Put Yourself out There! A Strategy for Effective Self-Promotion in Academic Medicine.

Introduction: Trainees and faculty in academic medicine often struggle with self-promotion. Barriers may be more formidable for women and other groups underrepresented in medicine. Experience-based stories illustrating personal strengths are preferable when engaging in self-promotion activities. Methods: We developed a 90- to 120-minute workshop utilizing approaches such as iterative journaling and peer discussion to teach the development of problem-action-result (PAR) stories for self-promotion efforts in interviews and written applications to new positions. Participants provided Likert-scale (1 = strongly disagree, 5 = strongly agree) and free-response evaluations, which we analyzed for workshop strengths and areas for improvement. Results: We presented the workshop in person to 28 pediatric residents and subsequently to 22 residents, fellows, and faculty at an in-person national meeting. Sixty-one percent of the resident group and 100% of the national workshop group completed the evaluation. Both groups reported high satisfaction with the workshop's format (M = 4.7) and content (M = 4.7) and indicated intention to use the skills learned (M = 4.7). Strengths included the PAR format, interactivity, journaling, opportunity for reflection, and tips for interviewing and writing. Areas to improve included offering the workshop earlier in the academic year and providing more written examples of PAR stories. Discussion: This workshop used strategies of personal reflection, journaling, and peer feedback to help participants understand behavior-based recruiting practices and the PAR framework as a strategy for successful self-promotion. Learners can use these strategies to develop greater confidence and efficacy and to address barriers to effective self-promotion they encounter.

How do life course events affect the accumulation of digital literacy?: Based on qualitative research of 16 medical university teachers of China.

The purpose of this article is to examine the level of the accumulation of digital literacy in medical university of China. In this study, we argue that positive life events facilitate the formation of digital literacy. We review the development of research of life course and digital literacy since the 2010. From the perspective of life course theory, this article examines the significant impact of social changes in information technology on the accumulation of digital literacy of 16 medical university teachers, and understands the life course of medical university teachers as a sequence composed of multiple life events. The results show that the accumulation of medical university teachers' digital Literacy includes 4 types: linear accumulation, multi drive accumulation, parallel accumulation, and leading accumulation, of which multi drive accumulation and leading accumulation are the most conducive to the formation of medical university teachers' digital literacy. In addition, our findings reveal that subjective initiative plays an important role in the accumulation of medical university teachers' digital literacy. The accumulation of digital literacy is a dynamic and systematic process of the accumulation of individual life events of medical university teachers. This paper also discusses the relationship between order of life events and career outcomes.

Student and educator experiences of a student-led clinic in general practice.

BACKGROUND: Giving students more responsibility for real patients during medical school may help prepare them for their transition to clinical practice. Student-led clinics (SLCs) may facilitate this. Within SLCs, students take the lead role in delivering patient care while being supported and supervised by qualified clinicians. A general practice SLC was established in Dundee, with four final-year medical students and one GP involved in each clinic. AIM: This study aimed to explore students' and educators' experiences and perceptions of this SLC. METHOD: This was an exploratory case study. Semi-structured interviews were conducted with 11 students and three educators, and 18 hours of observation were conducted over six clinics. Interview transcripts and fieldnotes were integrated and thematically analysed. RESULTS: Overall, students' and educators' experiences and perceptions were positive. Students thrived in their lead role in patient care, gaining a sense of empowerment and developing confidence in their abilities. Both students and educators felt comfortable with students having this level of responsibility due to the students' stage of training and the supervision provided by educators. Teaching within the SLC involved individual discussions and group debriefs. Students felt a sense of belonging as a result of their relationships with their peers and educators. Challenges arose when the clinic ran behind schedule due to unexpected complex patients or lengthy individual discussions. CONCLUSION: The findings suggest that giving students responsibility for real patients is beneficial and feasible when adequate support is provided, and that it is possible for one GP to supervise multiple students successfully.

Current situation and influencing factors of high-level role conflict among clinical teachers: A cross-sectional study.

