The matilda effect in science: awards and prizes in the US, 1990s and 2000s.

Science is stratified, with an unequal distribution of research facilities and rewards among scientists. Awards and prizes, which are critical for shaping scientific career trajectories, play a role in this stratification when they differentially enhance the status of scientists who already have large reputations: the 'Matthew Effect'. Contrary to the Mertonian norm of universalism--the expectation that the personal attributes of scientists do not affect evaluations of their scientific claims and contributions--in practice, a great deal of evidence suggests that the scientific efforts and achievements of women do not receive the same recognition as do those of men: the 'Matilda Effect'. Awards in science, technology, engineering and medical (STEM) fields are not immune to these biases. We outline the research on gender bias in evaluations of research and analyze data from 13 STEM disciplinary societies. While women's receipt of professional awards and prizes has increased in the past two decades, men continue to win a higher proportion of awards for scholarly research than expected based on their representation in the nomination pool. The results support the powerful twin influences of implicit bias and committee chairs as contributing factors. The analysis sheds light on the relationship of external social factors to women's science careers and helps to explain why women are severely underrepresented as winners of science awards. The ghettoization of women's accomplishments into a category of 'women-only' awards also is discussed.

The Veterans Affairs Learners' Perceptions Survey: the foundation for educational quality improvement.

PURPOSE: The U.S. Department of Veterans Affairs (VA) supports 8,700 resident positions nationally to enhance quality of care for veterans and to educate physicians. This study sought to establish a yearly quality indicator to identify and follow strengths and opportunities for improvement in VA clinical training programs. METHOD: In March 2001, the VA Learners' Perceptions Survey, a validated 57-item questionnaire, was mailed to 3,338 residents registered at 130 VA facilities. They were asked to rate their overall satisfaction with the VA clinical training experience and their satisfaction in four domains: faculty/preceptor, learning, working, and physical environments using a five-point Likert scale. Questionnaires were received from 1,775 residents (53.2%). A full analysis was conducted using 1,436 of these questionnaires, whose respondents were categorized in four training programs: medicine (n = 706), surgery (n = 291), subspecialty (n = 266), and psychiatry (n = 173). RESULTS: On a scale of 0 to 100, residents gave their clinical training experience an average score of 79. Eighty-four percent would have recommended VA training to peers, and 81% would have chosen VA training again. Overall, 87% were satisfied with their faculty/preceptors, 78% with the learning environment, and 67% with the working and physical environments. The survey was sensitive to differences in satisfaction among the trainee groups, with residents in internal medicine (IM) the least satisfied. CONCLUSION: The VA Learners' Perceptions Survey is the first validated survey to address comprehensive satisfaction issues in clinical training. The survey highlights strengths and opportunities for improvement in VA clinical training and is the first step toward improving education.

The VA National Quality Scholars Fellowship Program: current status, future directions.

The National Quality Scholars Fellowship Program has been highly successful in recruiting excellent fellows for training in process improvement and quality principles. Opportunities for improvement include improved communication with facility personnel and closer alignment with local improvement needs. Retention/recruitment of these skilled physicians and creation of a network of trained Veterans Affairs (VA) physicians are newly articulated goals.

Thalidomide therapy for cicatricial pemphigoid.

Cicatricial pemphigoid is a chronic, presumed autoimmune, blistering disease of the mucous membranes and occasionally of the skin. The characteristic feature is scarring at the sites of healing. We report the use of thalidomide as a therapeutic agent to control previously resistant disease.