Browsing by Author "Williamson, Francesca"

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    148. Exploring the Impact of College Students' COVID-19- and Capitol Insurrection-Related Horizontal and Vertical Collectivism/Individualism on Emotional Reaction to Those Events
    (Elsevier, 2022) Sorge, Brandon H.; Fore, Grant; Williamson, Francesca; Angstmann, Julia; Hensel, Devon J.; Engineering Technology, School of Engineering and Technology
    Purpose: While many studies have explored individuals’ feelings related to recent national events, none have explored the relationship of individualism and collectivist leanings caused by these events on the individuals emotions related to those events. For this research we specifically focus on the COVID-19 Pandemic and the January 6 Capitol Insurrection. Methods: Data were collected from college students at a small, private midwestern private university over a 10-day period at the end of January and the beginning of February 2021. A Qualtrics survey was sent to 1,041 students who had completed a similar survey 5 months earlier related to their feelings about the COVID-19 pandemic. We used a subsample (N=314 students; 74.2% female; 83.4% White; 0.6% freshman, 24.5% sophomores, 34.7% juniors and 29.3% seniors) who provided complete data. Measures included horizontal (“We are the same, high freedom, equality”) and vertical (“I am different, Authority ranking, high freedom”) individualism as well as horizontal (“We are the same, share, less freedom”) and vertical (“I am different, sharing, authority ranking”) collectivism. Participants also provided data on the positive and negative affective responses to COVID-19 and to the January 6 Capitol Insurrection. Structural equation modeling was used to investigate the direct effects between individual and collectivism and the affective responses to each event (all standardized; Stata v. 17.0). Global fit was evaluated using the chi-square test and the root mean square error of approximation (RMSEA). Local fit was addressed using the Comparative Fit Index (CFI) and the Tucker Louis Index (TLI). We also investigated group differences by gender (male/female) and race (minority/white) where significant overall direct effects were observed. Results: Fit indices (Chi-sq[df]: 60.99[31], p<.001; RMSEA[90% CI]: 0.046[0.035-0.076); CFI: 0.972; TLI: 0.905) suggested the specified model provided a good fit to the data. Higher COVID VI was associated with higher positive (B=0.12) and negative (B=0.15) affective reactions to COVID (B=0.12). Higher Capitol HI and HC were both associated with higher positive (both: B=0.21) and higher negative (B=0.12-0.23) affective reaction to the capitol riots. Higher COVID VI was associated with lower negative affective response (B=-0.16) to COVID. We observed no gender or race/ethnicity differences in these significant effects. Conclusions: Students who felt more strongly that people were the same (horizontal individualism and horizontal collectivism) were more likely to have both strong positive and negative emotions to the Janury 6th insurrection. For COVID-19 negative feelings, students whose feelings towards COVID were more individualistic had mixed results. Those who believed people are different (vertical individualism) were more likely to have lower negative feelings towards COVID-19 while those who believed people are the same (horizontal individualism) had greater negative feelings. These data have implications for scaffolding young adult support in advance of future socio-political emergencies.
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    Advancing Equity in Graduate Medical Education Recruitment Through a Diversity Equity and Inclusion (DEI) Toolkit for Program Directors
    (Sage, 2023-10-09) Nabhan, Zeina M.; Scott, Nicole; Kara, Areeba; Mullis, Leilani; Dams, Travis; Giblin, Mark; Williamson, Francesca; Wright, Curtis; Pediatrics, School of Medicine
    Objectives: To increase diversity and inclusion in graduate medical education (GME), the Accreditation Council for Graduate Medical Education (ACGME) issued new diversity standards requiring programs to engage in practices that focus on systematic recruitment and retention of a diverse workforce of trainees and faculty. The literature on how program directors (PDs) can incorporate and prepare for this standard is limited. Methods: We developed a diversity, equity, and inclusion (DEI) toolkit for PDs as an example of an institutional GME-led effort to promote inclusive recruitment and DEI awareness among residency and fellowship programs at a large academic center. Results: A survey was sent to 80 PDs before the launch of the toolkit and 6 months afterwards with response rates of 27% (22/80) and 97% (78/80), respectively. At baseline, 45% (10/22) anticipated that the DEI toolkit might provide better resources than those currently available to them and 41% (9/22) perceived that the toolkit might improve recruitment outcomes. At 6 months, 63% (49/78) found the toolkit helpful in the 2021-2022 recruitment season. By contrast, 2% (2/78) of PDs did not find the toolkit helpful, and 33% (26/78) said they did not access the toolkit. When asked if a PD changed their program's recruitment practices because of the toolkit, 31% (24/78) responded yes. Programs that changed recruitment practices started to require unconscious bias training for all faculty and residents involved in the residency interviews and ranking. Others worked on creating a standardized scoring rubric for interviews focused on four main domains: Experiences, Attributes, Competencies, and Academic Metrics. Conclusion: There is a need to support PDs in their DEI journey and their work to recruit a diverse workforce in medicine. Utilizing a DEI toolkit is one option to increase DEI knowledge, skills, awareness, and self-efficacy among PDs and can be adopted by other institutions and leaders in academic medicine.
