Relationships of primary productivity with anuran abundance, richness, and community composition in tropical streams.

The relationship between primary productivity and diversity has been demonstrated across taxa and spatial scales, but for organisms with biphasic life cycles, little research has examined whether productivity of larval and adult environments influence each life stage independently, or whether productivity of one life stage's environment outweighs the influence of the other. Experimental work demonstrates that tadpoles of stream-breeding anurans can exhibit a top-down influence on aquatic primary productivity (APP), but few studies have sought evidence of a bottom-up influence of primary productivity on anuran abundance, species richness and community composition, as seen in other organisms. We examined aquatic and terrestrial primary productivity in two forest types in Borneo, along with amphibian abundance, species richness, and community composition at larval and adult stages, to determine whether there is evidence for a bottom-up influence of APP on tadpole abundance and species richness across streams, and the relative importance of aquatic and terrestrial primary productivity on larval and adult phases of anurans. We predicted that adult richness, abundance, and community composition would be influenced by terrestrial primary productivity, but that tadpole richness, abundance, and community composition would be influenced by APP. Contrary to expectations, we did not find evidence that primary productivity, or variation thereof, predicts anuran richness at larval or adult stages. Further, no measure of primary productivity or its variation was a significant predictor of adult abundance, or of adult or tadpole community composition. For tadpoles, we found that in areas with low terrestrial primary productivity, abundance was positively related to APP, but in areas with high terrestrial primary productivity, abundance was negatively related to APP, suggesting a bottom-up influence of primary productivity on abundance in secondary forest, and a top-down influence of tadpoles on primary productivity in primary forest. Additional data are needed to better understand the ecological interactions between terrestrial primary productivity, aquatic primary productivity, and tadpole abundance.

Effect of a Workshop to Break the Bias Habit for Internal Medicine Faculty: A Multisite Cluster Randomized Controlled Study.

PURPOSE: Recognition that cultural stereotypes can unintentionally perpetuate inequities throughout academic medicine has led to calls for "implicit bias training" without strong evidence to support these recommendations and some evidence of potential harm. The authors sought to determine the effectiveness of a single 3-hour workshop in helping department of medicine faculty overcome implicit stereotype-based bias and in improving the climate in the working environment. METHOD: A multisite cluster randomized controlled study (October 2017 to April 2021) with clustering at the level of divisions within departments and participant-level analysis of survey responses involved 8,657 faculty in 204 divisions in 19 departments of medicine: 4,424 in the intervention group (1,526 attended a workshop) and 4,233 in the control group. Online surveys at baseline (3,764/8,657 = 43.48% response rate) and 3 months after the workshop (2,962/7,715 = 38.39% response rate) assessed bias awareness, bias-reducing intentional behavioral change, and perceptions of division climate. RESULTS: At 3 months, faculty in the intervention vs control divisions showed greater increases in awareness of personal bias vulnerability ( b = 0.190 [95% CI, 0.031 to 0.349], P = .02), bias reduction self-efficacy ( b = 0.097 [95% CI, 0.010 to 0.184], P = .03), and taking action to reduce bias ( b = 0.113 [95% CI, 0.007 to 0.219], P = .04). The workshop had no effect on climate or burnout, but slightly increased perceptions of respectful division meetings ( b = 0.072 [95% CI, 0.0003 to 0.143], P = .049). CONCLUSIONS: Results of this study should give confidence to those designing prodiversity interventions for faculty in academic medical centers that a single workshop which promotes awareness of stereotype-based implicit bias, explains and labels common bias concepts, and provides evidence-based strategies for participants to practice appears to have no harms and may have significant benefits in empowering faculty to break the bias habit.

Bidirectional multiciliated cell extrusion is controlled by Notch-driven basal extrusion and Piezo1-driven apical extrusion.

