Good practice or positive action? Using Q methodology to identify competing views on improving gender equality in academic medicine

Objectives: The number of women entering medicine has increased significantly, yet women are still under-represented at senior levels in academic medicine. To support the gender equality action plan at one School of Medicine, this study sought to (1) identify the range of viewpoints held by staff on how to address gender inequality and (2) identify attitudinal barriers to change. Design: Q methodology. 50 potential interventions representing good practice or positive action, and addressing cultural, organisational and individual barriers to gender equality, were ranked by participants according to their perception of priority. Setting: The School of Medicine at the University of Leeds, UK. Participants: Fifty-five staff members were purposively sampled to represent gender and academic pay grade. Results: Principal components analysis identified six competing viewpoints on how to address gender inequality. Four viewpoints favoured positive action interventions: (1) support careers of women with childcare commitments, (2) support progression of women into leadership roles rather than focus on women with children, (3) support careers of all women rather than just those aiming for leadership, and (4) drive change via high-level financial and strategic initiatives. Two viewpoints favoured good practice with no specific focus on women by (5) recognising merit irrespective of gender and (6) improving existing career development practice. No viewpoint was strongly associated with gender, pay grade or role; however, latent class analysis identified that female staff were more likely than male to prioritise the setting of equality targets. Attitudinal barriers to the setting of targets and other positive action initiatives were identified, and it was clear that not all staff supported positive action approaches. Conclusions: The findings and the approach have utility for those involved in gender equality work in other medical and academic institutions. However, the impact of such initiatives needs to be evaluated in the longer term

Ten years of NIHR Research Training: perceptions of the programmes. A qualitative interview study

Objectives The UK National Institute for Health Research (NIHR) training programmes were created to build and sustain research capacity in healthcare. Following the training programme 10-year strategic review, this qualitative study aimed to deepen understanding of facilitators and barriers for those progressing through NIHR-supported research careers. Design Semistructured qualitative study. Data collection and analysis Telephone interviews conducted between May and August 2017 were digitally recorded, transcribed and analysed using Framework Approach. Setting UK National Health Service (NHS) Trusts, university medical schools, District General Hospitals, Integrated Academic Training Programme centres and Research Design Services across the North East, North West, South East and South West of England, London and the Midlands. Participants Fourteen women and eight men, of whom, 14 were previous or current NIHR personal awardees (seven doctors and seven allied health professionals (AHPs) or nurses) and eight were managers (staff within clinical or university training-related roles). Results (1) NIHR awards were viewed as transformative for research careers; (2) however, there were perceptions of a biased ‘playing field’. (3) Inequalities were perceived for AHPs and nurses, those outside of established research institutes and those in ‘unfashionable’ specialisms. (4) While support for NIHR awards contributed to a healthy research culture, (5) short-term awards were perceived as a barrier to continuing an independent research career. Conclusions Participants perceived many strengths of the NIHR training programmes in terms of developing individual careers and research capacity. Areas in which improvement could enhance the ability to attract, develop and retain researcher were identified. Our findings are of relevance to schemes in other countries, where healthcare researchers experience similar challenges. Further work is needed to overcome barriers and ensure equity of access to, and success within, clinical research training schemes to sustain the research workforce needed to address future global health challenges

Mentoring as an intervention to promote gender equality in academic medicine: a systematic review

Background: Mentoring is frequently suggested as an intervention to address gender inequalities in the workplace. Objectives: To systematically review evidence published since a definitive review in 2006 on the effectiveness of mentoring interventions aimed at achieving gender equality in academic medicine. Design: Systematic Review, using the Template for Intervention Description and Replication as a template for data extraction and synthesis. Sample: Studies were included if they described a specific mentoring intervention in a medical school or analogous academic healthcare organisation and included results from an evaluation of the intervention. Eligibility criteria: Mentoring was defined as (1) a formally organised intervention entailing a supportive relationship between a mentor, defined as a more senior/experienced person and a mentee defined as a more junior/inexperienced person; (2) mentoring intervention involved academic career support (3) the mentoring relationship was outside line management or supervision of performance and was defined by contact over an extended period of time. Outcomes: The impact of mentoring was usually reported at the level of individual participants, for example, satisfaction and well-being or self-reported career progression. We sought evidence of impact on gender equality via reports of organisation-level effectiveness, of promotion or retention, pay and academic performance of female staff. Results: We identified 32 publications: 8 review articles, 20 primary observational studies and 4 randomised controlled trials. A further 19 discussed mentoring in relation to gender but did not meet our eligibility criteria. The terminology used, and the structures and processes reported as constituting mentoring, varied greatly. We identified that mentoring is popular with many who receive it; however, we found no robust evidence of effectiveness in reducing gender inequalities. Primary research used weak evaluation designs. Conclusions: Mentoring is a complex intervention. Future evaluations should adopt standardised approaches used in applied health research to the design and evaluation of effectiveness and cost-effectiveness

The curious under‐representation of women impact case leaders: Can we disengender inequality regimes?

