Here at sheMD, we believe in the importance of practicing Evidence-Based Medicine. We believe the same principles apply to discussing Gender and Medical Education. Therefore, we are bringing you an entire Journal Club series! Our series will focus on foundational and new literature within the gender and medicine space.
Today, we will be discussing the article entitled, Gender-focused training improves leadership of female medical students: A randomised trial.
Why is this article important?
Research indicates that the gender of a provider may impact their performance.
In medical emergencies, provider qualities which lead to greater performance and patient outcomes include leadership and teamwork. Female providers have been shown to have less efficient leadership than male colleagues.
This study focused on gender differences in CPR performance and trialed an intervention to impact the leadership behaviors of female medical students.
What they looked at:
The study utilized a single-blinded randomized trial with groups of medical students in a simulation center in Switzerland.
They studied the effect of gender composition of resuscitation teams with all different combinations (female-female; female-male; male-male; male-female).
They also studied the effects of a leadership behaviors intervention by randomizing female students into a control or an intervention group.
The intervention addressed seven key issues: repetition, awareness of the problem, self esteem, acknowledgement, professional role, know-how, and mission.
How they measured things:
Data was studied through video recordings collected for analysis. Transcripts were coded to sort data into “leadership occurrences” or “unrelated to leadership” as well as critical treatment decisions.
CPR-related performance items were coded by the second as present or absent.
Differences between genders were quantified by averages with confidence intervals.
What were their outcomes:
Of the 182 teams analyzed, females contributed significantly less leadership statements (53% vs 76%, p=0.001) and critical treatment decisions (57% vs 76%, p=0.018). When the second responder was male, this effect was more pronounced (47% vs 78%, p=0.007).
There was no difference in transcript codes unrelated to leadership, supporting the idea that females did not speak less often.
There was a significant increase in female contribution to leadership statements after behavioral intervention (53% vs 69%, p=0.011) as well as in critical treatment decisions (57% vs 73%, 0.029).
Why do we care about this article?
What does this mean?
This is one of the first trials of gender-specific leadership intervention in a medical context.
Differences in performance appear to be related to leadership, as females were not less likely to speak.
How does this apply to us?
Gender bias and stereotypes can have a marked effect on performance in medicine, and specific leadership interventions can have a great effect.
Take Home Point
Gender may have an impact on leadership performance in medicine, which can be improved through targeted leadership development.
For further reading on the topic, check out these articles!
Meier A, Yang J, Liu J, et al. Female physician leadership during cardiopulmonary resuscitation is associated with improved patient outcomes*. Crit Care Med. 2019; 47(1): e8- e13.
Tsugawa Y, Jena AB, Figueroa JF, Orav EJ, Blumenthal DM, Jha AK. Comparison of hospital mortality and readmission rates for Medicare patients treated by male vs female physicians. JAMA Intern Med. 2017; 177(2): 206- 213.
Wayne NL, Vermillion M, Uijtdehaage S. Gender differences in leadership amongst first-year medical students in the small-group setting. Acad Med. 2010; 85(8): 1276- 1281.