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    Association between clinician team segregation, receipt of cardiovascular care and outcomes in valvular heart diseases
    (Wiley, 2025) Bolakale-Rufai, Ikeoluwapo Kendra; Knapp, Shannon M.; Bisono, Janina Quintero; Johnson, Adedoyin; Moore, Wanda; Yankah, Ekow; Yee, Ryan; Trabue, Dalancee; Nallamothu, Brahmajee; Hollingsworth, John M.; Watty, Stephen; Williamson, Francesca; Pool, Natalie; Hebdon, Megan; Ezema, Nneamaka; Capers, Quinn; Blount, Courtland; Kimbrough, Nia; Johnson, Denee; Evans, Jalynn; Foree, Brandi; Holman, Anastacia; Lightbourne, Karen; Brown, David; Tucker Edmonds, Brownsyne; Breathett, Khadijah; Medicine, School of Medicine
    Aims: Racial disparities exist in clinical outcomes for valvular heart disease (VHD). It is unknown whether clinician segregation contributes to these disparities. Among an adequately insured population, we evaluated the relationship between clinician segregation in a hospital and receipt of care by a cardiologist according to patient race. We also evaluated the association between clinician segregation, race and care by a cardiologist on 30-day readmission and 1-year survival. Methods and results: Using Optum's Clinformatics® Data Mart Database (CDM, US commercial and Medicare beneficiaries) from 2010 to 2018, we identified patients with a primary diagnosis of VHD. Hospitals were categorized into low, medium and high segregation groups (SG), according to clinician segregation index (SI). SI can range from 0-1 (0: the ratio of Black to White patients is the same for all clinicians; 1: each clinician treats only Black or only White patients). Outcomes were analysed using generalized linear mixed effect models. Among 8649 patients [median age 75 (67-82), 45.4% female, 16.1% Black, 83.9% White], odds of care from a cardiologist did not vary across race for all SGs [Low SG adjusted odds ratio (aOR): 0.79 (95% CI: 0.58-1.08), P = 0.14; Medium SG aOR: 0.86 (95% CI: 0.60-1.25), P = 0.43; High SG aOR: 1.07 (95% CI: 0.68-1.69), P = 0.76]. Among those that received care from a cardiologist, there was no difference in the 30-day readmission between Black and White patients across SGs [Low SG aOR: 1.05 (95% CI: 0.83-1.31), P = 0.70; Medium SG aOR: 1.22 (95% CI: 0.92-1.61), P = 0.17; High SG aOR: 0.81 (95% CI: 0.57-1.17), P = 0.27]. Among patients that did not receive care from a cardiologist, Black patients in low SG had higher odds of 30-day readmission compared to White patients [aOR: 2.74 (95%CI:1.38-5.43), P < 0.01]. Odds of 1-year survival were similar across race for all SG irrespective of receipt of care from a cardiologist [seen by a cardiologist: Low SG aOR: 1.13 (95% CI: 0.86-1.48), P = 0.38; Medium SG aOR: 0.83 (95% CI: 0.59-1.17), P = 0.29; High SG aOR: 1.01 (95% CI: 0.66-1.52), P = 0.98; not seen by a cardiologist: Low SG aOR: 0.56 (95% CI: 0.23-1.34), P = 0.19; Medium SG aOR: 0.81 (95% CI: 0.28-2.37), P = 0.70; High SG aOR: 0.63 (95% CI: 0.23-1.74), P = 0.37]. Conclusions: Among an insured population, race was not associated with care by a cardiologist for VHD or survival. Black patients not seen by cardiologists had higher odds of 30-day readmission in low clinician SG.