Xenopus embryos are covered with a complex epithelium containing numerous multiciliated cells (MCCs). During late-stage development, there is a dramatic remodeling of the epithelium that involves the complete loss of MCCs. Cell extrusion is a well-characterized process for driving cell loss while maintaining epithelial barrier function. Normal cell extrusion is typically unidirectional, whereas bidirectional extrusion is often associated with disease (e.g. cancer). We describe two distinct mechanisms for MCC extrusion, a basal extrusion driven by Notch signaling and an apical extrusion driven by Piezo1. Early in the process there is a strong bias towards basal extrusion, but as development continues there is a shift towards apical extrusion. Importantly, response to the Notch signal is age dependent and governed by the maintenance of the MCC transcriptional program such that extension of this program is protective against cell loss. In contrast, later apical extrusion is regulated by Piezo1, such that premature activation of Piezo1 leads to early extrusion while blocking Piezo1 leads to MCC maintenance. Distinct mechanisms for MCC loss underlie the importance of their removal during epithelial remodeling.

Novel centriolar defects underlie a primary ciliary dyskinesia phenotype in an adenylate kinase 7 deficient ciliated epithelium.

The skin of Xenopus embryos contains numerous multiciliated cells (MCCs), which collectively generate a directed fluid flow across the epithelial surface essential for distributing the overlaying mucous. MCCs develop into highly specialized cells to generate this flow, containing approximately 150 evenly spaced centrioles that give rise to motile cilia. MCC-driven fluid flow can be impaired when ciliary dysfunction occurs, resulting in primary ciliary dyskinesia (PCD) in humans. Mutations in a large number of genes (~50) have been found to be causative to PCD. Recently, studies have linked low levels of Adenylate Kinase 7 (AK7) gene expression to patients with PCD; however, the mechanism for this link remains unclear. Additionally, AK7 mutations have been linked to multiple PCD patients. Adenylate kinases modulate ATP production and consumption, with AK7 explicitly associated with motile cilia. Here we reproduce an AK7 PCD-like phenotype in Xenopus and describe the cellular consequences that occur with manipulation of AK7 levels. We show that AK7 localizes throughout the cilia in a DPY30 domain-dependent manner, suggesting a ciliary function. Additionally, we find that AK7 overexpression increases centriole number, suggesting a role in regulating centriole biogenesis. We find that in AK7-depleted embryos, cilia number, length, and beat frequency are all reduced, which in turn, significantly decreases the tissue-wide mucociliary flow. Additionally, we find a decrease in centriole number and an increase in sub-apical centrioles, implying that AK7 influences both centriole biogenesis and docking, which we propose underlie its defect in ciliogenesis. We propose that AK7 plays a role in PCD by impacting centriole biogenesis and apical docking, ultimately leading to ciliogenesis defects that impair mucociliary clearance.

Bidirectional multiciliated cell extrusion is controlled by Notch driven basal extrusion and Piezo 1 driven apical extrusion.

Xenopus embryos are covered with a complex epithelium containing numerous multiciliated cells (MCCs). During late stage development there is a dramatic remodeling of the epithelium that involves the complete loss of MCCs. Cell extrusion is a well-characterized process for driving cell loss while maintaining epithelial barrier function. Normal cell extrusion is typically unidirectional whereas bidirectional extrusion is often associated with disease (e.g. cancer). We describe two distinct mechanisms for MCC extrusion, a basal extrusion driven by Notch signaling and an apical extrusion driven by Piezo1. Early in the process there is a strong bias towards basal extrusion, but as development continues there is a shift towards apical extrusion. Importantly, receptivity to the Notch signal is age-dependent and governed by the maintenance of the MCC transcriptional program such that extension of this program is protective against cell loss. In contrast, later apical extrusion is regulated by Piezo 1 such that premature activation of Piezo 1 leads to early extrusion while blocking Piezo 1 leads to MCC maintenance. Distinct mechansms for MCC loss underlie the importance of their removal during epithelial remodeling. Summay Statement: Cell extrusion typically occurs unidirectionally. We have identified a single population of multiciliated cells that extrudes bidirectionally: Notch-driven basal extrusion and Piezo 1-mediated apical extrusion.

