Dataset Information

From the sticky floor to the glass ceiling and everything in between: protocol for a systematic review of barriers and facilitators to clinical academic careers and interventions to address these, with a focus on gender inequality.

ABSTRACT:

Background

Gender inequality within academic medicine and dentistry is a well-recognised issue, but one which is not completely understood in terms of its causes, or interventions to facilitate equality. This systematic review aims to identify, critically appraise, and synthesise the literature on facilitators and barriers to progression through a clinical academic career across medicine and dentistry. It will also explore interventions developed to increase recruitment and retention to clinical academic careers, with a particular focus on gender inequality.

Methods

The search will cover five databases (MEDLINE (including MEDLINE Epub Ahead of Print, MEDLINE In-Process & Other Non-Indexed Citations, and MEDLINE Daily), Cochrane Controlled Register of Trials (CENTRAL), PsycINFO, and Education Resource Information Center (ERIC)), reference lists, and forward citation searching. We will include studies of doctors, dentists, and/or those with a supervisory role over their careers, with or without an academic career. Outcomes will be study defined, but relate to success rates of joining or continuing within a clinical academic career, including but not limited to success in gaining funding support, proportion of time spent in academic work, and numbers of awards/higher education qualifications, as well as experiences of professionals within the clinical academic pathway. Study quality will be assessed using the Cochrane risk of bias tool for randomised controlled trials, the Newcastle-Ottawa tool for non-randomised studies, and the QARI tool for qualitative studies. Detailed plans for screening, data extraction, and analysis are provided within this protocol.

Discussion

This systematic review is situated within a larger project evaluating gender inequalities in clinical academic careers. This review will identify and synthetize barriers, facilitators, and interventions addressing gender inequalities in clinical academia. Our findings will increase awareness of inequalities in clinical academic careers through informing clinical academics, regulators and funders of the issues involved, and potential interventions to counteract these. Results will be published in a peer-reviewed journal.

Systematic review registration

Open Science Framework: https://osf.io/mfy7a.

SUBMITTER: Brown JVE

PROVIDER: S-EPMC7011470 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

From the sticky floor to the glass ceiling and everything in between: protocol for a systematic review of barriers and facilitators to clinical academic careers and interventions to address these, with a focus on gender inequality.

Brown Jennifer V E JVE Crampton Paul E S PES Finn Gabrielle M GM Morgan Jessica E JE

Systematic reviews 20200210 1

<h4>Background</h4>Gender inequality within academic medicine and dentistry is a well-recognised issue, but one which is not completely understood in terms of its causes, or interventions to facilitate equality. This systematic review aims to identify, critically appraise, and synthesise the literature on facilitators and barriers to progression through a clinical academic career across medicine and dentistry. It will also explore interventions developed to increase recruitment and retention to ...[more]

PMID: 32041668

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Project description:IntroductionIn December 2017, Lancet called for gender inequality investigations. Holding other factors constant, trends over time for significant author (i.e., first, second, last or any of these authors) publications were examined for the three highest-impact medical research journals (i.e., New England Journal of Medicine [NEJM], Journal of the American Medical Association [JAMA], and Lancet).Materials and methodsUsing randomly sampled 2002-2019 MEDLINE original publications (n = 1,080; 20/year/journal), significant author-based and publication-based characteristics were extracted. Gender assignment used internet-based biographies, pronouns, first names, and photographs. Adjusting for author-specific characteristics and multiple publications per author, generalized estimating equations tested for first, second, and last significant author gender disparities.ResultsCompared to 37.23% of 2002 - 2019 U.S. medical school full-time faculty that were women, women's first author publication rates (26.82% overall, 15.83% NEJM, 29.38% Lancet, and 35.39% JAMA; all p < 0.0001) were lower. No improvements over time occurred in women first authorship rates. Women first authors had lower Web of Science citation counts and co-authors/collaborating author counts, less frequently held M.D. or multiple doctoral-level degrees, less commonly published clinical trials or cardiovascular-related projects, but more commonly were North American-based and studied North American-based patients (all p < 0.05). Women second and last authors were similarly underrepresented. Compared to men, women first authors had lower multiple publication rates in these top journals (p < 0.001). Same gender first/last authors resulted in higher multiple publication rates within these top three journals (p < 0.001).DiscussionSince 2002, this authorship "gender disparity chasm" has been tolerated across all these top medical research journals. Despite Lancet's 2017 call to arms, furthermore, the author-based gender disparities have not changed for these top medical research journals - even in recent times. Co-author gender alignment may reduce future gender inequities, but this promising strategy requires further investigation.