Role conflict is defined as pressures resulting from multiple job requirements that are perceived as incompatible. The purpose of this population-based cross-sectional study was to explore the current situation and influencing factors of high-level role conflict among clinical teachers at 4 affiliated hospitals of 3 medical universities in southern China. A self-administered online questionnaire was used for data collection through an online survey platform. Chi-square tests were used to determine significant differences for categorical variables. Binary logistic regression analysis models were performed for exploring the influencing factors of role conflict in clinical teachers. A total of 208 clinical teachers successfully completed the questionnaires. Of the respondents, 41.3% reportedly had high-level role conflict, and 58.7% had low-level role conflict. The study found that primary, intermediate, and deputy senior professional title, having a leadership position in the department, and devoting a lot of time to teaching work were associated with an increasing risk of the occurrence of high-level role conflict (all P < .05). However, undertaking moderate or few/very few clinical teaching workloads, keeping clinical teachers informed of the teaching requirements, getting guidance and help from colleagues, and thinking of the teaching work as their obligation were significantly associated with decreasing risks of high-level role conflict (all P < .05). Teaching management departments in hospitals might carry out regular and systematic professional training for clinical teachers to effectively decrease role conflict and improve the quality of clinical teaching.

Exploring the Use of Natural Language Processing to Understand Emotions of Trainees and Faculty Regarding Entrustable Professional Activity Assessments.

Background In medical education, artificial intelligence techniques such as natural language processing (NLP) are starting to be used to capture and analyze emotions through written text. Objective To explore the application of NLP techniques to understand resident and faculty emotions related to entrustable professional activity (EPA) assessments. Methods Open-ended text data from a survey on emotions toward EPA assessments were analyzed. Respondents were residents and faculty from pediatrics (Peds), general surgery (GS), and emergency medicine (EM), recruited for a larger emotions study in 2023. Participants wrote about their emotions related to receiving/completing EPA assessments. We analyzed the frequency of words rated as positive via a validated sentiment lexicon used in NLP studies. Specifically, we were interested if the count of positive words varied as a function of group membership (faculty, resident), specialty (Peds, GS, EM), gender (man, woman, nonbinary), or visible minority status (yes, no, omit). Results A total of 66 text responses (30 faculty, 36 residents) contained text data useful for sentiment analysis. We analyzed the difference in the count of words categorized as positive across group, specialty, gender, and being a visible minority. Specialty was the only category revealing significant differences via a bootstrapped Poisson regression model with GS responses containing fewer positive words than EM responses. Conclusions By analyzing text data to understand emotions of residents and faculty through an NLP approach, we identified differences in EPA assessment-related emotions of residents versus faculty, and differences across specialties.

Burnout Among Mid-Career Academic Medical Faculty.