Frog body size responses to precipitation shift from resource-driven to desiccation-resistant as temperatures warm.

Climate change threatens biodiversity in a range of ways, including changing animal body sizes. Despite numerous examples of size declines related to increasing temperatures, patterns of size change are not universal, suggesting that one or more primary mechanisms impacting size change are unknown. Precipitation is likely to influence the size different from and in conjunction with changes in temperature, yet tests of the interaction between these variables are rare. In this study, we show that a crossover interaction between temperature and precipitation impacts the body size of frogs as the climate warms. Using more than 3000 museum frog specimens from Borneo and climate records spanning more than 100 years, we found that frogs are larger in wet conditions than in dry conditions at cool temperatures, suggesting that resource availability determines body size at colder temperature. Conversely, frogs are larger in dry conditions than in wet conditions at warm temperatures, resulting in a crossover to desiccation resistance as the main determinant of body size as climates warm. Our results demonstrate that global warming can alter the impact of precipitation on life-history traits. We suggest that increased attention be paid to such interactive effects of climate variables, to identify complex mechanisms driving climate-induced size changes.

Body size responses to the combined effects of climate and land use changes within an urban framework.

Alterations in body size can have profound impacts on an organism's life history and ecology with long-lasting effects that span multiple biological scales. Animal body size is influenced by environmental drivers, including climate change and land use change, the two largest current threats to biodiversity. Climate warming has led to smaller body sizes of many species due to impacts on growth (i.e., Bergmann's rule and temperature-size rule). Conversely, urbanization, which serves as a model for investigating the effects of land use changes, has largely been demonstrated to cause size increases, but few studies have examined the combined influences of climate and land use changes on organism size. We present here the background theory on how each of these factors is expected to influence body size, summarize existing evidence of how size has recently been impacted by climate and land use changes, and make several recommendations to guide future research uniting these areas of focus. Given the rapid pace of climate change and urbanization, understanding the combined effects of climate and land use changes on body size is imperative for biodiversity preservation.

Antibiotic resistance patterns of Escherichia coli isolates from the clinic through the wastewater pathway.

Antimicrobial resistance (AMR) remains one of the leading global health threats. This study compared antimicrobial resistance patterns among E. coli isolates from clinical uropathogenic Escherichia coli (UPEC) to hospital wastewater populations and throughout an urban wastewater treatment facility - influent, pre- and post-chlorinated effluents. Antibiotic susceptibility of 201 isolates were analyzed against eleven different antibiotics, and the presence of twelve antibiotic resistant genes and type 1 integrase were identified. AMR exhibited the following pattern: UPEC (46.8%) > hospital wastewater (37.8%) > urban post-chlorinated effluent (27.6%) > pre-chlorinated effluent (21.4%) > urban influent wastewater (13.3%). However, multi-drug resistance against three or more antimicrobial classes was more prevalent among hospital wastewater populations (29.7%) compared to other sources. E. coli from wastewaters disinfected with chlorine were significantly correlated with increased trimethoprim-sulfamethoxazole resistance in E. coli compared to raw and treated wastewater populations. blaCTX-M-1 group was the most common extended spectrum beta-lactamase in E. coli from hospital wastewater (90%), although UPEC strains also encoded blaCTX-M-1 group (50%) and blaTEM (100%) genes. Among tetracycline-resistant populations, tetA and tetB were the only resistance genes identified throughout wastewater populations that were associated with increased phenotypic resistance. Further characterization of the E. coli populations identified phylogroup B2 predominating among clinical UPEC populations and correlated with the highest AMR, whereas the elevated rate of multi-drug resistance among hospital wastewater was mostly phylogroup A. Together, our findings highlight hospital wastewater as a rich source of AMR and multi-drug resistant bacterial populations.

Engaging faculty in a workshop intervention on overcoming the influence of implicit bias.

