Identifying Positive and Negative Factors That Affect the Promotion of Clinical Faculty at the Wayne State University School of Medicine: Does Gender Matter?

INTRODUCTION: Despite well-documented gender disparity in academic medicine, there are many women who achieve success, including successful promotion to associate and full professor status. This study sought to determine whether there was a gender difference in the perception of positive and negative factors affecting the process of promotion to associate or full professor at the Wayne State University School of Medicine (WSUSOM). METHODS: All clinically active associate and full professors who achieved their most recent promotion at the WSUSOM were sent a link to a survey that obtained demographic information as well as the opinions of the respondents regarding what positive and negative factors impacted their most recent promotion. RESULTS: Of the 73 respondents (24%), 58 (19%) were included in our final analysis. Two obstacles ("Lack of interest and encouragement from institutional or departmental leaders" and "Lack of tangible commitment from institutional or departmental leadership [e.g., protected time]") were ranked in the top three ranks by a substantially greater percentage of females than males. Gender-specific networking was seen as significantly more valuable to female faculty members whereas having a stay-at-home partner was seen as significantly more valuable to male faculty members. CONCLUSION: At the WSUSOM, providing more gender-specific networking for women, increasing interest and encouragement from institutional and departmental leaders, and providing a tangible commitment to female faculty from these leaders may help more women to achieve promotion to associate or full professor.

The prevalence of and attitudes toward neonatal functional echocardiography use and training in the United States: a survey of neonatal intensive care unit medical directors.

BACKGROUND: Internationally, neonatologists are increasingly performing functional echocardiography to evaluate the hemodynamic status and cardiac function in neonates. The purpose of this study was to describe the current prevalence of and attitudes toward the use and training of neonatologists in functional echocardiography in the United States. METHODS: An anonymous survey was sent to United States neonatal intensive care unit medical directors. Neonatologists scored availability of echocardiography and attitudes toward the use and training of neonatologists in functional echocardiography. RESULTS: Response rate was 43.7% (247 of 565 surveys sent) and captured 95% of the neonatal-perinatal training programs. Nine percent of units had a functional echocardiography trained neonatologist; eight percent of the neonatal-perinatal training programs offered functional echocardiography training. There was no difference in the timely ability to obtain hemodynamic status with echocardiography in units compared by the presence of functional echocardiography trained neonatologists (mean = 3.13 vs. 2.67, p = 0.08) and fellowships (mean = 2.69 vs. 2.72, p = 0.85). Overall positive attitudes (mean = 14.6 ± 3.46) towards the training of neonatologists in functional echocardiography did not correlate with the perceived timely availability of echocardiography support (mean = 2.72 ± 1.43, r = -0.11, p = 0.1). CONCLUSION: Functional echocardiography use and training is not prevalent in the United States. There are positive attitudes toward the training of neonatologists in functional echocardiography that are independent of the presence of fellowships, neonatologists with echocardiography training, and the perceived availability of echocardiography support.

Patient-provider perceptions of diabetes and its impact on self-management: a comparison of African-American and White patients.

AIMS: To compare patient-provider differences in diabetes-related perceptions between African-American and White patients and to examine its association with self-care behaviours. METHODS: One hundred and thirty patient-provider pairs were recruited from the greater Detroit area. Patients and providers completed a survey assessing perceptions about diabetes-related concepts and demographic background. The Diabetes Semantic Differential Scale was used to measure diabetes-related perceptions. Patients also reported the frequency of performing self-care behaviours, including following a healthy eating plan, engaging in physical activity, blood glucose monitoring, and taking medication and/or insulin. RESULTS: There were a greater number of patient-provider differences in diabetes-related perceptions for the African-American patients (nine of 18 concepts) compared with the White patients (four of 18 concepts). Stepwise regression analyses found patients' semantic differential scores to be significantly associated with five self-care behaviours for African-American patients and two self-care behaviours for White patients. Providers' semantic differential scores emerged as predictors of self-care behaviours for African-American patients, but not for White patients. CONCLUSIONS: Our findings suggest that compared with White patients, African-Americans differ in a greater number of diabetes-related perceptions than their providers. Patients' and providers' perceptions of diabetes care concepts have a significant impact on a greater number of self-care behaviours for African-American patients than White patients.

Effects of anticipatory stress on decision making in a gambling task.

Recent research has highlighted the fact that emotion that is intrinsic to a task benefits decision making. The authors tested the converse hypothesis, that unrelated emotion disrupts decision making. Participants played the Iowa Gambling Task, during which only experimental participants anticipated giving a public speech (A. Bechara, D. Tranel, & H. Damasio, 2000). Experimental participants who were anticipating the speech learned the contingencies of the choices more slowly, and there was a gender interaction later in the game, with stressed female participants having more explicit knowledge and more advantageous performance and stressed male participants having poorer explicit knowledge and less advantageous performance. Effects of anticipatory stress on decision making are complex and depend on both the nature of the task and the individual.