Importance: Studies reveal that most physicians report symptoms of burnout. Less is known about burnout in mid-career medical faculty specifically. Objective: To characterize burnout and its risk factors, particularly differences by gender, among mid-career medical faculty. Design, Setting, and Participants: Between August 2021 and August 2022, a survey was sent to 1430 individuals who received new National Institutes of Health K08 and K23 career development awards from 2006 to 2009. Data were analyzed between June and October 2023. Main Outcomes and Measures: Personal and work-related burnout as evaluated using the Copenhagen Burnout Inventory (CBI). The CBI score ranges from 0 to 100, with a score of 50 or higher indicating a high degree of burnout. Multivariable models were used to investigate associations between burnout and participant characteristics, including race and ethnicity, sexual orientation and gender identity, academic rank, work climate, experiences of workplace sexual harassment, sleep hours, work and domestic caregiving time, and time allocation changes in work and domestic work hours compared with before the COVID-19 pandemic. Work climate was evaluated by a general climate elements scale assessing elements such as friendliness, respect, and collegiality, and a diversity, equity, and inclusion climate elements scale assessing elements such as homogeneity, sexism, and homophobia; higher scores indicated a more favorable view of the climate. Results: In all, 1430 surveys were sent, 926 candidates responded (65% response rate), and the analytic cohort was limited to the 841 respondents who were still in academic medicine (50.7% men). Burnout was significantly more common for women than men (mean [SD] CBI personal scores, 46.6 [19.4] vs 37.5 [17.2]; P < .001; mean [SD] CBI work-related scores, 43.7 [20.4] vs 34.6 [19.7]; P < .001). In multivariable models, personal burnout was significantly more likely for women (adjusted odds ratio [AOR], 2.29 [95% CI, 1.54-3.41]; P < .001) and with more weekly hours of patient care (AOR, 1.07 [95% CI, 1.00-1.15] for each 5-hour increase; P = .04). Personal burnout was less likely with more nightly sleep hours (AOR, 0.68 [95% CI, 0.56-0.81] for each 1-hour increase; P < .001) and with an improved general work climate rating (AOR, 0.64 [95% CI, 0.48-0.85] for each 1-point increase in general work climate scale score; P = .002). Work-related burnout was also significantly more likely for women than men (AOR, 1.77 [95% CI, 1.17-2.69]; P = .007). Greater work-related burnout was associated with an increase of 8 or more work hours per week compared with before the COVID-19 pandemic (AOR, 1.87 [95% CI, 1.13-3.08]; P = .01), more weekly hours of patient care (AOR, 1.11 [95% CI, 1.03-1.19] for each 5-hour increase; P = .007), and a workplace sexual harassment experience in the past 2 years (AOR, 1.71 [95% CI, 1.11-2.62]; P = .01). Work-related burnout was significantly less likely with more nightly sleep hours (AOR, 0.80 [95% CI, 0.66-0.96] for each 1-hour increase; P = .02) and with an improved general work climate rating (AOR, 0.49; [95% CI, 0.36-0.65] for each 1-point increase in general work climate scale score; P < .001). Conclusions and Relevance: This survey study of K grant awardees revealed substantial rates of burnout among mid-career medical faculty, and burnout rates differed by gender. Evidence-based interventions are needed to realize the benefits of workforce diversity and vitality.

Variegated racism: exploring experiences of anti-Black racism and their progression in medical education.

BACKGROUND: Addressing anti-Black racism in medical education in Canada has become increasingly urgent as more Black learners enter medical institutions and bring attention to the racist harms they face. We sought to gather evidence of experiences of racism among Black medical learners and to explore the contexts within which racism is experienced by learners. METHODS: Drawing on critical race and structural violence theories, we conducted interviews with Black medical faculty, students, residents, and staff at the University of Saskatchewan College of Medicine between May and July 2022. We thematically analyzed interviews using instrumental case study methodology. RESULTS: Thematic analyses from 13 interviews revealed 5 central themes describing experiences of racism and the compounding nature of racist exposures as learners progressed in medicine. Medical learners experienced racism through uncomfortable encounters and microaggressions. Blatant acts of racism were instances where patients and superiors harmed students in various ways, including through use of the N-word by a superior in 1 instance. Learners also experienced curricular racism through the absence of the Black body in the curriculum and the undue pathologizing of Blackness. Medical hierarchies reinforced anti-Black racism by undermining accountability and protecting powerful perpetrators. Finally, Black women medical learners identified intersecting oppressions and misogynoir that compounded their experience of racism. We propose that experiences of racism may worsen as learners progress in medicine in part because of increases in the sources of and exposure to racism. INTERPRETATION: Anti-Black racism in medical education in Canada is experienced subtly through microaggressions or blatantly from different sources including medical faculty. As Black learners progress in medicine, anti-Black racism may become worse because of the compounding effects of exposures to a wider range of sources of racist behaviour.

How Student and Faculty Perceptions Differ on the Stressors that Medical Students Face.

