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The Standardized Letter of Evaluation Narrative: Differences in Language Use by Gender.

ABSTRACT: INTRODUCTION:Prior research demonstrates gender differences in language used in letters of recommendation. The emergency medicine (EM) Standardized Letter of Evaluation (SLOE) format limits word count and provides detailed instructions for writers. The objective of this study is to examine differences in language used to describe men and women applicants within the SLOE narrative. METHODS:All applicants to a four-year academic EM residency program within a single application year with a first rotation SLOE available were included in the sample. We used the Linguistic Inquiry and Word Count (LIWC) program to analyze word frequency within 16 categories. Descriptive statistics, chi-squared, and t-tests were used to describe the sample; gender differences in word frequency were tested for using Mann-Whitney U tests. RESULTS:Of 1117 applicants to the residency program, 822 (82%) first-rotation SLOEs were available; 64% were men, and 36% were women. We did not find a difference in baseline characteristics including age (mean 27 years), top 25 schools (22.5%), Alpha Omega Alpha Honor Medical Society rates (13%), and having earned advanced degrees (10%). The median word count per SLOE narrative for men was 171 and for women was 180 (p = 0.15). After adjusting for letter length, word frequency differences between genders were only present in two categories: social words (women: 23 words/letter; men: 21 words/letter, p = 0.02) and ability words (women: 2 words/letter; men: 1 word/letter, p = 0.04). We were unable to detect a statistical difference between men and women applicants in the remaining categories, including words representing communal traits, agentic traits, standout adjectives, grindstone traits, teaching words, and research words. CONCLUSION:The small wording differences between genders noted in two categories were statistically significant, but of unclear real-world significance. Future work is planned to evaluate how the SLOE format may contribute to this relative lack of bias compared to other fields and formats.

SUBMITTER: Miller DT

PROVIDER: S-EPMC6860384 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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The Standardized Letter of Evaluation Narrative: Differences in Language Use by Gender.

Miller Danielle T DT McCarthy Danielle M DM Fant Abra L AL Li-Sauerwine Simiao S Ali Aimee A Kontrick Amy V AV

The western journal of emergency medicine 20191017 6

<h4>Introduction</h4>Prior research demonstrates gender differences in language used in letters of recommendation. The emergency medicine (EM) Standardized Letter of Evaluation (SLOE) format limits word count and provides detailed instructions for writers. The objective of this study is to examine differences in language used to describe men and women applicants within the SLOE narrative.<h4>Methods</h4>All applicants to a four-year academic EM residency program within a single application year ...[more]

PMID: 31738723

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Project description:BackgroundIn varied educational settings, narrative evaluations have revealed systematic and deleterious differences in language describing women and those underrepresented in their fields. In medicine, limited qualitative studies show differences in narrative language by gender and under-represented minority (URM) status.ObjectiveTo identify and enumerate text descriptors in a database of medical student evaluations using natural language processing, and identify differences by gender and URM status in descriptions.DesignAn observational study of core clerkship evaluations of third-year medical students, including data on student gender, URM status, clerkship grade, and specialty.ParticipantsA total of 87,922 clerkship evaluations from core clinical rotations at two medical schools in different geographic areas.Main measuresWe employed natural language processing to identify differences in the text of evaluations for women compared to men and for URM compared to non-URM students.Key resultsWe found that of the ten most common words, such as "energetic" and "dependable," none differed by gender or URM status. Of the 37 words that differed by gender, 62% represented personal attributes, such as "lovely" appearing more frequently in evaluations of women (p < 0.001), while 19% represented competency-related behaviors, such as "scientific" appearing more frequently in evaluations of men (p < 0.001). Of the 53 words that differed by URM status, 30% represented personal attributes, such as "pleasant" appearing more frequently in evaluations of URM students (p < 0.001), and 28% represented competency-related behaviors, such as "knowledgeable" appearing more frequently in evaluations of non-URM students (p < 0.001).ConclusionsMany words and phrases reflected students' personal attributes rather than competency-related behaviors, suggesting a gap in implementing competency-based evaluation of students. We observed a significant difference in narrative evaluations associated with gender and URM status, even among students receiving the same grade. This finding raises concern for implicit bias in narrative evaluation, consistent with prior studies, and suggests opportunities for improvement.

