Sélection des résidents et efficacité d’une formation en matière de biais implicites pour les directeurs des programmes de résidence

Implication Statement One element to address health disparities and historical injustices of systemically excluded groups is to examine selection processes. Implicit association testing for selection committees is suggested as one intervention to address bias in selection and is used for Undergraduate Medical Education at the University of Manitoba.  Our study demonstrated that implicit bias training for PDs in isolation has minimal impact on addressing bias within resident selection. This training must occur as part of a systemic institutional approach to address bias in resident selection. Programs should consider a multipronged and sustained approach when committing to diversifying postgraduate medical education programs.Énoncé des implications de la recherche Le processus de sélection est un des éléments à revoir pour lutter contre les inégalités en matière de santé et les injustices historiques dont souffrent les populations victimes d’exclusion systémique. Une des mesures suggérées pour contrer le biais de sélection est de soumettre les membres des comités de sélection à des tests d'association implicite. Ils sont utilisés à l'Université du Manitoba au programme d’études médicales de premier cycle. Or, notre étude montre qu’une formation en matière de biais implicites, lorsqu’elle est offerte de manière isolée aux directeurs de programme, a peu d’impact sur l’élimination des préjugés dans la sélection des résidents. Les programmes qui désirent favoriser la diversité doivent envisager une approche multidimensionnelle et soutenue

Payer le prix? Conciliation travail universitaire et famille pendant la pandémie de la COVID-19

Introduction: The shift to remote working/learning to slow transmission of the SARS-CoV-2 virus has had widespread mental health impacts. We aimed to describe how the COVID-19 pandemic impacted the mental health of students and faculty within a health sciences faculty at a central Canadian university. Methods: Via an online survey, we queried mental health in the first four months of the COVID-19 pandemic quantitatively (scale: 1 (most negative)-100 (most positive)) and qualitatively. Results: The sample (n = 110) was predominantly women (faculty 39/59; [66.1%]; students 46/50; [92.0%]). Most faculty were married/common law (50/60; [84.8%]) and had children at home (36/60; [60.0%]); the opposite was true for most students.  Faculty and students self-reported comparable mental health (40.47±24.26 and 37.62±26.13; respectively). Amongst women, those with vs. without children at home, reported significantly worse mental health impacts (31.78±23.68 vs. 44.29±27.98; respectively, p = 0.032). Qualitative themes included: “Sharing resources,” “spending money,” “few changes,” for those without children at home; “working at home can be isolating,” including the subtheme, “balancing act”: “working in isolation,” “working more,” for those with children at home. Discussion: Amongst women in academia, including both students and faculty, those with children at home have disproportionately worse mental health than those without children at home.Introduction : Le virage vers le travail et l’enseignement à distance pour ralentir la transmission du virus SRAS-CoV-2 a eu des répercussions étendues sur la santé mentale. Notre étude vise à décrie l’impact de la pandémie de la COVID-19 sur la santé mentale des étudiants et du corps professoral au sein Faculté des sciences de la santé d’une université du centre du Canada. Méthodes : Un questionnaire en ligne a été administré pour récolter des données qualitatives et quantitatives (échelle : de 1 [le plus négatif] à 100 [le plus positif] à l’égard de la santé mentale des participants au cours des quatre premiers mois de la pandémie. Résultats : L’échantillonnage (n = 110) était majoritairement composé de femmes (membres du corps professoral : 39/59 ou 66,1 %; étudiantes 46/50 ou 92,0 %). La plupart des répondants du corps professoral étaient mariés ou en union libre (50/60 ou 84,8 %) et avaient des enfants à la maison (36/60 ou 60,0 %). Le contraire était vrai pour la plupart des étudiants. L’état de santé mentale déclaré par le corps professoral et les étudiants était comparable (40,47±24,26 et 37,62±26,13 respectivement). Parmi les femmes, autant celles qui avaient des enfants à la maison que celles qui n’en avaient pas, ont déclaré que leur santé mentale était nettement moins bonne (31,78±23,68 contre 44,29±27,98 respectivement; p = 0,032). Pendant l’analyse des données qualitatives, on a identifié les thèmes « le partage de ressources », « les dépenses » et « peu de changements » pour les répondants qui n’avaient pas d’enfants à la maison alors que les thème « le télétravail accentue l’isolement », ainsi que lessous-thèmes « maintien de l’équilibre : travailler en isolement’’ et ‘’travailler plus » ont émergé pour ceux qui avaient des enfants à la maison. Discussion : Parmi les femmes œuvrant dans le milieu universitaire, qu’elles soient étudiantes ou membres du corps professoral, la santé mentale de celles qui ont des enfants à la maison est davantage affectée que celle des femmes qui n’en ont pas