OBJECTIVES: Medical education is notorious for the stress that students face as they strive to succeed both academically and clinically. This stress has been linked to declining academic performance and worsening mental health. To combat these negative outcomes, it is essential for medical school faculty and administration to address common stressors among medical students. No studies have addressed whether medical school faculty and students perceive stressors similarly, however. METHODS: In this two-part study, data collected from medical students in 2021 to 2022 to identify their most significant sources of stress were used to create a survey that queries the frequency and intensity of these stressors. This survey was distributed to medical students and faculty at the same institution. The responses between students and faculty were compared and student data also were analyzed by academic year to observe changes in perception that accompany progression through the medical curriculum. RESULTS: The results showed that faculty overestimated the impact of certain stressors on medical students (eg, in-house examinations, US Medical Licensing Examination Steps 1 and 2 examinations, and patient interactions). In addition, preclinical students were more concerned with finding extracurricular activities, missing opportunities, and performing research compared with clinical students. CONCLUSIONS: This study demonstrated that although faculty anticipated most medical student stressors, there are significant gaps that still need to be addressed to better reduce and respond to the stress experienced by medical students.

Experiences of Leaders in Diversity, Equity, and Inclusion in US Academic Health Centers.

Importance: The murder of George Floyd in 2020 spurred an outpouring of calls for racial justice in the United States, including within academic medicine. In response, academic health centers announced new antiracism initiatives and expanded their administrative positions related to diversity, equity, and/or inclusion (DEI). Objective: To understand the experiences of DEI leaders at US allopathic medical schools and academic health centers, ie, the structure of their role, official and unofficial responsibilities, access to resources, institutional support, and challenges. Design, Setting, and Participants: This qualitative study used key informant interviews with participants who held formal DEI positions in their school of medicine, health system, or department. Interviews were conducted from December 2020 to September 2021. Transcripts were coded using a phenomenographic approach, with iterative concurrent analysis to identify thematic categories across participants. Data were analyzed from January to December 2021. Exposure: Formal DEI role. Main Outcomes and Measures: Questions elicited reflection on the responsibilities of the role and the strengths and challenges of the unit or office. Results: A total of 32 participants (18 of 30 [56%] cisgender women; 16 [50%] Black or African American, 6 [19%] Latinx or Hispanic, and 8 [25%] White) from 27 institutions with a mean (range) of 14 (3-43) years of experience in medical education were interviewed. More than half held a dean position (17 [53%]), and multiple participants held 2 or more titled DEI roles (4 [13%]). Two-thirds self-identified as underrepresented in medicine (20 [63%]) and one-third as first generation to attend college (11 [34%]). Key themes reflected ongoing challenges for DEI leaders, including (1) variability in roles, responsibilities, and access to resources, both across participants and institutions as well as within the same position over time; (2) mismatch between institutional investments and directives, including insufficient authority, support staff, and/or funding, and reduced efficacy due to lack of integration with other units within the school or health system; (3) lack of evidence-based practices, theories of change, or standards to guide their work; and (4) work experiences that drive and exhaust leaders. Multiple participants described burnout due to increasing demands that are not met with equivalent increase in institutional support. Conclusions and Relevance: In this qualitative study, DEI leaders described multiple institutional challenges to their work. To effectively address stated goals of DEI, medical schools and academic centers need to provide leaders with concomitant resources and authority that facilitate change. Institutions need to acknowledge and implement strategies that integrate across units, beyond one leader and office. Policymakers, including professional organizations and accrediting bodies, should provide guidance, accountability mechanisms, and support for research to identify and disseminate evidence for best practices. Creating statements and positions, without mechanisms for change, perpetuates stagnation and injustice.

More Than a Joke: The Intersection of Gender-Based Humor and Gender Inequities Experienced by Women Department Chairs in Academic Medicine.

