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Biomedical subjects

Lois Margaret Nora

Publications and source records attributed to Lois Margaret Nora.

10 recordsLinked to original sources
PubMed2006

Experiences of belittlement and harassment and their correlates among medical students in the United States: longitudinal survey.

OBJECTIVE: To determine medical students' perceptions of having been harassed or belittled and their correlates, for the purposes of reducing such abuses. DESIGN: Longitudinal survey. SETTING: 16 nationally representative US medical schools. PARTICIPANTS: 2884 students from class of 2003. MAIN OUTCOME MEASURES: Experiences of harassment and belittlement at freshman orientation, at entry to wards, and in senior year by other students, by residents or fellows, by preclinical professors, by clinical professors or attendings, or by patients. RESULTS: 2316 students provided data (response rate 80.3%). Among seniors, 42% (581/1387) reported having experienced harassment and 84% (1166/1393) belittlement during medical school. These types of abuse were caused by other students (11% (158/1389) and 32% (443/1390) of students experienced such harassment or belittlement, respectively). Harassment and belittlement was also caused by residents (27% (374/1387) and 71% (993/1393)), preclinical professors (9% (131/1386) and 29% (398/1385)), clinical professors (21% (285/1386) and 63% (878/1390)), and patients (25% (352/1387) and 43% (592/1388)). Only 13% (181/1385) of students classified any of these experiences as severe. Medical students who reported having been harassed or belittled did not differ significantly from those not reporting such experiences by sex, ethnicity, political orientation, or religion. They did differ significantly by chosen specialty and were significantly more likely to be stressed, depressed, and suicidal, to drink alcohol or to binge drink, and to state that their faculty did not care about medical students. They were also significantly less likely to be glad they trained to become a doctor. CONCLUSION: Most medical students in the United States report having been harassed or belittled during their training. Although few students characterised the harassment or belittlement as severe, poor mental health and low career satisfaction were significantly correlated with these experiences.

Aggression↗
PubMed2006

Stories from the field: students' descriptions of gender discrimination and sexual harassment during medical school.

PURPOSE: Previous studies have documented the prevalence of gender discrimination and sexual harassment during medical training, but very few have examined the behaviors that students perceive as discriminatory or harassing. The authors addressed this lack of information by examining graduating medical students' written descriptions of personal experiences with such behaviors during medical school. METHOD: The authors reviewed the responses of graduating seniors at 12 U.S. medical schools to a questionnaire, administered in 2001-02, that asked them to provide written descriptions of their personal experiences with gender discrimination and sexual harassment. Seven response categories were created on the basis of recurring themes: educational inequalities; stereotypical comments; sexual overtures; offensive, embarrassing, or sexually explicit comments; inappropriate touching; sexist remarks; and not classifiable. The three authors examined the students' written accounts and placed each into one or more of the categories. RESULTS: Of the students' responses, 290 (36.6%) contained 313 written descriptions of personal experiences that the students perceived as either discriminatory or harassing. The most frequently reported experiences involved educational inequalities; experiences in this category were reported more frequently by men than by women. All other categories of experiences were reported more frequently by women. CONCLUSIONS: The results support earlier findings of the prevalence of gender discrimination and sexual harassment during undergraduate medical education. Perhaps formal antiharassment policies should provide examples of unacceptable behavior that are based on categories such as those revealed by this analysis. Perhaps, too, medical students' comments could be used to develop educational interventions for physicians in supervisory positions.

Education, Medical, Undergraduate↗
PubMed2005

Does students' exposure to gender discrimination and sexual harassment in medical school affect specialty choice and residency program selection?

PURPOSE: To examine the role of gender discrimination and sexual harassment in medical students' choice of specialty and residency program. METHOD: Anonymous, self-administered questionnaires were distributed in 1997 to fourth-year students enrolled in 14 public and private U.S. medical schools. In addition to reporting the frequency of gender discrimination and sexual harassment encountered during preclinical coursework, core clerkships, elective clerkships, and residency selection, students assessed the impact of these exposures (none, a little, some, quite a bit, the deciding factor) on their specialty choices and rankings of residency programs. RESULTS: A total of 1,314 (69%) useable questionnaires were returned. Large percentages of men (83.2%) and women (92.8%) experienced, observed, or heard about at least one incident of gender discrimination and sexual harassment during medical school, although more women reported such behavior across all training contexts. Compared with men, significantly (p </= .01) more women who reported exposure indicated that gender discrimination and sexual harassment influenced their specialty choices (45.3% versus 16.4%) and residency rankings (25.3% versus 10.9%). Across all specialties, more women than men experienced gender discrimination and sexual harassment during residency selection, with one exception: a larger percentage of men choosing obstetrics and gynecology experienced such behavior. Among women, those choosing general surgery were most likely to experience gender discrimination and sexual harassment during residency selection. Interestingly, correlations between exposure to gender discrimination and sexual harassment and self-assessed impact on career decisions tended to be larger for men, suggesting that although fewer men are generally affected, they may weigh such experiences more heavily in their choice of specialty and residency program. CONCLUSION: This study suggests that exposure to gender discrimination and sexual harassment during undergraduate education may influence some medical students' choice of specialty and, to a lesser degree, ranking of residency programs.