It takes (at least) two to tango: comparing the affordances of two learner mistreatment reporting mechanisms

Background: The affordances, or characteristics, of learner mistreatment reporting mechanisms can shape the information elicited from these mechanisms, which has an impact on how institutions understand the scope and nature of learner mistreatment. This study compares whether and how the affordances of two mistreatment reporting mechanisms elicit different information about learner mistreatment at a single institution.   Methods: We conducted an interpretive content analysis of reports submitted using two mechanisms, one that elicits reports through end-of-rotation evaluations and one through a voluntary web-based system, between July 2015 and December 2021. We extracted the metadata from reports and applied a coding framework informed by the Healthcare Complaints Analysis Tool (HCAT) to the narrative descriptions in reports. Data analysis included descriptive statistics and the chi-square test on SPSS v.27.  Results: We collected 90 elicited reports and 240 voluntary reports of mistreatment. Similar types of mistreatment were reported through each mechanism, but disrespectful behaviour and bias and discrimination were reported significantly more in voluntary reports. Elicited reports most frequently included incidents of learner mistreatment in clinical settings, whereas voluntary reports included incidents from a wide variety of settings and people or were issues other than mistreatment. Discussion: Utilizing multiple learner mistreatment reporting mechanisms with different affordances can mitigate the limitations of a single mechanism, help identify a more nuanced understanding of learner mistreatment, and increase reporters’ choices for how and when to report mistreatment. Increased information allows an institution to address specific incidents and develop targeted, preventive educational activities and faculty development

Advancing positive medical student academic learning environments to enhance student well-being

Advancing Positive Medical Student Academic Learning Environments to Enhance Student Well-Being by Jackie Gruber Abstract Problem: Learner mistreatment is common in medical education and comes with an array of effects for learners and the profession. Mistreatment can truncate learning if a learner does not feel safe to speak up. This can limit learners in reporting patient safety issues, particularly if there are potential negative consequences to their careers. This study sought to understand what impedes speaking up culture by examining undergraduate medical students’ perspectives on barriers to speaking up, and reporting hesitancy drawing on theories of power imbalances, implicit voice, fear of reprisal, and learners’ social locations and identity. Methods: This study employed a participatory research design. Stakeholders from the Max Rady College of Medicine (MRCM) provided feedback on the study design, implementation, and study results. Mixed-methods electronic semi-structured survey that captured both quantitative and qualitative data was administered. The study population was the undergraduate medical learners’ years one to four who were enrolled as of 2018 at the MRCM. Analyses were performed using statistical and qualitative analysis programs. Results: We identified the comfort level of learners speaking up to different power roles and learners’ implicit voice theories, which acted as barriers to speaking up. We identified gendered differences in comfort with speaking up about mistreatment. We described the implicit theories students held about risks of reporting including impact on future career and harm to reputation. Themes of what learners wanted to contribute to a positive learning environment were identified, such as supporting one another. Conclusions: We concluded that reporting processes must consider power, gender, third party and multi-party reporting in their processes. Institutions need to address speaking up and fear of reprisal by means of education on anti-racism, rights and responsibilities, implicit bias, and gender and social orientation discrimination. This research could inform intervention studies by clarifying the sources of resistance to reporting and allow for the design of reporting mechanisms that specifically address these perceived risks. We attempted to identify who felt unsafe speaking up as it relates to intersectionality, however, given the relatively small sample size, we were not able to make conclusive statements in this regard. Further research is needed.October 202

Does it work? Resident selection and implicit bias training for postgraduate program directors

Implication StatementOne element to address health disparities and historical injustices of systemically excluded groups is to examine selection processes. Implicit association testing for selection committees is suggested as one intervention to address bias in selection and is used for Undergraduate Medical Education at the University of Manitoba. Our study demonstrated that implicit bias training for PDs in isolation has minimal impact on addressing bias within resident selection. This training must occur as part of a systemic institutional approach to address bias in resident selection. Programs should consider a multipronged and sustained approach when committing to diversifying postgraduate medical education programs.Énoncé des implications de la rechercheLe processus de sélection est un des éléments à revoir pour lutter contre les inégalités en matière de santé et les injustices historiques dont souffrent les populations victimes d’exclusion systémique. Une des mesures suggérées pour contrer le biais de sélection est de soumettre les membres des comités de sélection à des tests d'association implicite. Ils sont utilisés à l'Université du Manitoba au programme d’études médicales de premier cycle. Or, notre étude montre qu’une formation en matière de biais implicites, lorsqu’elle est offerte de manière isolée aux directeurs de programme, a peu d’impact sur l’élimination des préjugés dans la sélection des résidents. Les programmes qui désirent favoriser la diversité doivent envisager une approche multidimensionnelle et soutenue