INTRODUCTION: To study the effectiveness of any educational intervention for faculty requires first that they attend the training. Using attendance as a measure of faculty engagement, this study examined factors associated with the percentage of faculty in divisions of departments of medicine who attended a workshop as part of a multisite study. METHODS: Between October 2018 and March 2020, 1675 of 4767 faculty in 120 divisions of 14 departments of medicine attended a 3-hour in-person workshop as part of the Bias Reduction in Internal Medicine (BRIM) initiative. This paper describes the workshop development and study design. The number of faculty per division ranged from 5 to 296. Attendance rates varied from 2.7% to 90.1%. Taking a quality improvement approach, the study team brainstormed factors potentially related to variations in workshop attendance, constructed several division- and institution-level variables, and assessed the significance of factors on workshop attendance with hierarchical linear models. RESULTS: The following were positively associated with workshop attendance rate: the division head attended the workshop, the BRIM principal investigator gave Medical Grand Rounds, and the percentage of local workshop presenters who completed training. Workshop attendance rates fell when departments identified more than five on-site study leaders. CONCLUSIONS: Factors associated with higher workshop attendance may have increased the perceived status and value of attending the workshop, leading faculty to choose the workshop over other competing demands. For future investigators studying educational interventions that require participation of faculty in clinical departments at multiple sites, this work offers several valuable lessons.

Improving Department Climate Through Bias Literacy: One College's Experience.

Many institutions of higher education are investing in "implicit bias training" as a mechanism to improve diversity and inclusion on their campuses. In this study, we describe an effort to implement this training in the form of a 3-hour workshop delivered to faculty members in the College of Engineering at the University of Wisconsin-Madison. Evaluation form data collected immediately post-workshop, and in-person interviews and survey data collected 6-12 months post-workshop, were used to measure the effectiveness of the intervention. These data show that faculty awareness of implicit bias in their workplace environments increased significantly, although individual motivation and self-efficacy to act without bias, and self-reported bias-reduction actions, did not increase. At the same time, we found evidence of improved department climates and bias-reduction actions at the department level, which increase our confidence that the workshops were having a positive impact. Importantly, women and faculty of color in the College did not report increases in negative behavior after the workshop, and reported that their departments were engaging in explicit discussions of potential biases in departmental processes more often. These findings support the continued implementation of the "Breaking the Bias Habit®" workshops along with measurement of their success.

Promises and Pitfalls of Diversity Statements: Proceed With Caution.

As part of their efforts to increase the diversity of their workforce and student body, medical schools, academic medical centers, and individual departments are increasingly crafting public statements about their value for and commitment to diversity. For these statements to effectively enhance diversity, however, care must be taken, as research shows that some diversity-related messages can backfire. To avoid the pitfalls and realize the promise of diversity statements, this article presents recommendations based on experimental studies that investigate the impact of diversity messages. These studies suggest that diversity statements be aspirational, emphasize autonomy, and express a value for difference. Aspirational statements avoid creating the impression that equity has been achieved, thus preventing the "illusion of fairness" and the "paradox of meritocracy," wherein espousing egalitarian values and the existence of a meritocracy can increase biased outcomes and workplace disparities. Statements that emphasize autonomy avoid the backlash that can occur when organizational members feel coerced into adopting prodiversity actions. Statements that emphasize the value of human differences convey a multicultural message that has shown positive outcomes compared with "colorblind" statements that acknowledge our common humanity. Although there are no studies specific to academic medicine, current research on a variety of organizations, including some studies from the health care industry, suggests that relying on these recommendations to craft a diversity statement may help contribute to academic medical centers' larger efforts to promote diversity and inclusion and may help them avoid some deleterious effects.

Hidden species diversity in Sylvirana nigrovittata (Amphibia: Ranidae) highlights the importance of taxonomic revisions in biodiversity conservation.

