Different Destinations: Clarifying and Addressing Pipeline Problems for Women in Academic Archaeology

Racism in Pain Medicine: We Can and Should Do More

In response to persistent systemic gendered and racial exclusions in the sciences, unconscious or implicit bias training is now widely established as an organizational intervention in Higher Education (HE). Recent systematic reviews have considered the efficacy of unconscious bias training (UBT) but not the wider characteristics and effects of the interventions themselves. Guided by feminist scholarship in critical psychology and post‐structuralist discourse theory, this article critically examines UBT across STEMM and in HE institutions with a discursive analysis of published studies. Drawn from systematic searches in 4 databases, we identify three types of UBT reported in 22 studies with considerable variation in intervention types, target groups, and evaluation methods. Guided by limited cognitive problematizations of unconscious bias as a problem located inside individual minds, interventions follow established patterns in neoliberal governmentality and make available specific feeling rules and subject positions. These current Equality, Diversity & Inclusion practices present a new technology of power through which organizations may regulate affect and behavior but leave structural inequalities and barriers to inclusion intact.

BackgroundThere has been renewed focus on advancing inclusivity within organized medicine to reduce health disparities and achieve health equity by addressing the deleterious effects of implicit bias in healthcare and clinical outcomes. It is well documented that negative implicit attitudes and stereotypes perpetuate inequity in healthcare.The aim of this study is to investigate implicit bias training in postgraduate physician assistant (PA) and nurse practitioner (NP) education; describe delivery of content to trainees; and detail program directors’ attitudes toward this type of training. Although there is research examining implicit bias training in physician residency education, there are no published studies on implicit bias training in postgraduate PA and NP postgraduate residency/fellowship programs.MethodA non-experimental, descriptive study was designed to obtain information via survey from members of the Association of Postgraduate Physician Assistant Programs (APPAP).ResultsThe response rate was 41%. The majority of respondents (76%) felt that PA and NP postgraduate programs should include implicit bias instruction. Educational strategies used by PA and joint PA/NP postgraduate programs or their sponsoring institution to deliver implicit bias content to trainees include: implicit bias training modules (50%), facilitated group discussions (36%), invited speaker on implicit bias (33%), case studies on implicit bias (16%), and implicit association test (10%); however, 30% of postgraduate programs do not provide implicit bias training to PA and/or NP trainees. Barriers to implementing implicit bias training expressed by some postgraduate programs include: uncertainty in how to incorporate implicit bias training (16%); lack of strategic alignment with training program or sponsoring institution (13%); time constraints (10%); financial constraints (6%); lack of access to content experts (6%); and unfamiliarity with evidence supporting implicit bias training (6%).ConclusionThe present study sheds some light on the current state of implicit bias training in PA and joint PA/NP postgraduate residency/fellowship programs. While the majority of programs offer some sort of implicit bias training, there is a need to standardize this training in PA and joint PA/NP postgraduate education curricula using an actionable framework.