Project description:Chemically active particles achieve motility without external forces and torques ("self-propulsion") due to catalytic chemical reactions at their surfaces, which change the chemical composition of the surrounding solution (called "chemical field") and induce hydrodynamic flow of the solution. By coupling the distortions of these fields back to its motion, a chemically active particle experiences an effective interaction with confining surfaces. This coupling can lead to a rich behavior, such as the occurrence of wall-bound steady states of "sliding". Most active particles are density mismatched with the solution and, thus, tend to sediment. Moreover, the often employed Janus spheres, which consist of an inert core material decorated with a cap-like, thin layer of a catalyst, are gyrotactic (i.e., "bottom-heavy"). Whether or not they may exhibit sliding states at horizontal walls depends on the interplay between the active motion and the gravity-driven sedimentation and alignment, such as the gyrotactic tendency to align the axis along the gravity direction being overcome by a competing, activity-driven alignment with a different orientation. It is therefore important to understand and quantify the influence of these gravity-induced effects on the behavior of model chemically active particles moving in the vicinity of walls. For model gyrotactic, self-phoretic Janus particles, here we study theoretically the occurrence of sliding states at horizontal planar walls that are either below ("floor") or above ("ceiling") the particle. We construct "state diagrams" characterizing the occurrence of such states as a function of the sedimentation velocity and of the gyrotactic response of the particle, as well as of the phoretic mobility of the particle. We show that in certain cases sliding states may emerge simultaneously at both the ceiling and the floor, while the larger part of the experimentally relevant parameter space corresponds to particles that would exhibit sliding states only either at the floor or at the ceiling-or there are no sliding states at all. These predictions are critically compared with the results of previous experimental studies, as well as with our dedicated experiments carried out with Pt-coated, polystyrene-core, or silica-core Janus spheres immersed in aqueous hydrogen peroxide solutions.

Project description:Goals and methodsA simulation study investigated how ceiling and floor effect (CFE) affect the performance of Welch's t-test, F-test, Mann-Whitney test, Kruskal-Wallis test, Scheirer-Ray-Hare-test, trimmed t-test, Bayesian t-test, and the "two one-sided tests" equivalence testing procedure. The effect of CFE on the estimate of group difference and on its confidence interval, and on Cohen's d and on its confidence interval was also evaluated. In addition, the parametric methods were applied to data transformed with log or logit function and the performance was evaluated. The notion of essential maximum from abstract measurement theory is used to formally define CFE and the principle of maximum entropy was used to derive probability distributions with essential maximum/minimum. These distributions allow the manipulation of the magnitude of CFE through a parameter. Beta, Gamma, Beta prime and Beta-binomial distributions were obtained in this way with the CFE parameter corresponding to the logarithm of the geometric mean. Wald distribution and ordered logistic regression were also included in the study due to their measure-theoretic connection to CFE, even though these models lack essential minimum/maximum. Performance in two-group, three-group and 2 × 2 factor design scenarios was investigated by fixing the group differences in terms of CFE parameter and by adjusting the base level of CFE.Results and conclusionsIn general, bias and uncertainty increased with CFE. Most problematic were occasional instances of biased inference which became more certain and more biased as the magnitude of CFE increased. The bias affected the estimate of group difference, the estimate of Cohen's d and the decisions of the equivalence testing methods. Statistical methods worked best with transformed data, albeit this depended on the match between the choice of transformation and the type of CFE. Log transform worked well with Gamma and Beta prime distribution while logit transform worked well with Beta distribution. Rank-based tests showed best performance with discrete data, but it was demonstrated that even there a model derived with measurement-theoretic principles may show superior performance. Trimmed t-test showed poor performance. In the factor design, CFE prevented the detection of main effects as well as the detection of interaction. Irrespective of CFE, F-test misidentified main effects and interactions on multiple occasions. Five different constellations of main effect and interactions were investigated for each probability distribution, and weaknesses of each statistical method were identified and reported. As part of the discussion, the use of generalized linear models based on abstract measurement theory is recommended to counter CFE. Furthermore, the necessity of measure validation/calibration studies to obtain the necessary knowledge of CFE to design and select an appropriate statistical tool, is stressed.

Dataset Information

From the sticky floor to the glass ceiling and everything in between: protocol for a systematic review of barriers and facilitators to clinical academic careers and interventions to address these, with a focus on gender inequality.

Background

Methods

Discussion

Systematic review registration

Publications

From the sticky floor to the glass ceiling and everything in between: protocol for a systematic review of barriers and facilitators to clinical academic careers and interventions to address these, with a focus on gender inequality.

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