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Browsing by Author "Morgan, Zachary S."
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Item Exploring Gender Bias in Nursing Evaluations of Emergency Medicine Residents(Wiley, 2019) Brucker, Krista; Whitaker, Nash; Morgan, Zachary S.; Pettit, Katie; Thinnes, Erynn; Banta, Alison M.; Palmer, Megan M.; Emergency Medicine, School of MedicineObjectives Nursing evaluations are an important component of residents’ professional development as nurses are present for interactions with patients and nonphysician providers. Despite this, there has been few prior studies on the benefits, harms, or effectiveness of using nursing evaluations to help guide emergency medicine residents’ development. We hypothesized that gender bias exists in nursing evaluations and that female residents, compared to their male counterparts, would receive more negative feedback on the perception of their interpersonal communication skills. Methods Data were drawn from nursing evaluations of residents between March 2013 and April 2016. All comments were coded if they contained words falling into four main categories: standout, ability, grindstone, and interpersonal. This methodology and the list of words that guided coding were based on the work of prior scholars. Names and gendered pronouns were obscured and each comment was manually reviewed and coded for valence (positive, neutral, negative) and strength (certain or tentative) by at least two members of the research team. Following the qualitative coding, quantitative analysis was performed to test for differences. To evaluate whether any measurable differences in ability between male and female residents existed, we compiled and compared American Board of Emergency Medicine in‐training examination scores and relevant milestone evaluations between female and male residents from the same period in which the residents were evaluated by nursing staff. Results Of 1,112 nursing evaluations, 30% contained comments. Chi‐square tests on the distribution of valence (positive, neutral, or negative) indicated statistically significant differences in ability and grindstone categories based on the gender of the resident. A total of 51% of ability comments about female residents were negative compared to 20% of those about male residents (χ2 = 11.83, p < 0.01). A total of 57% of grindstone comments about female residents were negative as opposed 24% of those about male residents (χ2 = 6.03, p < 0.01). Conclusions Our findings demonstrate that, despite the lack of difference in ability or competence as measured by in‐service examination scores and milestone evaluations, nurses evaluate female residents lower in their abilities and work ethic compared to male residents.Item Failure of an Educational Intervention to Improve Consultation and Implications for Healthcare Consultation.(Cureus, Inc., 2019-02-20) Turner, Joseph; Litzau, Megan; Morgan, Zachary S.; Pollard, Katherine; Cooper, Dylan; Emergency Medicine, School of MedicineINTRODUCTION: Consultation of another physician for his or her specialized expertise regarding a patient's care is a common occurrence in most physicians' daily practice, especially in the emergency department (ED). Therefore, the ability to communicate effectively with another physician during a patient consultation is an essential skill. However, there has been limited research on a standardized method for a physician to physician consultation with little guidance on teaching consultations to physicians in training. The objective of our study was to measure the effect of a structured consultation intervention on both content standardization and quality of medical student consultations. METHODS: Senior medical students were assessed on a required emergency medicine rotation with a physician phone consultation during a standardized, simulated chest pain case. The intervention groups received a standard consult checklist as part of their orientation to the rotation, followed by a video recording of a good consult call and a bad consult call with commentary from an emergency physician. The intervention was given to students every other month, alternating with a control group who received no additional education. Recordings were reviewed by three second-year internal medicine residents pursuing a fellowship in cardiology. Each recording was evaluated by two of the three reviewers and scored using a standardized checklist. RESULTS: Providing a standardized consultation intervention did not improve students' ability to communicate with consultants. In addition, there was variability between evaluators in regards to how they received the same information and how they perceived the quality of the same recorded consultation calls. Evaluator inter-rater reliability (IRR) was poor on the questions of 1) would you have any other questions of the student calling the consult and 2) did the student calling the consult provide an accurate account of information and case detail. The IRR was also poor on objective data such as whether the student stated their name. CONCLUSIONS: A brief intervention may not be enough to change complex behavior such as a physician to physician consultant communication. Importantly, despite consultants listening to the same audio recordings, the information was processed differently. Future investigations should focus on both those delivering as well as those receiving a consultation.Item Stepping Stones: A Leadership Development Program to Inspire and Promote Reflection Among Women Faculty and Staff(Wiley, 2017-06) Hoffmann-Longtin, Krista; Morgan, Zachary S.; Schmidt, Lauren Chism; Walvoord, Emily C.; Palmer, Megan M.; Dankoski, Mary E.; Communication Studies, School of Liberal ArtsWomen frequently benefit from focused faculty development opportunities not because they need to be “fixed,” but rather it is a means to demonstrate that success, even in chilly environments, is possible. The Stepping Stones program uses a unique design to provide participants with inspiration, time for reflection, and strategies for how to navigate one's career, through hearing about the journeys of successful women. In this article, we describe the program and evaluation results. Post‐event and longitudinal follow‐up surveys indicate that the program and its unique narrative format help to debunk the superwoman myth and leave participants with a sense of optimism about their future careers.Item Teaching advocacy communication to pediatric residents: the efficacy of applied improvisational theater (AIT) as an instructional tool(Taylor & Francis, 2018) Hoffmann-Longtin, Krista; Organ, Jason M.; Helphinstine, Jill V.; Reinoso, Deanna R.; Morgan, Zachary S.; Weinstein, Elizabeth; Communication Studies, School of Liberal ArtsIn today’s communication landscape, the public often turn to the Internet and social media instead of their physician for health information. To remain relevant and respected amidst the wealth of health information available online, physicians need to offer something the Internet cannot fully emulate: empathetic imagination and an ability to instantaneously tailor messages to reach and teach worried and often confused audiences effectively. We developed an instructional communication module for pediatric residents that used applied improvisational theater to help residents develop complex and dynamic communication skills. The module included opportunities to develop empathy, practice audience analysis, distill messages to key points, and apply these skills in media and community contexts. Attendees completed surveys regarding their perceptions of curricular structure, efficacy, and utility. Preliminary results indicate gains in communication confidence and skills. This type of instructional communication and training module encourages healthcare practitioners to position themselves as trusted experts and partners in helping clients make meaning of health information, thus empowering a new generation of pediatricians to bridge communication gaps created by new technologies and increased access to multiple information sources.