Accurately delimiting species and their geographic ranges is imperative for conservation, especially in areas experiencing rapid habitat loss. Southeast Asia currently has one of the highest rates of deforestation in the world, is home to multiple biodiversity hotspots, and the majority of its countries have developing economies with limited resources for biodiversity conservation. Thus, accurately delimiting species and their ranges is particularly important in this region. We examined genetic and morphological variation in the widespread frog species Sylvirana nigrovittata (and its long-treated junior synonym S. mortenseni) with the goal of clarifying its taxonomic content and geographic range boundaries for conservation. We present evidence that the current concept of S. nigrovittata contains at least eight species, two of which are each known from only two localities, but that S. mortenseni is more geographically widespread than currently realized. Five of these species are described as new to science.

Signals of forest degradation in the demography of common Asian amphibians.

BACKGROUND: Lowland areas in tropical East and Southeast Asia have a long history of conversion from forestland to agricultural land, with many remaining forests being chronically degraded by wood cutting, livestock grazing, and burning. Wetland-breeding amphibians that have evolved in lowland forests in the region have adjusted to changes in habitat composition caused by humans' activities, and populations continue to persist. However, we have little understanding of the impacts of forest disturbance on these species beyond assessments of abundance and distribution, and species considered to be common and widespread have been largely neglected. METHODS: We examined body condition and sex ratios of toads (Duttaphrynus melanostictus), predation risk in treefrogs (2 Polypedates spp.), and growth and survival of leaf litter frogs (2 Microhyla spp.) in agricultural land, degraded forest, and intact forest in two study areas, Thailand and Hong Kong. RESULTS: Toad populations exhibited higher body condition and female-biased sex ratios in intact forest. Predation of treefrog embryos by flies was lower in intact and degraded forests than in agricultural land. Embryonic survival and larval growth and survival in leaf litter frogs were lower in intact forests than in agricultural land. Results for each study were similar between study areas. DISCUSSION: For three of five of these common amphibian species, we documented signals of forest loss and disturbance in their populations. Although these species occur in disturbed habitats, loss of forest cover continues to degrade aspects of their population demography. We urge conservation biologists to consider that populations of species appearing to be common, widespread, and tolerant of human disturbance may be eroding over time.

Shifts in frog size and phenology: Testing predictions of climate change on a widespread anuran using data from prior to rapid climate warming.

Changes in body size and breeding phenology have been identified as two major ecological consequences of climate change, yet it remains unclear whether climate acts directly or indirectly on these variables. To better understand the relationship between climate and ecological changes, it is necessary to determine environmental predictors of both size and phenology using data from prior to the onset of rapid climate warming, and then to examine spatially explicit changes in climate, size, and phenology, not just general spatial and temporal trends. We used 100 years of natural history collection data for the wood frog, Lithobates sylvaticus with a range >9 million km2, and spatially explicit environmental data to determine the best predictors of size and phenology prior to rapid climate warming (1901-1960). We then tested how closely size and phenology changes predicted by those environmental variables reflected actual changes from 1961 to 2000. Size, phenology, and climate all changed as expected (smaller, earlier, and warmer, respectively) at broad spatial scales across the entire study range. However, while spatially explicit changes in climate variables accurately predicted changes in phenology, they did not accurately predict size changes during recent climate change (1961-2000), contrary to expectations from numerous recent studies. Our results suggest that changes in climate are directly linked to observed phenological shifts. However, the mechanisms driving observed body size changes are yet to be determined, given the less straightforward relationship between size and climate factors examined in this study. We recommend that caution be used in "space-for-time" studies where measures of a species' traits at lower latitudes or elevations are considered representative of those under future projected climate conditions. Future studies should aim to determine mechanisms driving trends in phenology and body size, as well as the impact of climate on population density, which may influence body size.

"Apple Far from the Tree": comparative effectiveness of fiberoptic single-operator cholangiopancreatoscopy (FSOCP) and digital SOCP (DSOCP).