Paying the price? Academic work and parenting during COVID-19

Introduction: The shift to remote working/learning to slow transmission of the SARS-CoV-2 virus has had widespread mental health impacts. We aimed to describe how the COVID-19 pandemic impacted the mental health of students and faculty within a health sciences faculty at a central Canadian university.Methods: Via an online survey, we queried mental health in the first four months of the COVID-19 pandemic quantitatively (scale: 1 (most negative)-100 (most positive)) and qualitatively.Results: The sample (n = 110) was predominantly women (faculty 39/59; [66.1%]; students 46/50; [92.0%]). Most faculty were married/common law (50/60; [84.8%]) and had children at home (36/60; [60.0%]); the opposite was true for most students. Faculty and students self-reported comparable mental health (40.47±24.26 and 37.62±26.13; respectively). Amongst women, those with vs. without children at home, reported significantly worse mental health impacts (31.78±23.68 vs. 44.29±27.98; respectively, p = 0.032).Qualitative themes included: “Sharing resources,” “spending money,” “few changes,” for those without children at home; “working at home can be isolating,” including the subtheme, “balancing act”: “working in isolation,” “working more,” for those with children at home.Discussion: Amongst women in academia, including both students and faculty, those with children at home have disproportionately worse mental health than those without children at home.Introduction : Le virage vers le travail et l’enseignement à distance pour ralentir la transmission du virus SRAS-CoV-2 a eu des répercussions étendues sur la santé mentale. Notre étude vise à décrie l’impact de la pandémie de la COVID-19 sur la santé mentale des étudiants et du corps professoral au sein Faculté des sciences de la santé d’une université du centre du Canada.Méthodes : Un questionnaire en ligne a été administré pour récolter des données qualitatives et quantitatives (échelle : de 1 [le plus négatif] à 100 [le plus positif] à l’égard de la santé mentale des participants au cours des quatre premiers mois de la pandémie.Résultats : L’échantillonnage (n = 110) était majoritairement composé de femmes (membres du corps professoral : 39/59 ou 66,1 %; étudiantes 46/50 ou 92,0 %). La plupart des répondants du corps professoral étaient mariés ou en union libre (50/60 ou 84,8 %) et avaient des enfants à la maison (36/60 ou 60,0 %). Le contraire était vrai pour la plupart des étudiants. L’état de santé mentale déclaré par le corps professoral et les étudiants était comparable (40,47±24,26 et 37,62±26,13 respectivement). Parmi les femmes, autant celles qui avaient des enfants à la maison que celles qui n’en avaient pas, ont déclaré que leur santé mentale était nettement moins bonne (31,78±23,68 contre 44,29±27,98 respectivement; p = 0,032).Pendant l’analyse des données qualitatives, on a identifié les thèmes « le partage de ressources », « les dépenses » et « peu de changements » pour les répondants qui n’avaient pas d’enfants à la maison alors que les thème « le télétravail accentue l’isolement », ainsi que lessous-thèmes « maintien de l’équilibre : travailler en isolement’’ et ‘’travailler plus » ont émergé pour ceux qui avaient des enfants à la maison.Discussion : Parmi les femmes œuvrant dans le milieu universitaire, qu’elles soient étudiantes ou membres du corps professoral, la santé mentale de celles qui ont des enfants à la maison est davantage affectée que celle des femmes qui n’en ont pas

Paying the price? Academic work and parenting during COVID-19

Introduction: The shift to remote working/learning to slow transmission of the SARS-CoV-2 virus has had widespread mental health impacts. We aimed to describe how the COVID-19 pandemic impacted the mental health of students and faculty within a health sciences faculty at a central Canadian university. Methods: Via an online survey, we queried mental health in the first four months of the COVID-19 pandemic quantitatively (scale: 1 (most negative)-100 (most positive)) and qualitatively. Results: The sample (n = 110) was predominantly women (faculty 39/59; [66.1%]; students 46/50; [92.0%]). Most faculty were married/common law (50/60; [84.8%]) and had children at home (36/60; [60.0%]); the opposite was true for most students.  Faculty and students self-reported comparable mental health (40.47±24.26 and 37.62±26.13; respectively). Amongst women, those with vs. without children at home, reported significantly worse mental health impacts (31.78±23.68 vs. 44.29±27.98; respectively, p = 0.032). Qualitative themes included: “Sharing resources,” “spending money,” “few changes,” for those without children at home; “working at home can be isolating,” including the subtheme, “balancing act”: “working in isolation,” “working more,” for those with children at home. Discussion: Amongst women in academia, including both students and faculty, those with children at home have disproportionately worse mental health than those without children at home.</jats:p