Purpose: The purpose of this qualitative descriptive study is to describe how women academic department chairs in emergency medicine, surgery, and anesthesiology experience humor in the workplace. Method: Interviews were conducted with 35 women department chairs in academic medicine from 27 institutions that aimed to describe women's leadership emergence. The data from the primary study yielded rich and revealing themes involving participants' experiences with humor in the context of their leadership roles, justifying a secondary analysis focusing specifically on these experiences. Relevant remarks were extracted, coded, and summarized. Results: Participants discussed two broad types of humor-related experiences. First, they described how they responded to aggressive gender-based humor directed at themselves or their colleagues by tolerating it or expressing disapproval. This humor includes demeaning quips, insulting monikers, sexist jokes, and derogatory stories. Participants often did not confront this humor directly as they feared being rejected or ostracized by colleagues. Second, they described how they initiated humor to address gender-related workplace issues by highlighting gender inequalities, coping with sexual harassment and assault, and managing gender-based leadership challenges. Participants felt constrained in their own use of humor because of the need to be taken seriously as women leaders. Conclusion: Women leaders in academic medicine use humor to confront gender-related issues and experience aggressive gender-based humor in the workplace. The constraints placed on women leaders discourage them from effectively confronting this aggressive gender-based humor and perpetuating gender inequities. Eliminating aggressive gender-based humor is needed to create safe and equitable work environments in academic medicine.

Impact of COVID-19 pandemic on physician-scientist trainees to faculty one year into the pandemic.

PURPOSE: Physician-scientists play a crucial role in advancing biomedical sciences. Proportionally fewer physicians are actively engaged in scientific pursuits, attributed to attrition in the training and retention pipeline. This national study evaluated the ongoing and longer-term impact of the COVID-19 pandemic on stress levels, research productivity, and optimism for physician-scientists at all levels of training. METHODS: A multi-institutional cross-sectional survey of medical students, graduate students, and residents/fellows/junior faculty (RFJF) was conducted from April to August 2021 to assess the impact of COVID-19 on individual stress, productivity, and optimism. Multivariate regression analyses were performed to identify associated variables and unsupervised variable clustering techniques were employed to identify highly correlated responses. RESULTS: A total 677 respondents completed the survey, representing different stages of physician-scientist training. Respondents report high levels of stress (medical students: 85%, graduate students: 63%, RFJF: 85%) attributed to impaired productivity concerns, concern about health of family and friends, impact on personal health and impairment in training or career development. Many cited impaired productivity (medical students: 65% graduate students: 79%, RFJF: 78%) associated with pandemic impacts on training, labs closures and loss of facility/resource access, and social isolation. Optimism levels were low (medical students: 37%, graduate students: 38% and RFJF: 39%) with females less likely to be optimistic and more likely to report concerns of long-term effects of COVID-19. Optimism about the future was correlated with not worrying about the long-term effects of COVID-19. Since the COVID-19 pandemic, all respondents reported increased prioritization of time with family/friends (67%) and personal health (62%) over career (25%) and research (24%). CONCLUSIONS: This national survey highlights the significant and protracted impact of the COVID-19 pandemic on stress levels, productivity, and optimism among physician-scientists and trainees. These findings underscore the urgent need for tailored support, including mental health, academic, and career development assistance for this biomedical workforce.

Psychometric properties of the Persian version of the Engaged teachers Scale (ETS).

BACKGROUND & AIM: Teacher engagement can be defined as the teachers' effort and attention to teaching professional tasks, adequate emotions and commitment to relationships with students and colleagues in classroom and school. The Engaged Teacher Scale (ETS) is the frequently used scale, measuring teacher engagement developed by Klassen et al., 2013 in the UK, and consists of four dimensions: cognitive engagement (CE), emotional engagement (EE), social engagement with students (SES), and social engagement with colleagues (SEC). Therefore, the aim of this study was to measure the psychometric properties of the Persian version of the Engaged Teachers Scale (ETS). MATERIALS & METHODS: A total of 123 teachers who worked at Shahid Beheshti University of Medical Sciences, Tehran, Iran, were included in this study. The study participants were selected using the convenience sampling. The Persian version of a 16-item scale developed by Klassen et al. was validated by this study. Face and Content validity index and reliability were assessed after translation and cultural adaptation, and also construct validity was calculated by confirmatory factor analysis using the PLS22. RESULTS: Of the 123 study participants, 74 (60.01%) were females and 49 (39.9%) were males. The mean age of the subjects was about 30-40 years. The majority of the study participants were general practitioners (n = 75; 60.9%) and others were from different specialists. Content validity among 15 experts was 0.88. Confirmatory factor analysis for all 16 items loaded across four factors, and this four-factor scale showed a good fit in the Iranian community. Reliability using Cronbach's alpha was 0.79. The value of root mean square error of approximation (RMSEA) was 0.0094 with the 99% confidence interval, and also the goodness of fit index GFI value was 0.98. CONCLUSION: The Persian version of ETS had good validity and reliability in Iran and could be a useful tool for measuring the teacher engagement factors of faculty members that can be used by teachers and educational administrators.

