Objectives: Prior research has demonstrated that men and women emergency medicine (EM) residents receive similar numerical evaluations at the beginning of residency, but that women receive significantly lower scores than men in their final year. To better understand the emergence of this gender gap in evaluations we examined discrepancies between numerical scores and the sentiment of attached textual comments. Methods: This multicenter, longitudinal, retrospective cohort study took place at four geographically diverse academic EM training programs across the United States from July 1, 2013-July 1, 2015 using a real-time, mobile-based, direct-observation evaluation tool. We used complementary quantitative and qualitative methods to analyze 11,845 combined numerical and textual evaluations made by 151 attending physicians (94 men and 57 women) during real-time, direct observations of 202 residents (135 men and 67 women). Results: Numerical scores were more strongly positively correlated with positive sentiment of the textual comment for men (r = 0.38, P < 0.001) compared to women (r = -0.26, P < 0.04); more strongly negatively correlated with mixed (r = -0.39, P < 0.001) and negative (r = -0.46, P < 0.001) sentiment for men compared to women (r = -0.13, P < 0.28) for mixed sentiment (r = -0.22, P < 0.08) for negative; and women were around 11% more likely to receive positive comments alongside lower scores, and negative or mixed comments alongside higher scores. Additionally, on average, men received slightly more positive comments in postgraduate year (PGY)-3 than in PGY-1 and fewer mixed and negative comments, while women received fewer positive and negative comments in PGY-3 than PGY-1 and almost the same number of mixed comments. Conclusion: Women EM residents received more inconsistent evaluations than men EM residents at two levels: 1) inconsistency between numerical scores and sentiment of textual comments; and 2) inconsistency in the expected career trajectory of improvement over time. These findings reveal gender inequality in how attendings evaluate residents and suggest that attendings should be trained to provide all residents with feedback that is clear, consistent, and helpful, regardless of resident gender.
// Laura Nelson 1, * , Hayley D. McKeen 1, * , Andrea Marshall 2, * , Laoighse Mulrane 3 , Jane Starczynski 4 , Sarah J. Storr 5 , Fiona Lanigan 3 , Christopher Byrne 6 , Ken Arthur 7 , Shauna Hegarty 8 , Ahlam Abdunnabi Ali 1 , Fiona Furlong 1 , Helen O. McCarthy 1 , Ian O. Ellis 5 , Andrew R. Green 5 , Emad Rakha 5 , Leonie Young 6 , Ian Kunkler 10 , Jeremy Thomas 10 , Wilma Jack 10 , David Cameron 10 , Karin Jirström 11 , Anita Yakkundi 1 , Lana McClements 1 , Stewart G. Martin 5 , William M. Gallagher 3 , Janet Dunn 2 , John Bartlett 4, 9 , Darran O'Connor 3 , Tracy Robson 1 1 School of Pharmacy, Queen's University Belfast, Belfast, United Kingdom 2 Warwick Clinical Trials Unit, University of Warwick, Coventry, United Kingdom 3 Conway Institute, University College Dublin, Dublin, Ireland 4 Ontario Institute for Cancer Research, Toronto, Canada 5 Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham, United Kingdom 6 Royal College of Surgeons Ireland, Dublin, Ireland 7 Northern Ireland Molecular Pathology Laboratory, CCRCB, Queens University Belfast, Belfast, United Kingdom 8 Department of Pathology, Royal Group of Hospitals, Grosvenor Road, Belfast, United Kingdom 9 Edinburgh Cancer Research Centre, The University of Edinburgh, Edinburgh, United Kingdom 10 Edinburgh Breast Unit, The University of Edinburgh, Edinburgh, United Kingdom 11 Department of Clinical Sciences, Lund University, Sweden * These authors have contributed equally to this work Correspondence to: Tracy Robson, e-mail: t.robson@qub.ac.uk Keywords: FKBPL, breast cancer, biomarker, personalized medicine Received: January 27, 2015 Accepted: March 09, 2015 Published: April 03, 2015 ABSTRACT FK506-binding protein-like (FKBPL) has established roles as an anti-tumor protein, with a therapeutic peptide based on this protein, ALM201, shortly entering phase I/II clinical trials. Here, we evaluated FKBPL's prognostic ability in primary breast cancer tissue, represented on tissue microarrays (TMA) from 3277 women recruited into five independent retrospective studies, using immunohistochemistry (IHC). In a meta-analysis, FKBPL levels were a significant