Aim/Purpose: This mixed-methods research study examined impostor phenomenon during postdoctoral training in science, technology, engineering and mathematics (STEM) through the following research question: “What are the manifestations of the impostor phenomenon experienced during postdoctoral training in STEM?” Background: The impostor phenomenon occurs when competent, high-achieving students and professionals believe that they are fraud and will be exposed eventually. It involves fear of failure, lack of authenticity, feeling fake or fraud-like, denial of one’s competence, and is linked to lower self-esteem, mental health consequences, and lack of belonging. Methodology: This study was conducted with US-based postdoctoral trainees (or postdocs) using mixed-methods approach. The study examined aspects of impostor phenomenon among 43 postdocs by converging survey data using Clance Impostor Phenomenon Scale (CIPS) and qualitative data from semi-structured interviews from the same participants. Both convenience and snowball sampling were used. Majority of the participants were White, female, and from science disciplines. Interview findings were organized into themes using constant comparative method and analytic induction. Contribution: Findings pointed to the need for better designing professional development programs for postdocs that would: 1) address fears and insecurities due to impostor-feelings, 2) normalize conversations around perceived failure, judgment, and one’s lack of belonging, and 3) provide support with networking, mentoring, academic communication, and mental health challenges. Findings: Survey results indicated moderate to intense impostor-feelings; interviews found six triggers of the impostor phenomenon during postdoctoral training: 1. not pursuing new things, 2. not making social connections, 3. impaired academic communication, 4. not applying, 5. procrastination and mental health, and 6. feeling undeserving and unqualified. Current findings were compared with prior findings of impostor-triggers among PhD students who also experienced the first three of these challenges during doctoral training: challenges to applying newly learnt knowledge in other domains, reaching out for help, and developing skills in academic communication verbally and through academic writing. Recommendations for Practitioners: The office of postdoctoral affairs could design professional development programs and individual development plans for those experiencing the impostor phenomenon, focusing on strengthening skills (e.g., academic writing) in particular. There was an environmental and systemic dimension to the imposter phenomenon, perhaps more prevalent among women in STEM. The academy could devise ways to better support scholars who experience this phenomenon. Recommendation for Researchers: Research characterizing the qualitative characteristics of the impostor phenomenon across the STEM pipeline (undergrads, PhD students, postdocs, and faculty) would help understand if the reasons and manifestations of this phenomenon vary among differing demographics of students and professionals. Impact on Society: Organizations could focus on the training, development, mental health, and stressors among postdocs in STEM, particularly by focusing on career transition points (e.g., PhD to postdoc transition, postdoc to faculty transition), especially for those at-risk of experiencing this phenomenon and therefore dropping out. Future Research: Future research could examine how to manage or overcome the impostor phenomenon for students and professionals, focus on disciplines outside STEM, and investigate how socialization opportunities may be compromised due to this phenomenon. Longitudinal studies might characterize the phenomenon better than those that focused on the impostor phenomenon at a single time-point.

Background: In a review, Hall (2015) found that implicit bias was significantly related to patient-provider interactions and health outcomes. Implicit Bias Training is a tool to help individuals understand and take corrective action for unfair behaviors. Purpose: Our goal was to assess physician attitudes towards Implicit Bias Training and to measure physician participation in the training when implemented as an NCCN quality measure. Methodology: Implicit Bias Training was offered by the DEI Office at Yale-New Haven Health. This incentivized quality initiative was required for all practicing oncologists. Of 109 physicians, 45 (41.3%) completed this training. The anonymous survey, which included a link to the Harvard Implicit Project's Implicit Association Test (IAT), was emailed to the 45 oncologists prior to participation in the session. There were 21 respondents (46.7% response rate). Results: The self-reported results of the IAT are as follows: 9.5% (n=2) report a strong automatic preference for European Americans (EA) vs. African Americans (AA). 23.8% (n=5) report a moderate automatic preference for EAs vs. AAs 42.9% (n=9) reported little to no automatic preference between AAs vs. EAs. 4.8% (n=1) report a slight automatic preference for AAs vs. EAs. 19% (n=4) did not participate in the IAT. 33.3% (n=7) of physicians report being either extremely or moderately surprised by the result of their IAT, while 33.3% (n=7) report being neither surprised nor unsurprised. 14.3% (n=3) report being moderately unsurprised, and the remainder did not respond. Physicians were asked to report their enthusiasm about Implicit Bias Training on a scale of 0 to 10. The Mean was 6. While physician enthusiasm reports show polarization not apparent by the mean, 57.1% (n=12) of physicians report being hopeful or very hopeful that training would help to improve both collegial and patient-physician relationships. Conclusion: Though this was a mandatory quality initiative that was incentivized, participation was less than 50%. Explanations for the observed participation rate are multifactorial and nuanced. Of the 17 respondents who completed the IAT, nearly one-half (n=7) reported strong or moderate bias for one racial group, and 41% report being surprised by their result. Our findings suggest that unconscious bias was demonstrated in a significant percentage of participants, many of whom were surprised by their results. The results support the need for Implicit Bias Training as part of ongoing oncology quality improvement. 57% of participating physicians were optimistic that the initiative would lead to positive changes. Future Work: We postulate that bias training could increase awareness and result in improved communication with minority patients. Our next project will evaluate the effect of Implicit Bias Training on minority participation in clinical trials. Inclusivity and representation in clinical trials is paramount in efforts to democratize cancer care and our study suggests that bias training could be a valuable tool to achieve this goal. Citation Format: Renee C. Taylor, Andrea Silber. Introduction of implicit bias training to oncology faculty as a quality improvement initiative [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-078.