Adult↗
PubMed2003

Spirituality in medicine: a comparison of medical students' attitudes and clinical performance.

OBJECTIVE: The authors sought to examine attitudes about spirituality in medicine among medical students in psychiatric clerkships and determine whether instruction on concepts of spirituality in medicine had an effect on students' clinical performance in related tasks. METHODS: A total of 192 students entering psychiatric clerkships were randomly assigned to one of two groups; both groups received identical didactic instruction on spirituality in medicine. One group worked on a problem-based learning case that featured spirituality as a prominent theme, whereas the other group worked on problem-based learning cases that made no mention of it. Students completed pre- and posttest questionnaires, and their examination at the end of rotation included a standardized patient encounter requiring them to elicit a spiritual history. RESULTS: Among the 131 students who completed and returned both questionnaires, a significant difference (p=0.001) was noted between groups on students' self-reported knowledge of taking a spiritual history. However, students in the two groups received identical scores on the component of the examination requiring them to write a spiritual history. CONCLUSIONS: Although students who were exposed to material on spirituality in medicine reported greater understanding of the issue, no difference in clinical performance was observed.

Adult↗
PubMed2002

Gender discrimination and sexual harassment in medical education: perspectives gained by a 14-school study.

PURPOSE: The authors attempted to determine male and female medical students' exposures to and perceptions of gender discrimination and sexual harassment (GD/SH) in selected academic and nonacademic contexts. METHOD: An anonymous, self-report questionnaire was administered in the spring of 1997 to senior medical students at 14 U.S. medical schools. Data were collected about students' exposures to GD/SH during undergraduate medical education and outside the medical training environment. Students' perceptions of GD/SH in various medical specialties and practice settings were also measured. RESULTS: Of the 1,911 questionnaires administered, 1,314 were completed (response rate, 69%). Both men and women reported exposures to GD/SH. More women than men reported all types of exposures to GD/SH across all academic and nonacademic contexts. Differences between men and women in the frequencies of exposures were greatest outside the medical training environment (t = 15.67, df = 1171, p <or=.001). Within academic medical training contexts, the differences by sex were most evident in core clerkships (t = 11.17, df = 1176, p <or=.001). Women students perceived the prevalence of GD/SH to be significantly (p <or=.001) higher in a number of medical specialties than did men. However, both groups believed these behaviors to be most common in general surgery and obstetrics-gynecology. Women perceived significantly more GD/SH in academic medical centers and community hospitals. Both groups perceived these behaviors to be significantly more prevalent in academic medical centers than in community hospitals, and more prevalent in community hospitals than in outpatient office settings. CONCLUSIONS: This study suggests that mistreatment in the form of GD/SH is prevalent in undergraduate medical education, particularly within core clerkships. Interventions focused on particular specialties and training periods may be helpful.

Adult↗
PubMed2002

Buzzwords in medical education: what they are, what they mean, and what we are doing about them at the University of Kentucky College of Medicine.

This article defines common buzzwords used to describe innovations in teaching medical students. As background for outlining the innovative educational programs in place at the University of Kentucky College of Medicine, the dual, or bimodal, missions of the College and their historical antecedents are presented. Definitions of important educational outcomes, or standards of achievement expected from University of Kentucky College of Medicine graduates, including professionalism, active learning, evidence-based medicine, and cultural diversity are given. In addition, their relevance to the development of medical professionals is outlined, and examples of where and how these standards are introduced in the Kentucky Medical Curriculum are presented. Similarly, definitions and examples of educational methods or pedagogies used to teach our medical students are discussed including the use of problem-based learning, computer-based instruction, standardized patients, and performance-based assessment.

Education, Medical↗