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1. Exploring Gender Bias in Nursing Evaluations of Emergency Medicine Residents

Author

Alison M. Banta, Erynn Thinnes, Katie Pettit, Megan M. Palmer, Zachary S. Morgan, Krista Brucker, and Nash Whitaker

Subjects
Male, medicine.medical_specialty, Work ethic, media_common.quotation_subject, Sexism, MEDLINE, Interpersonal communication, Nursing Staff, Hospital, Feedback, 03 medical and health sciences, 0302 clinical medicine, Nursing, Perception, Humans, Medicine, Valence (psychology), Competence (human resources), Retrospective Studies, media_common, business.industry, Professional development, Internship and Residency, Physician-Nurse Relations, 030208 emergency & critical care medicine, Retrospective cohort study, General Medicine, Emergency medicine, Emergency Medicine, Female, Clinical Competence, business
Abstract

OBJECTIVES Nursing evaluations are an important component of residents' professional development as nurses are present for interactions with patients and nonphysician providers. Despite this, there has been few prior studies on the benefits, harms, or effectiveness of using nursing evaluations to help guide emergency medicine residents' development. We hypothesized that gender bias exists in nursing evaluations and that female residents, compared to their male counterparts, would receive more negative feedback on the perception of their interpersonal communication skills. METHODS Data were drawn from nursing evaluations of residents between March 2013 and April 2016. All comments were coded if they contained words falling into four main categories: standout, ability, grindstone, and interpersonal. This methodology and the list of words that guided coding were based on the work of prior scholars. Names and gendered pronouns were obscured and each comment was manually reviewed and coded for valence (positive, neutral, negative) and strength (certain or tentative) by at least two members of the research team. Following the qualitative coding, quantitative analysis was performed to test for differences. To evaluate whether any measurable differences in ability between male and female residents existed, we compiled and compared American Board of Emergency Medicine in-training examination scores and relevant milestone evaluations between female and male residents from the same period in which the residents were evaluated by nursing staff. RESULTS Of 1,112 nursing evaluations, 30% contained comments. Chi-square tests on the distribution of valence (positive, neutral, or negative) indicated statistically significant differences in ability and grindstone categories based on the gender of the resident. A total of 51% of ability comments about female residents were negative compared to 20% of those about male residents (χ2 = 11.83, p more...

Published
2019
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3. "Showing up to the conversation": Qualitative reflections from a diversity, equity, and inclusion book club with emergency medicine leadership.

Author

Alexander AB, Palmer M, Palmer D, and Pettit K

Subjects
Humans, Female, Male, Adult, Social Inclusion, Emergency Medicine education, Qualitative Research, Leadership, Cultural Diversity
Abstract

Background: Diversity, equity, and inclusion (DEI) in health care fosters many positive outcomes including improved patient care. DEI initiatives are often created by or require buy-in from departmental leaders with low DEI literacy. Book clubs are one way to develop DEI literacy. The purpose of this paper is to describe how leaders in the department of emergency medicine (DEM) process the information gained from reading a DEI book through discussion in a book club setting and explore how participation enhances their DEI literacy and fosters self-reflection., Methods: This was a qualitative exploratory study based on a constructivist approach. Data were analyzed by four researchers using inductive thematic analysis techniques., Results: Sixty-eight leaders within the DEM participated in 11 book clubs. Nine themes were identified (examination of privilege, initial reaction to discussion about racism, discomfort, worry, self-reflection, release, role recognition, readiness, and education). After prompted examination of their own privilege participants moved through a model of perceived readiness to act. Participants started with feeling paralyzed by the work's enormity or becoming defensive. They then moved toward discomfort with discussions of racism and systemic racism and progressed to discussions around worrying that they were contributing to noninclusive environments. After a period of self-reflection, participants tended to release their paralysis, push aside their defensiveness, accept the role of discomfort, and express the importance of education on these issues. Participants then recognized their role in creating inclusive environments and started discussing what they can do about it, which, for many, was to show up to the conversation. An underlying driver of movement through this model was the education that was provided through the book., Conclusions: By addressing privilege and systemic inequities through the reflective practice and dialogue of a book club, participants demonstrated a growing commitment and perceived readiness to advancing inclusive practices within medicine., (© 2024 The Author(s). Academic Emergency Medicine published by Wiley Periodicals LLC on behalf of Society for Academic Emergency Medicine.) more...

Published
2025
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