Project description:ObjectivesThe standardized letter of evaluation (SLOE) in emergency medicine (EM) is a widely used metric for determining interview invitations and ranking of candidates. Previous research has questioned the validity of certain sections of the SLOE. However, there remains a paucity of literature on the qualifications for EM section, which evaluates seven attributes of applicants. The aim of this study was to determine the correlation between the qualifications questions and grades, global assessment, and anticipated rank list position for EM applicants.MethodsA multi-institutional cross-sectional study was performed using SLOEs from applicants to three geographically distinct U.S. EM residency programs during the 2019-2020 application cycle. We abstracted EM rotation grade, qualifications scores, global assessment, and anticipated rank list position from the SLOEs. A Spearman correlation was calculated between each of the qualifications scores and the applicant's grades, global assessment, and anticipated rank list position in a pairwise fashion.ResultsIn total, 2,106 unique applicants (4,939 SLOEs) were included. Of the seven qualifications for EM questions, three were moderately to strongly correlated with global assessment and anticipated rank list position: "ability to develop and justify an appropriate differential and a cohesive treatment plan" (ρ = 0.65 and ρ = 0.63, respectively; p < 0.001), "how much guidance do you predict this applicant will need during residency?" (ρ = 0.68 and ρ = 0.68, respectively; p < 0.001), and "what is your prediction of success for the applicant?" (ρ = 0.69 and ρ = 0.69, respectively; p < 0.001). There was no strong correlation between the seven qualifications and grades.ConclusionsThere was a moderate to strong correlation between three of seven qualifications for EM questions (ability to develop and justify a differential and develop a cohesive plan, anticipated need for the amount of guidance, and prediction of success) with both global assessment and anticipated rank list position, suggesting that these qualifications may provide the most useful data to residency selection while some of the other factors may not be needed.

Project description:Background: Narratives play a central role in the recovery process following death, and linguistic properties of grief narratives can serve as indicators of adjustment to loss. The present study examined whether bereaved men and women differ in how they discuss their loss, and how linguistic markers relate to psychological functioning. Positive associations were hypothesized between first-person singular pronoun use and psychological distress. Gender differences were expected for different emotion and social process words, and overall word use. Exploratory analyses were conducted to assess the relationship between linguistic markers and psychosocial outcomes for men and women separately. Method: 50 bereaved widow(er)s and parents (29 women, 21 men; M Age = 71.16 years, SD = 9.95) completed psychosocial self-report questionnaires and individual in-depth interviews. Grief narratives were analysed using Linguistic Inquiry and Word Count (LIWC), a software program that quantifies words into linguistic and psychological categories. Results: Contrary to our hypothesis, first-person pronoun use was not related to psychological distress. Although gender differences emerged in self-reported psychosocial outcomes, we failed to find the predicted gender differences in linguistic markers (emotion and social process words, overall word count). Exploratory analyses revealed additional associations between linguistic markers and psychosocial outcomes, and gender differences in these relationships. Notably, first-person pronoun use was related to heightened grief avoidance. Furthermore, various linguistic markers were associated with increased depression levels in females, but not males. In contrast, nonfluencies were positively associated with indicators of psychological distress in men only. Conclusion: In line with the gender similarities hypothesis, analyses suggest similarities between men and women's discussion of their grief experience. Associations between linguistic markers and psychological adjustment indicate that grief narratives contain meaningful indices of underlying health.

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The Standardized Letter of Evaluation Narrative: Differences in Language Use by Gender.

Publications

The Standardized Letter of Evaluation Narrative: Differences in Language Use by Gender.

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