The Perceived Value of Same-Sex or Same-Race Mentors and Role Models in Academic Medicine.

This study aims to describe the perception of need for same-sex and same-race mentorship and role models at evolving stages of a medical career and to explore whether these differences affect career choices within the field of medicine. A total of 326 medical students, 309 resident physicians, and 200 faculty attending physicians at the University of California, Davis School of Medicine completed an online survey focused on their perceived value of same-sex and same-race mentorship throughout their stages of medical training and practice. The top three factors influencing specialty choice were lifestyle, time commitment, and supportive department. Although most respondents did not believe same-sex or same-race mentors or role models influenced their specialty choice, there were significant differences in the perceived importance and value of gender or race concordance between male versus female and white versus nonwhite populations. (Journal of Surgical Orthopaedic Advances 33(1):041-048, 2024).

What do the teachers want? A targeted needs assessment survey for prospective didactic training of psychiatry medical educators.

Objectives: Physicians and psychologists at psychiatric university hospitals are assigned teaching tasks from the first day of work without necessarily having the prerequisite training in teaching methods. This exploratory survey provides a needs-based analysis for the prospective didactic training of physicians and psychologists at psychiatric hospitals in Germany, Austria and Switzerland. Methods: An online questionnaire was distributed at medical schools via email in German-speaking countries in Europe. All physicians involved in teaching medical students at psychiatry faculties were eligible to participate in the survey. Participants were further requested to recruit eligible participants (snowball sampling). Responses were analyzed descriptively, and differences between groups were calculated using nonparametric Mann-Whitney U tests (p<.05). Results: Overall, 97 respondents (male=55, female=42; mean age= 40.6) from 19 medical schools completed the survey. The respondents consisted of 43 residents, 39 specialists, 6 chief physicians and 9 psychologists. Of the respondents, 97.6% rated didactic competence as either highly relevant or rather relevant for teaching medical students. The highest overall interest was shown for bedside teaching (mode=4; IQR: 2-4) and error culture (mode=3; IQR: 2-4). Respondents expressed the highest training needs for topics regarding presentation and communication (mode=3; IQR: 2-3). Resident physicians were significantly more interested in bedside teaching (U=362.0, p=0.004) and roleplay (U=425.0; p=0.036) than specialist physicians, who were more interested in examination didactics (U=415.0; p=0.022). Chief physicians displayed significantly deeper interest in group dynamics (U=51; p=0.023) than specialist physicians. In-person training was preferred by a majority of respondents, and 27.4% preferred online/web-based training. Conclusions: The majority of physicians and psychologists at psychiatric university hospitals considered professional development for faculty to be helpful for teaching medical students. Bedside teaching and error culture management were the most desired teaching topics for training medical teachers. Tailored educational interventions are recommended, with target-oriented priorities for different hierarchical levels.

Meaningful Work, Career Fit, and Professional Well-Being of Pediatric Academicians in the United States.