BACKGROUND: While the fiberoptic single-operator cholangiopancreatoscopy (FSOCP) system has demonstrated efficacy in the diagnosis and management of pancreaticobiliary diseases, the digital SOCP (DSOCP) appears to provide higher resolution digital imaging, however a comparison of these devices has not been established. The aim of this work was to compare the efficacy of FSOCP and DSOCP in biliary stone disease and indeterminate biliary strictures. METHODS: A retrospective analysis of a prospective cohort was performed in patients undergoing FSOCP or DSOCP demographics included indication, diagnostic yield, procedure time, radiation dose, and complications. RESULTS: 324 patients underwent cholangioscopy. FSOCP and DSOCP were utilized in 198 and 126 patients respectively. Male/female ratio was similar and mean age was 66 ± 13 years. Indications included stone disease, indeterminate stricture evaluation and "other" were 47%, 42% and 11% respectively. Mean procedure time for stone disease and the amount of radiation doses in DSOCP group were lower than the FSOCP group (P = 0.032 and P = 0.02, respectively). Diagnostic yield in indeterminate strictures was higher 78% with DSOCP system compared to 37% with FSOCP system (P = 0.004). Complication were low and similar between the groups. CONCLUSIONS: DSOCP system provides enhanced diagnostic yield, shorter procedure times and less radiation exposure compared to FSOCP system.

A Gender Bias Habit-Breaking Intervention Led to Increased Hiring of Female Faculty in STEMM Departments.

Addressing the underrepresentation of women in science is a top priority for many institutions, but the majority of efforts to increase representation of women are neither evidence-based nor rigorously assessed. One exception is the gender bias habit-breaking intervention (Carnes et al., 2015), which, in a cluster-randomized trial involving all but two departmental clusters (N = 92) in the 6 STEMM focused schools/colleges at the University of Wisconsin - Madison, led to increases in gender bias awareness and self-efficacy to promote gender equity in academic science departments. Following this initial success, the present study compares, in a preregistered analysis, hiring rates of new female faculty pre- and post-manipulation. Whereas the proportion of women hired by control departments remained stable over time, the proportion of women hired by intervention departments increased by an estimated 18 percentage points (OR = 2.23, dOR = 0.34). Though the preregistered analysis did not achieve conventional levels of statistical significance (p < 0.07), our study has a hard upper limit on statistical power, as the cluster-randomized trial has a maximum sample size of 92 departmental clusters. These patterns have undeniable practical significance for the advancement of women in science, and provide promising evidence that psychological interventions can facilitate gender equity and diversity.

Write More Articles, Get More Grants: The Impact of Department Climate on Faculty Research Productivity.

BACKGROUND: Many studies find that female faculty in academic medicine, science, and engineering experience adverse workplace climates. This study longitudinally investigates whether department climate is associated with future research productivity and whether the associations are stronger for female than male faculty. METHOD: Two waves of a faculty climate survey, institutional grant records, and publication records were collected for 789 faculties in academic medicine, science, and engineering at the University of Wisconsin-Madison between 2000 and 2010. Research productivity was measured as Number of Publications and Number of Grants awarded, and department climate was measured with scales for professional interactions, department decision-making practices, climate for underrepresented groups, and work/life balance. Ordinary least squares and negative binomial regression methods were used to assess gender differences in productivity, influences of department climate on productivity, and gender differences in effects of climate on productivity. RESULTS: Female faculty published fewer articles and were awarded fewer grants in the baseline period, but their productivity did not differ from male faculty on these measures in subsequent years. Number of Publications was positively affected by professional interactions, but negatively affected by positive work/life balance. Number of Grants awarded was positively affected by climate for underrepresented groups. These main effects did not differ by gender; however, some three-way interactions illuminated how different aspects of department climate affected productivity differently for men and women in specific situations. CONCLUSIONS: In perhaps the first study to assess the longitudinal impact of department climate on faculty research productivity, positive department climate is associated with significantly greater productivity for all faculty-women and men. However, some positive aspects of climate (specifically, work/life balance) may be associated with lower productivity for some female faculty at specific career periods. These findings suggest that departments that wish to increase grants and publications would be wise to foster a positive workplace climate.

The location of obstruction predicts stent occlusion in malignant gastric outlet obstruction.

