The Intersection of Gender and Resuscitation Leadership Experience in Emergency Medicine Residents: A Qualitative Study

Linden, Judith A.; Breaud, Alan H.; Mathews, Jasmine C.; McCabe, Kerry K.; Schneider, Jeffrey I.; Liu, James H.; Halpern, Leslie E.; Barron, Rebecca; Clyne, Brian; Smith, Jo; Kauffman, Douglas F.; Dempsey, Michael S.; Dechert, Tracey; Mitchell, Patricia

doi:10.1002/aet2.10096

Cited by 22 publications

(32 citation statements)

References 17 publications

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“…With respect to when medical residents negotiate (negotiation frequency), it became apparent that medical residents interacted more with nurses than with their supervisors. Nurses expect female medical residents to be more sympathetic and communicative as described by Linden et al 20 This could explain why medical residents interact more often with nurses than with supervisors to build trust and a good relationship 20 - 22 . Even though medical residents interacted more frequently with nurses, negotiation frequency did not vary with WE, hierarchy, NS, NK or CS.…”

Section: Discussionmentioning

confidence: 87%

Exploring medical residents’ perceived need for negotiation skills training

et al. 2019

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ObjectivesThis study explores the optimal focus for negotiation skills development training by investigating how often medical residents negotiate in practice, and how they perceive the effectiveness of their negotiation capabilities. MethodsAn exploratory study was performed using a questionnaire regarding the medical residents’ working environment, negotiation frequency, knowledge and skills using a 5-point Likert scale, multiple choice questions and open questions. Exploratory factor analysis with principal component analysis, varimax rotation, reliability analysis, and content analysis were used to reduce the number of variables. Descriptive and interferential statistics and multiple regression analysis were used to analyze the data. ResultsWe analyzed the responses of 60 medical residents. The findings showed that the perceived development of their negotiation knowledge (M=3.06, SD=0.83) was less than their negotiation skills (M=3.69, SD=0.47). Their attitude during negotiations, especially females, differed substantially in the interactions with nurses than with their supervisors. Medical residents with more working experience, better negotiation skills or who worked in hierarchical environments negotiated more frequently with their supervisors. Medical residents with better collaboration skills and negotiation knowledge demonstrated better negotiation skills. ConclusionsThis study underlines medical residents’ need for negotiation training. In addition to the basic negotiation knowledge and skills, training programs in negotiation should focus on the medical residents’ awareness of their attitudes during negotiations, combining the assertiveness shown in interactions with supervisors with the empathy and emotional engagement present in interactions with nurses. Furthermore, attention should be paid to the influence of the environmental hierarchy on negotiation skill development.

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Section: Discussionmentioning

confidence: 87%

Exploring medical residents’ perceived need for negotiation skills training

et al. 2019

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“…Narrative analysis of the included studies collectively indicates that there are two types of leadership in ED. The first type relates to clinical leadership, which involve leading a team to complete specific clinical tasks, such as trauma management or resuscitation 11–13,20–33 . This may be performed by the attending fellow or resident physician who may or may not have a formal leadership position but who does have the necessary clinical expertise.…”

Section: Resultsmentioning

confidence: 99%

“…Consistent with this, the literature provided important insights into the dynamic delegation of leadership 27 and the interplay between directive, facilitative and shared leadership styles in ad hoc interdisciplinary extreme action teams. 15,29,32 This line of inquiry draws attention to the notion that leadership in ED teams is characterised not by a single leadership style by a formal leader, but rather a range of styles that are deployed dynamically, formally and informally by a range of actors as a function of a range of situational and social factors. This suggests that ED team leadership is pluralistic, relational, dynamic and contingent.…”

Section: Discussionmentioning

confidence: 99%

“…The first type relates to clinical leadership, which involve leading a team to complete specific clinical tasks, such as trauma management or resuscitation. [11][12][13][20][21][22][23][24][25][26][27][28][29][30][31][32][33] This may be performed by the attending fellow or resident physician who may or may not have a formal leadership position but who does have the necessary clinical expertise. The second type of ED leadership relates to medical leadership (e.g.…”

Section: Types Of Medical Leadershipmentioning

confidence: 99%

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Review article: Systematic literature review of leadership in emergency departments

Wilson

Rixon

Hartanto

et al. 2020

Emerg Medicine Australasia

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Emergency medicine (EM) is a discipline with complex leadership demands. However, studies of EM physician leadership and ED leadership are in their infancy. As such, there is a lack of clarity about the forms, antecedents, enablers, barriers and consequences of EM physician leadership. A systematic review of the scientific literature was conducted to reveal the different conceptualisations of EM physician leadership, the activities involved in the practice of leadership, and the knowledge and skills of effective ED leaders. Seven databases were systematically searched for peerreviewed empirical studies on the topic of EM physicians carrying out a manager or leadership role in an ED setting. Finally, 26 articles were included, and their findings were synthesised and analysed narratively. Two conceptualisations of EM physician leadership were found, reflecting clinical leadership and medical leadership, respectively. Clinical leadership is performed by all EM physicians, often informally, within their daily clinical practice, whereas medical leadership is performed by EM physicians who work at the management level within a hospital, in addition to or instead of their clinical practice. The focus of EM physician leadership and ED leadership research is team leadership, with much less attention given to wider organisation leadership. Consistent with the focus on team leadership, clinical knowledge and skill in orchestrating teams, especially trauma and resuscitation teams, emerged as the most important factors underpinning leadership effectiveness. Future research and training should make better use of existing leadership theory and research designs to illuminate the forms, dynamics, antecedents, moderators and consequences of EM physician leadership.

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“…Several studies have attempted to explore the dynamic relationships between genders in leadership positions in medicine. Keck‐McNulty and Wear reported that female residents most commonly expressed “excessive self‐monitoring of communication style due to fears of being perceived as too demanding and not friendly enough … having to justify their orders more than their male peers … and receiving less assistance than their male peers.” The study of female leadership roles during resuscitations by Linden and colleagues also revealed gender discrepancies, stating that “female residents had to earn the trust and respect of the nurses more than their male counterparts.” These prior studies suggest that female residents continue to face challenges in their training program that their male counterparts do not.…”

mentioning

confidence: 99%

Exploring Gender Bias in Nursing Evaluations of Emergency Medicine Residents

Brucker

Whitaker

Morgan

et al. 2019

Academic Emergency Medicine

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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 (v 2 = 11.83, p < 0.01). A total of 57% of grindstone comments about female residents were negative as opposed 24% of those about male residents (v 2 = 6.03, p < 0.01).Conclusions: Our findings demonstrate that, despite the lack of difference in ability or competence as measured by in-service examination scores and milestone evaluations, nurses evaluate female residents lower in their abilities and work ethic compared to male residents.From the

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The Intersection of Gender and Resuscitation Leadership Experience in Emergency Medicine Residents: A Qualitative Study

Cited by 22 publications

References 17 publications

Exploring medical residents’ perceived need for negotiation skills training

Exploring medical residents’ perceived need for negotiation skills training

Review article: Systematic literature review of leadership in emergency departments

Exploring Gender Bias in Nursing Evaluations of Emergency Medicine Residents

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