OBJECTIVE: Examine associations between time spent in academic activities perceived as meaningful and professional well-being among academic pediatrics faculty. METHODS: The sample comprised 248 full-time pediatric faculty (76% female, 81% white, non-Hispanic, 41% instructor or assistant professor) across the United States who completed an online survey in November 2019. Survey items included sociodemographic and professional characteristics, professional well-being measures (Stanford Professional Fulfillment Index; Maslach Burnout Inventory; Intention to Leave Academic Medicine), perceived meaningfulness of academic activities and assigned time to those activities. We defined global career fit as total percentage time assigned to professional activities considered meaningful by individuals, and activity-specific career fit as percentage time assigned to each meaningful professional activity. RESULTS: As global career fit scores increased, professional fulfillment increased (r = 0.45, P < .001), whereas burnout (r = -0.29, P < .001) and intention to leave (r = -0.22, P < .001) decreased. Regarding activity-specific career fit, for individuals who considered patient care meaningful, as assigned time to patient care increased, professional fulfillment decreased (r = -0.14, P = .048) and burnout (r = 0.16, P = .02) and intention to leave (r = 0.26, P < .001) increased. There was no significant correlation between assigned time for teaching, research, or advocacy and professional well-being. Faculty were less likely to intend to leave academic medicine as assigned time increased for administrative or leadership activities if considered meaningful (r = -0.24, P = .01). CONCLUSIONS: Time assigned to meaningful work activities may relate to professional well-being of academic pediatrics faculty. More time assigned to patient care, despite being meaningful, was associated with poor self-reported professional well-being. Effort allocation among diverse academic activities needs to be optimized to improve faculty well-being.

A Gravid Situation: General Surgery Faculty Support for Pregnant Surgical Residents.

INTRODUCTION: The perceptions of teaching faculty toward pregnant general surgery residents have been overlooked despite the daily interactions amongst these groups. METHODS: A 32-question survey designed to measure general surgery teaching faculty perceptions toward pregnant residents was distributed electronically from March 2022 to April 2022 to general surgery teaching faculty in the United States. Descriptive statistics were used to characterize responses and differences in perceptions, and qualitative analysis identified recurring themes from free-text responses. RESULTS: Among 163 respondents included in the final analysis, 58.5% were male and 41.5% were female. Despite 99.4% of surgeons feeling comfortable if a resident told them they were pregnant, 22.4% of surgeons disagreed that their institutions have supportive cultures toward pregnancy. Almost half (45.4%) have witnessed negative comments about pregnant residents and half (50.3%) believe that pregnant surgical residents are discriminated against by their coresidents. Nearly two-thirds of surgeons (64.8%) believe that someone should have a child whenever they wish during training. Given recent reports, 80.2% of surgeons recognized that female surgeons have increased risks of infertility and pregnancy complications. Recurring themes of normalizing pregnancy, improving policies, and creating a culture change were expressed. CONCLUSIONS: In this national survey, although there appears to be positive perceptions of pregnancy in surgical training amongst those surveyed, there is acknowledged necessity of further normalizing pregnancy and improving policies to better support pregnant residents. These data provide further evidence that though perceptions may be improving, changes are still needed to better support pregnancy during training.

Unprofessionalism in anesthesiology: A qualitative study on classifying unprofessional behavior in anesthesiology residency education.

STUDY OBJECTIVE: This study aims to identify the domains that constitute behaviors perceived to be unprofessional in anesthesiology residency training programs. DESIGN: Qualitative study. SETTING: Anesthesiology residency training programs. PATIENTS: Not applicable. The participants involved residents, fellows, and faculty members purposefully sampled in four US-based anesthesiology residency programs. INTERVENTIONS: Participants were asked to submit examples of unprofessional behavior they witnessed in anesthesiology residents, fellows, or faculty members via a Qualtrics link. MEASUREMENTS: Not applicable. The behavior examples were independently reviewed and categorized into themes using content analysis. MAIN RESULTS: A total of 116 vignettes were collected, resulting in a final list of 111 vignettes after excluding those that did not describe behavior exhibited by anesthesiology faculty or trainees. Fifty-eight vignettes pertained to unprofessional behaviors observed in faculty members and 53 were observed in trainees (residents and fellows). Nine unprofessionalism themes emerged in the analysis. The most common themes were VERBAL, SUPERVISION, QUALITY, ENGAGEMENT, and TIME. As to the distribution of role group (faculty versus trainee) by theme, unprofessional behaviors falling into the categories of BIAS, GOSSIP, LEWD, and VERBAL were observed more in faculty; whereas themes with unprofessional behavior primarily attributed to trainees included ENGAGEMENT, QUALITY, TIME, and SUPERVISION. CONCLUSION: By reviewing reported professionalism-related vignettes within residency training programs, we identified classification descriptors for defining unprofessional behavior specific to anesthesiology residency education. Findings from this study enrich the definition of professionalism as a multi-dimensional competency pertaining to anesthesiology graduate medical education. This framework may facilitate preventative intervention and timely remediation plans for unprofessional behavior in residents and faculty.