predictor of BCSS; low FKBPL levels indicated poorer breast cancer specific survival (BCSS) (hazard ratio (HR) = 1.30, 95% confidence interval (CI) 1.14–1.49, p < 0.001). The prognostic impact of FKBPL remained significant after adjusting for other known prognostic factors (HR = 1.25, 95% CI 1.07–1.45, p = 0.004). For the sub-groups of 2365 estrogen receptor (ER) positive patients and 1649 tamoxifen treated patients, FKBPL was significantly associated with BCSS (HR = 1.34, 95% CI 1.13–1.58, p < 0.001, and HR = 1.25, 95% CI 1.04–1.49, p = 0.02, respectively). A univariate analysis revealed that FKBPL was also a significant predictor of relapse free interval (RFI) within the ER positive patient group, but it was only borderline significant within the smaller tamoxifen treated patient group (HR = 1.32 95% CI 1.05–1.65, p = 0.02 and HR = 1.23 95% CI 0.99–1.54, p = 0.06, respectively). The data suggests a role for FKBPL as a prognostic factor for BCSS, with the potential to be routinely evaluated within the clinic.
Education in the medical and health professions is considerably different than education in most higher education contexts (e.g., multiple instructors, clinical focus, student cohorts, etc.). Thus, despite a mature research literature relating to course and instructor evaluations in higher education, there largely is an absence of such literature in medical and health professions education. This study sought to contribute to the medical and health professions education literature by: 1) introducing a new instrument for evaluating course effectiveness; 2) demonstrating how to conduct a state-of-the-art psychometric validation study of an instrumentâs psychometric properties; and 3) providing a framework for interpreting construct validity evidence. Results of the validation study indicated a considerable amount of construct validity evidence is discernible to conclude the instrument is capable of producing valid and reliable measures of course quality and effectiveness. Other medical and health professions educators are encouraged to adopt the instrument for use at oneâs own campus, and/or replicate the validation procedures on other survey instruments.
Veterinary internships are common 1-year post-graduate clinical training programs that are offered both at veterinary colleges and in private practice settings. To promote the quality of these training programs, the American Association of Veterinary Medical Colleges (AAVMC) charged a working group to develop these internship guidelines, which were approved by the AAVMC in 2018 and have also been endorsed by the American Association of Veterinary Clinicians. These guidelines are intended to be applicable to all internships, in both academic and private practice settings, and they place particular emphasis on three aspects of internship training programs: competency-based education, intern well-being, and program outcome.
Abstract Experiments were conducted in the field and the greenhouse to determine whether vesicular‐arbus‐cular mycorrhizae affect growth and competition between the native perennial Stipa pulchra and the introduced annual Avena barbata. Soils in the greenhouse were steam‐sterilized, and in the field they were treated with the fungicide benomyl. Stipa pulchra showed decreased shoot dry mass and increased root mass when inoculated, while A. barbata showed the opposite response, increased shoot mass and decreased root mass. Mycorrhizal A. barbata also produced more seeds. Mycorrhizae did not alleviate the negative effects of competition of A. barbata on S. pulchra , as has been demonstrated for other pairs of weedy and nonweedy species. The same three species of mycorrhizal fungi were present in annual and perennial grasslands, but their relative composition was different. When inoculum from the two grassland types were tested in the field, the fungal species began to revert within five months to the species composition found in grasslands of the host plant. This indicates that, once annual grassland has been revegetated with the native S. pulchra , the original fungal species composition may return relatively quickly. Where A. barbata dominates, inoculation with mycorrhizal fungi alone will not suffice for establishing S. pulchra , and the usual practices for control of weed competition need to be employed.
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