Universities are increasingly expected to demonstrate the wider societal impacts of academic research. Yet women management scholars were disproportionately under‐represented in leading impact cases in the UK's REF (Research Excellence Framework) 2014. An analysis of 395 REF impact cases for business and management studies with an identifiable lead author revealed that only 25 per cent were led by women, of which 54 per cent were sole authored. Based on 12 in‐depth interviews with women impact case writers, we use Acker's inequality regimes framework to understand invisible and socially constructed gendering of the UK's policy that is designed to evaluate research impact. In a knowledge‐intensive workplace dominated by men, the shape and degree of gendered bases of inequality, systemic practices, processes and controls result in sub‐optimal talent management and gendered knowledge. We call for university leaders to be proactive in addressing barriers that fail to support or recognize women's leadership of research impact

A user-centred approach to developing bWell, a mobile app for arm and shoulder exercises after breast cancer treatment

Purpose: The study aim was to develop a mobile application (app) supported by user preferences to optimise self-management of arm and shoulder exercises for upper-limb dysfunction (ULD) after breast cancer treatment. Methods: Focus groups with breast cancer patients were held to identify user needs and requirements. Behaviour change techniques were explored by researchers and discussed during the focus groups. Concepts for content were identified by thematic analysis. A rapid review was conducted to inform the exercise programme. Preliminary testing was carried out to obtain user feedback from breast cancer patients who used the app for 8 weeks post-surgery. Results: Breast cancer patients’ experiences with ULD and exercise advice and routines varied widely. They identified and prioritised several app features: tailored information, video demonstrations of the exercises, push notifications, and tracking and progress features. An evidence-based programme was developed with a physiotherapist with progressive exercises for passive and active mobilisation, stretching and strengthening. The exercise demonstration videos were filmed with a breast cancer patient. Early user testing demonstrated ease of use, and clear and motivating app content. Conclusions: bWell, a novel app for arm and shoulder exercises was developed by breast cancer patients, health care professionals and academics. Further research is warranted to confirm its clinical effectiveness. Implications for Cancer Survivors: Mobile health has great potential to provide patients with information specific to their needs. bWell is a promising way to support breast cancer patients with exercise routines after treatment and may improve future self-management of clinical care

Genders at Work: Gender as a Geography of Power in the Academy

This chapter discusses contemporary research investigating how gender operates as a geography of power in the contemporary academy, particularly in relation to notions of ‘career’. Massey’s understanding of space as ‘a simultaneity of stories-so-far and places as collections of those stories’ (2005, p.11) shapes the research questions and a methodology of ‘spatial storytelling’ which foregrounds relationships between space and power in considering lived experiences of work and career. The chapter presents a selection of participants’ ‘stories-so-far’ which illustrate the complexity and dimensionality of lived, gendered experiences in the workplace and provide a basis for reflection on the opportunities these afford to resist sexism in the academy

An Investigation into the Feasibility of Using Mobile Technology to Support Search and Rescue Operations

In Search and Rescue (SAR) operations, the search team must know how to scan their search area efficiently with limited resources. Advances in mobile technology are driving the rapid growth of location based services (LBS) and this dissertation project investigates the feasibility of an LBS to support SAR operations. The LBS requires the ability to locate search team members, perform visibility analysis on-the-fly, and dynamically convey this information back to the user on a variety of mobile devices. The SARMApp (Search And Rescue Mapping Application) LBS is developed with the objective of providing proof of concept for such an application. SARMApp is implemented with a thin client architecture and the feasibility of visibility analysis for a single observation point, along with the feasibility of cumulative visibility analysis are investigated and performed to varying degrees of success. On the other hand, temporal cumulative visibility analysis is currently considered infeasible with the technologies investigated. The development and subsequent testing of SARMApp highlights a number of strengths and weaknesses in relation to geolocation performance , visibility analysis performance, the effectiveness of a web map and the usability of the user interface. It is concluded that SARMApp provides sufficient proof of concept that mobile technology could be used effectively to support SAR operations, however more work would be required if the application were to be used in a real-life SAR operation. In future it is anticipated that with further advances in technology, the envisaged SAR application will become more feasible and LBS could play a large role in SAR operations by increasing the efficiency of search operations and potentially saving lives as a result of this