDamned If You Do, Damned if you Don\u2019t: Bias in Evaluations of Female Resident Physicians,\u201d Esther Choo implored medical educators to \u201callow our female trainees to spend less time learning how to walk the fine line between normative and counternormative behaviors and more time simply learning to be physicians.\u201d<\/p>\n

So now, armed with an understanding of the complexity of gender biases how they impact our medical education and clinical care, how do we proceed?\u00a0 First, we, as women in medicine, do NOT have to copy men.\u00a0 We are punished socially when we try to take on the autocratic \u201cmale\u201d way of leadership.\u00a0 But our communal traits make us strong collaborative leaders.\u00a0 We can use this to our advantage. As stated my Carnes et al. women are more likely than men to lead with a collaborative or transformational leadership style, which is consistently found to be the most effective style of leadership3<\/sup>. Collaborative leaders have an open, team-building approach to their work environment.\u00a0 They allow information to be shared openly. They seek feedback, suggestions and ideas from those they work with or those they are leading.\u00a0They facilitate brainstorming within their team.\u00a0 We can succeed by highlighting our strengths, not assuming the strengths of men.\u00a0 Second, while in training and adjusting to added stress of violating gender norms, young women in medicine can employ some strategies to increase their confidence, such as tying their hair back, wearing a white coat, power-posing, or standing on a stool for additional height7<\/sup>.\u00a0These small adjustments may make residents in training more comfortable with assuming a more assertive role.\u00a0 \u00a0And the third way is aimed at the educators.\u00a0 We, as medical educators, have to acknowledge and examine our own implicit gender biases.\u00a0 Whether male or female, we have our own biases that can affect the feedback we are giving to our learners.\u00a0 We need to look at evaluations critically, evaluating for the effects of gender bias. And finally, for all the women reading this, educators and learners, we need to beware of our own gender biases.\u00a0 We can be the HARDEST critics at times on our female learners, the first to criticize them for being overly confident or outspoken or bossy.\u00a0 We should also be careful how we interpret feedback. Don\u2019t assume the feedback is \u201cbitchy\u201d just because it\u2019s from a female. We all need to examine our gender biases and realize when they are taking effect.\u00a0Then we need to pull each other up, instead of tearing each other down.<\/p>\n

This piece originally appeared in Melissa Parson’s blog\u00a0MelissaParsonsMD.com<\/a>.<\/em><\/p>\n

References:<\/p>\n

    \n
  1. Eagly, Alice H., and Steven J. Karau. \u201cRole Congruity Theory of Prejudice toward Female Leaders.\u201d Psychological Review<\/em>109, no. 3 (2002): 573\u201398. https:\/\/doi.org\/10.1037\/\/0033-295X.109.3.573<\/a>.<\/li>\n
  2. Heilman, Madeline E., Aaron S. Wallen, Daniella Fuchs, and Melinda M. Tamkins. \u201cPenalties for Success: Reactions to Women Who Succeed at Male Gender-Typed Tasks.\u201d Journal of Applied Psychology<\/em>89, no. 3 (2004): 416\u201327. https:\/\/doi.org\/10.1037\/0021-9010.89.3.416<\/a>.<\/li>\n
  3. Carnes, Molly; Christie Bartels; Carol Isaac; Anna Kaatz; and Christine Kolehmainen. 2015. \u201cWhy is John More Likely to Become Department Chair than Jennifer?\u201dAmerican Clinical and Climatological Society<\/em>. 126: 197\u2013214.<\/li>\n
  4. Sandberg, S. (2013).\u00a0Lean in: Women, work, and the will to lead<\/em>(First edition.). New York: Alfred A. Knopf.<\/li>\n
  5. Dayal, Arjun, Daniel M. O\u2019Connor, Usama Qadri, and Vineet M. Arora. \u201cComparison of Male vs Female Resident Milestone Evaluations by Faculty During Emergency Medicine Residency Training.\u201d JAMA Internal Medicine<\/em>177, no. 5 (May 1, 2017): 651. https:\/\/doi.org\/10.1001\/jamainternmed.2016.9616<\/a>.<\/li>\n
  6. Mueller, Anna S., Tania M. Jenkins, Melissa Osborne, Arjun Dayal, Daniel M. O\u2019Connor, and Vineet M. Arora. \u201cGender Differences in Attending Physicians\u2019 Feedback to Residents: A Qualitative Analysis.\u201d Journal of Graduate Medical Education<\/em>9, no. 5 (October 2017): 577\u201385. https:\/\/doi.org\/10.4300\/JGME-D-17-00126.1<\/a>.<\/li>\n
  7. Kolehmainen, Christine, Meghan Brennan, Amarette Filut, Carol Isaac, and Molly Carnes. \u201cAfraid of Being \u2018Witchy With a \u201cB\u201d\u2019: A Qualitative Study of How Gender Influences Residents\u2019 Experiences Leading Cardiopulmonary Resuscitation.\u201d Academic Medicine<\/em>89, no. 9 (September 2014): 1276\u201381. https:\/\/doi.org\/10.1097\/ACM.0000000000000372<\/a>.<\/li>\n
  8. Choo, Esther K. \u201cDamned If You Do, Damned If You Don\u2019t: Bias in Evaluations of Female Resident Physicians.\u201d Journal of Graduate Medical Education<\/em>9, no. 5 (October 2017): 586\u201387. https:\/\/doi.org\/10.4300\/JGME-D-17-00557.1<\/a>.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Editor’s Note: This is the third in a three part series. Evaluations show conflict related to gender, but do those conflicts occur in our clinical practice?\u00a0Decidedly YES!\u00a0 As a resident running a code, I learned to swaddle my commands for…<\/p>\n","protected":false},"author":123,"featured_media":11219,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_mi_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":"","_jetpack_memberships_contains_paid_content":false,"jetpack_publicize_message":"Check out part three in the three part series by @MEParsonsMD on gender bias and medical education!","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[1,5],"tags":[52],"coauthors":[462],"jetpack_publicize_connections":[],"acf":[],"yoast_head":"\nGender & Medical Education - Part 3 - FemInEM<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/feminem.org\/2018\/07\/12\/gender-medical-education-part-3\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Gender & Medical Education - Part 3 - FemInEM\" \/>\n<meta property=\"og:description\" content=\"Editor’s Note: This is the third in a three part series. 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