Introduction:In an attempt to address health inequities, many U.S. states have considered or enacted legislation requiring antibias or implicit bias training (IBT) for health care providers. California's “Dignity in Pregnancy and Childbirth Act” requires that hospitals and alternative birthing centers provide IBT to perinatal clinicians with the goal of improving clinical outcomes for Black women and birthing people. However, there is as yet insufficient evidence to identify what IBT approaches, if any, achieve this goal. Engaging the experiences and insights of IBT stakeholders is a foundational step in informing nascent IBT policy, curricula, and implementation.Methods:We conducted a multimethod community-based participatory research study with key stakeholders of California's IBT policy to identify key challenges and recommendations for effective clinician IBT. We used focus groups, in-depth interviews, combined inductive/deductive thematic analysis, and multiple techniques to promote rigor and validity. Participants were San Francisco Bay Area-based individuals who identified as Black or African American women with a recent hospital birth (n=20), and hospital-based perinatal clinicians (n=20).Results:We identified numerous actionable challenges and recommendations regarding aspects of (1) state law; (2) IBT content and format; (3) health care facility IBT implementation; (4) health care facility environment; and (5) provider commitment and behaviors. Patient and clinician insights overlapped substantially. Many respondents felt IBT would improve outcomes only in combination with other antiracism interventions.Health Equity Implications:These stakeholder insights offer policy-makers, health system leaders, and curriculum developers crucial guidance for the future development and implementation of clinician antibias interventions.

JANUARY 2014 PLACEMENT ADS

The process of selecting students likely to complete science, technology, engineering and mathematics (STEM) doctoral programs has not changed greatly over the last few decades and still relies heavily on Graduate Record Examination (GRE) scores in most U.S. universities. It has been long debated whether the GRE is an appropriate selection tool and whether overreliance on GRE scores may compromise admission of students historically underrepresented in STEM. Despite many concerns about the test, there are few studies examining the efficacy of the GRE in predicting PhD completion and even fewer examining this question in STEM fields. For the present study, we took advantage of a long-lived collaboration among institutions in the Northeast Alliance for Graduate Education and the Professoriate (NEAGEP) to gather comparable data on GRE scores and PhD completion for 1805 U.S./Permanent Resident STEM doctoral students in four state flagship institutions. We found that GRE Verbal (GRE V) and GRE Quantitative (GRE Q) scores were similar for women who completed STEM PhD degrees and those who left programs. Remarkably, GRE scores were significantly higher for men who left than counterparts who completed STEM PhD degrees. In fact, men in the lower quartiles of GRE V or Q scores finished degrees more often than those in the highest quartile. This pattern held for each of the four institutions in the study and for the cohort of male engineering students across institutions. GRE scores also failed to predict time to degree or to identify students who would leave during the first year of their programs. Our results suggests that GRE scores are not an effective tool for identifying students who will be successful in completing STEM doctoral programs. Considering the high cost of attrition from PhD programs and its impact on future leadership for the U.S. STEM workforce, we suggest that it is time to develop more effective and inclusive admissions strategies.

A 12-Year North American Longitudinal Study of Gender Equity and Equality in Gastroenterology

Implicit bias often affects patient care in insidious ways, and has the potential for significant damage. Several educational interventions regarding implicit bias have been developed for health care professionals, many of which foster reflection on individual biases and encourage personal awareness. In an attempt to address racism and other implicit biases at a more systemic level in our family medicine residency training program, our objectives were to offer and evaluate parallel trainings for residents and faculty by a national expert. The trainings addressed how both personal biases and institutional inequities contribute to structural racism, and taught skills for managing instances of implicit biases in one's professional interactions. The training was deliberately designed to increase institutional capacity to engage in crucial conversations regarding implicit bias. Six months after the trainings, an external evaluator conducted two separate 1-hour focus groups, one with residents (n=18) and one with program faculty and leadership (n=13). Four themes emerged in the focus groups: increased awareness of and commitment to addressing racial bias; appreciation of a safe forum for sharing concerns; new ways of addressing and managing bias; and institutional capacity building for continued vigilance and training regarding implicit bias. Both residents and faculty found this training to be important and empowering. All participants desired an ongoing programmatic commitment to the topic.