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    Serving on a Graduate Medical Education Diversity, Equity, Inclusion, and Justice Committee: Lessons Learned From a Journey of Growth and Healing
    (Frontiers Media, 2022-04-27) Kara, Areeba; Wright, Curtis; Funches, Levi; Williamson, Francesca; Hicks, Ralph A.; Sutton, Timothy A.; Nabhan, Zeina; Medicine, School of Medicine
    Efforts toward achieving diversity, equity, inclusion, and justice (DEIJ) within graduate medical education (GME) often begin with the formation of a DEIJ committee that steers the work. Little is known about the experiences and the challenges faced by those serving on such committees. We sought to describe the experiences of members of our institutional GME DEIJ committee to gain knowledge that would propel this work forward. An open-ended survey was electronically administered to members of our institutional GME DEIJ committee. Responses were analyzed using a rapid qualitative analytical approach. Eighteen members (58%) responded. Of these, (67%) were women and five (28%) were Black. Six domains emerged: "motivation," "challenges," "emotional response," "highs," "facilitators," and "advice." Black respondents more often cited the need to increase diversity as a motivator to join this work. Women and Black respondents more often identified time constraints as a challenge to participation. Some members found the work emotionally draining; others described it as uplifting. Two themes emerged as high points of participation-pride and achievement around the work completed and the personal benefits of building a community with a shared purpose. Three themes emerged as facilitators: effective leadership, support, and establishing psychological safety during the meetings. Many arrived at the realization that change would take time and advocated for patience and perseverance. Protected time and DEIJ expertise were identified as integral to successful committee work. Our findings provide novel insights into the experience of serving on a GME DEIJ committee and highlights infrastructural and institutional prerequisites for success.
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    Understanding the experiences of Black women medical students and residents: A narrative review.
    (2022-04-23) Sharp, Sacha; Hixson, Ashley; Stumpff, Julia C.; Williamson, Francesca
    Few research studies examine medical students and residents with intersectional identities. In the emerging literature, data on Black women’s experiences may be misrepresented and misinterpreted as studies aggregate data for women, students of color, and Black/African American men. As such, these studies do not account for the nuanced experiences of gendered racism that Black women students and residents may encounter during their medical education. Using Crenshaw’s intersectionality as an analytical lens, we conducted a narrative review to highlight how Black women medical students and residents are rendered invisible in the current literature on medical education. The results generated 13 citations specifically discussing Black women medical students and residents. This study underscores the importance of diversifying medical education.
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    Understanding the Experiences of Black Women Medical Students and Residents: A Narrative Review..
    (2022-06-14) Sharp, Sacha; Hixson, Ashley; Stumpff, Julia C.; Williamson, Francesca
    Background: Few research studies examine medical students and residents with intersectional identities. In the emerging literature, data on Black women’s experiences may be misrepresented and misinterpreted as studies aggregate data for women, students of color, and Black/African American men. As such, these studies do not account for the nuanced experiences of gendered racism that Black women students and residents may encounter during their medical education. Methods: Using Crenshaw’s intersectionality as an analytical tool, we conducted a narrative review to highlight how Black women medical students and residents are rendered invisible in the current literature on medical education. Results: The results generated 13 citations specifically discussing Black women medical students and residents, with only six studies being empirical research. Conclusion: We conclude that 13 articles is inadequate for understanding the experiences of these populations. Without centering Black women or using an intersectional lens, researchers could invalidate the lived experiences of this population and create barriers to the political resources Black women learners need to be successful. Moreover, the lack of intention behind addressing the needs of Black women can be viewed as complicity in the oppressive structures that serve to subjugate them.