Author:
Houchens Nathan,Quinn Martha,Harrod Molly,Cronin Daniel T,Hartley Sarah,Saint Sanjay
Abstract
BACKGROUND: Women in medicine experience
discrimination, hostility, and unconscious bias frequently
and with deleterious effects. While these gender-based
challenges are well described, strategies to navigate and
respond to them are less understood.
OBJECTIVE: To explore the lived experiences of female
teaching attending physicians emphasizing strategies
they use to mitigate gender-based challenges in clinical
environments.
DESIGN: Multisite exploratory, qualitative study.
SETTING: Inpatient general medicine teaching rounds in
six geographically diverse US academic hospitals between
April and August 2018.
PARTICIPANTS: With use of a modified snowball sampling
approach, female attendings and their learners were
identified; six female attendings and their current (n = 24)
and former (n = 17) learners agreed to participate.
MEASUREMENTS: Perceptions of gender-based
challenges in clinical teaching environments and strategies
with which to respond to these challenges were evaluated
through semistructured in-depth interviews, focus
group discussions, and direct observations of rounds.
Observations were documented using handwritten field
notes. Interviews and focus groups were audio recorded
and transcribed. All transcripts and field note data were
analyzed using a content analysis approach.
MAIN OUTCOMES: Attending experience levels ranged
from 8 to 20 years (mean, 15.3 years). Attendings were
diverse in terms of race/ethnicity. Strategic approaches to
gender-based challenges clustered around three themes:
female attendings (1) actively position themselves as
physician team leaders, (2) consciously work to manage
gender-based stereotypes and perceptions, and (3)
intentionally identify and embrace their unique qualities.
CONCLUSION: Female attendings manage their roles
as women in medicine through specific strategies to
both navigate complex gender dynamics and role model
approaches for learners. Journal of Hospital Medicine
2020;15:XXX-XXX. © 2020 Society of Hospital Medicine
Subject
Assessment and Diagnosis,Care Planning,Health Policy,Fundamentals and skills,General Medicine,Leadership and Management
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