BACKGROUND: Gastric outlet obstruction (GOO) can occur with locally invasive or metastatic cancer involving the upper gastrointestinal tract at the pylorus or the duodenum. Endoscopic management with self-expanding metal stents (SEMSs) is often the preferred palliative approach. Stent occlusion is a common reason for failure and reintervention. We set out to determine whether the location of the malignant obstruction is associated with the angulation of the stent and can predict stent occlusion. METHODS: We performed a retrospective review of consecutive patients who underwent successful duodenal stenting with SEMS for malignant GOO between 2006 and 2015 at a large advanced endoscopy referral center. We determined the location of obstruction, the stent angle, and the rate of technical and clinical success of stent placement. We then identified cases of subsequent stent occlusion confirmed by endoscopic evaluation. RESULTS: A total of 100 consecutive patients were included in the study; 91 of these patients had enough data to evaluate SEMS occlusion. A total of 21 patients (23%) developed stent occlusion with a median time of 39 days. The risk of occlusion sequentially increased as the obstruction occurred more distally from the antrum to the third or fourth portion of the duodenum (p = 0.006). This relationship was maintained after controlling for stent angle (p = 0.05). CONCLUSIONS: A distal location of malignant GOO was strongly predictive of stent occlusion, independent of stent angle. This may be due to longer and more complex distal obstructions, along with foreshortening of the stent during placement and tumor infiltration. If replicated, these results will have implications for endoscopic practice and future device development.

Difficult Dialogues: Negotiating Faculty Responses to a Gender Bias Literacy Training Program.

Diversity training is challenging and can evoke strong emotional responses from participants including resistance, shame, confusion, powerlessness, defensiveness, and anger. These responses create complex situations for both presenters and other learners. We observed 3 experienced presenters as they implemented 41 gender bias literacy workshops for 376 faculty from 42 STEMM (science, technology, engineering, mathematics, medicine) departments at one Midwestern university. We recorded questions and answers as well as participants' non-verbal activity during each 2.5-hour workshop. Employing content analysis and critical incident technique, we identified content that elicited heightened activity and challenging dialogues among presenters and faculty. Results from analysis of this observational data found three important findings: (1) presenters continually reinforced the idea that implicit bias is ordinary and pervasive, thus avoiding participant alienation by allowing participants to protect their self-worth and integrity; (2) difficult dialogues were managed calmly without verbal sparring or relinquishing control; (3) the presenters created an environment where individuals were more likely to accept threatening information.

The effect of an intervention to break the gender bias habit for faculty at one institution: a cluster randomized, controlled trial.

PURPOSE: Despite sincere commitment to egalitarian, meritocratic principles, subtle gender bias persists, constraining women's opportunities for academic advancement. The authors implemented a pair-matched, single-blind, cluster randomized, controlled study of a gender-bias-habit-changing intervention at a large public university. METHOD: Participants were faculty in 92 departments or divisions at the University of Wisconsin-Madison. Between September 2010 and March 2012, experimental departments were offered a gender-bias-habit-changing intervention as a 2.5-hour workshop. Surveys measured gender bias awareness; motivation, self-efficacy, and outcome expectations to reduce bias; and gender equity action. A timed word categorization task measured implicit gender/leadership bias. Faculty completed a work-life survey before and after all experimental departments received the intervention. Control departments were offered workshops after data were collected. RESULTS: Linear mixed-effects models showed significantly greater changes post intervention for faculty in experimental versus control departments on several outcome measures, including self-efficacy to engage in gender-equity-promoting behaviors (P = .013). When ≥ 25% of a department's faculty attended the workshop (26 of 46 departments), significant increases in self-reported action to promote gender equity occurred at three months (P = .007). Post intervention, faculty in experimental departments expressed greater perceptions of fit (P = .024), valuing of their research (P = .019), and comfort in raising personal and professional conflicts (P = .025). CONCLUSIONS: An intervention that facilitates intentional behavioral change can help faculty break the gender bias habit and change department climate in ways that should support the career advancement of women in academic medicine, science, and engineering.