The latest fashion of ‘unconscious bias training’ is a diversity intervention based on unproven suppositions and is unlikely to help eliminate racism in the workplace. Knowing about bias does not automatically result in changes in behaviour by managers and employees. Even if ‘unconscious bias training’ has the theoretical potential to change behaviour, it will depend on the type of racism: symbolic/modern/colour-blind, aversive or blatant. In addition, even if those deemed racist are motivated to change behaviour, structural constraints can militate against pro-diversity actions. Agency is overstated by psychology-inspired ‘unconscious bias training’ proponents, leading them to assume the desirability and effectiveness of this type of diversity training intervention, but from a critical diversity perspective (sociologically influenced) the training looks pointless.

Implicit bias training (IBT) is now frequently provided by employers, in order to raise awareness of the problems related to implicit biases, and of how to safeguard against discrimination that may result. However, as Atewologun et al. (2018) have noted, there is very little systematicity in IBT, and there are many unknowns about what constitutes good IBT. One important issue concerns the tone of information provided regarding implicit bias. This paper engages this question, focusing in particular on the observation that much bias training is delivered in exculpatory tone, emphasising that individuals are not to blame for possessing implicit biases. Normative guidance around IBT exhorts practitioners to adopt this strategy (Moss-Racusin et al. 2014). However, existing evidence about the effects of moralized feedback about implicit bias is equivocal (Legault et al. 2011; Czopp et al. 2006). Through a series of studies, culminating in an experiment with a pre-registered analysis plan, we develop a paradigm for evaluating the impact of moralized feedback on participants’ implicit racial bias scores. We also conducted exploratory analyses of the impact on their moods, and behavioural intentions. Our results indicated that an exculpatory tone, rather than a blaming or neutral tone, did not make participants less resistant to changing their attitudes and behaviours. In fact, participants in the blame condition had significantly stronger explicit intentions to change future behaviour than those in the ‘no feedback’ condition (see experiment 3). These results indicate that considerations of efficacy do not support the need for implicit bias feedback to be exculpatory. We tease out the implications of these findings, and directions for future research.

State Member Board Briefs

<p>The STEM (Science, Technology, Engineering and Mathematics) faculties in Denmark suffer from a dearth of women in tenured positions. This is particularly the case for the geosciences in spite of a seemingly equal distribution of men and women graduating in geoscience.</p><p>In this presentation, we highlight the disparities and processes that hinder women from progressing in an academic career in the geosciences in Denmark. We have collected data from Geocenter Denmark that comprises three institutions, Institute for Geoscience, University of Aarhus, Institute for Geoscience and Natural Resources, University of Copenhagen and the Geological Survey of Denmark and Greenland. The data include information on all publications from 2018-2020 including number of publications per researcher, number of (female) authors per publication, impact factor etc. A detailed study has been performed tracking the publication records of all PhD students employed at Geocenter Denmark from<br>2010-2017. Our data also detail the uptake and graduation of undergraduate, masters and PhD students.</p><p>Our results show that for the last 15 years, an equal number of men and women have graduated with a geoscience degree in Denmark. Similarly, on average an equal number of men and women have been awarded a geoscientific PhD degree.</p><p>Analysis of publications from PhD students reveals disparities between genders. Regardless of gender, PhD students publish on average the same number of first author publications during the early years of their career* but male PhD students have more co-authorships. This suggests that female PhD students are not provided with the same opportunities for networking and co-authorship as their male colleagues.</p><p>This disparity continues on all levels, where more than 1/3 of all publications from Geocenter Denmark have no women on the author list. If the first author is male, the number of publications without any female co-authors further increases. Statistically, the chances of obtaining such a high number of publications without female co-authors by random is practically nil. We argue that mechanisms are in place that exclude women from contributing to and co-authoring studies.</p><p>Number of publications is a key factor in academic hireability and can determine success with career progression, funding applications etc. Our data highlight a structural problem in placing a high emphasis on the number of publications.</p><p><br>Disclaimer: Due to lack of data, we consider only binary gender and thus we cannot represent the true<br>non-binary gender diversity.<br>*here defined as up to and including 3 years after PhD graduation.</p>

Bridging the Racial, Ethnic, and Gender Gap in Gastroenterology