How's Your Soul?

In this narrative essay, a physician reflects on the way in which his residency program director's unique background as a Master of Divinity helped him to focus on his growth as a human being rather than concentrating solely on clinical evaluations.

Structured Exposure Achieves High Acceptance of Immersive Technology Among Medical Students and Educators.

Virtual reality (VR) is a potent educational tool with untapped potential in medical training. However, its integration into medical schools faces challenges such as cybersickness and hesitancy among medical students and professionals. Notably, there has been no systematic assessment of the acceptance of medical educational VR applications by both students and educators. In our single-center study, we enrolled 133 medical students and 14 medical educators. Following a practical demonstration of the established VR anatomy application, Sharecare YOU VR, participants completed a self-reporting survey based on the Technology Acceptance Model (TAM), exploring user acceptance of information technologies and focusing on perceived usefulness (PU), perceived ease of use (PEU), and attitude toward using (ATU). We also sought insights into potential future applications of VR in medical education. Our findings indicate a high level of acceptance among medical students and educators upon structured exposure to VR with significantly positive responses for all three TAM variables (PU, PEU, and ATU). Intriguingly, hands-on experience influenced acceptance. Students envisioned VR's benefits in anatomy, surgery, emergency medicine, and communication skill training with patients. Both students and educators believed that VR could enhance traditional approaches and complement the existing curriculum, anticipating improved preparedness for medical students through VR training applications. In conclusion, our results demonstrate the receptivity of both students and educators to immersive technologies, including VR, in medical education. Importantly, the data suggest that the adoption of VR in this field would be welcomed rather than resisted, potentially enhancing students' self-efficacy and enriching the medical school curriculum.

Gender Disparity in Full Professor Rank Among Academic Physicians: A Systematic Review and Meta-Analysis.

PURPOSE: The gender gap in promotion in academic medicine is well established. However, few studies have reported gender differences in promotion adjusted for scholarly production and national or international reputation, namely, career duration, publications, grant funding, and leadership positions. The authors performed a systematic review and meta-analysis of the differences between men and women in achieving benchmarks for promotion and analyze where such differences lie geographically and within specialties. METHOD: A systematic search of Academic Search Premier, Business Source Complete, Cochrane Library, ERIC, GenderWatch, Google Scholar, Embase, MEDLINE, PubMed, Scopus, and Web of Science was conducted from inception to August 17, 2022. All studies that reported the number of male and female full professors on medical school faculty were included. The primary outcome was the adjusted odds ratio (AOR) for promotion to full professor for women compared with men. RESULTS: Two hundred forty-four studies met the inclusion criteria. The unadjusted OR for promotion to full professor for women was 0.38 (95% confidence interval [CI], 0.36-0.41). Sixteen studies reported an AOR. The pooled AOR of promotion for women to full professor was 0.60 (95% CI, 0.46-0.77). The AOR for promotion to full professor was 0.55 (95% CI, 0.34-0.88) in surgery and 0.80 (95% CI, 0.57-1.11) in internal medicine. Statistical heterogeneity was high ( Q = 66.6, I2 = 79.4%, P < .001). On meta-regression, 77% of the heterogeneity was from studies outside the United States, where more disparity was reported (AOR, 0.29; 95% CI, 0.22-0.38). CONCLUSIONS: Most studies continued to find decreased promotion of women. Gender disparity was particularly notable in surgery and in studies from outside the United States. The results suggest that differences in promotion were due to differences in productivity and leadership and to gender bias.