{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:21:49Z","timestamp":1771633309961,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hosp Med"],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:p>BACKGROUND: Women in medicine experience\ndiscrimination, hostility, and unconscious bias frequently\nand with deleterious effects. While these gender-based\nchallenges are well described, strategies to navigate and\nrespond to them are less understood.\nOBJECTIVE: To explore the lived experiences of female\nteaching attending physicians emphasizing strategies\nthey use to mitigate gender-based challenges in clinical\nenvironments.\nDESIGN: Multisite exploratory, qualitative study.\nSETTING: Inpatient general medicine teaching rounds in\nsix geographically diverse US academic hospitals between\nApril and August 2018.\nPARTICIPANTS: With use of a modified snowball sampling\napproach, female attendings and their learners were\nidentified; six female attendings and their current (n = 24)\nand former (n = 17) learners agreed to participate.\nMEASUREMENTS: Perceptions of gender-based\nchallenges in clinical teaching environments and strategies\nwith which to respond to these challenges were evaluated\nthrough semistructured in-depth interviews, focus\ngroup discussions, and direct observations of rounds.\nObservations were documented using handwritten field\nnotes. Interviews and focus groups were audio recorded\nand transcribed. All transcripts and field note data were\nanalyzed using a content analysis approach.\nMAIN OUTCOMES: Attending experience levels ranged\nfrom 8 to 20 years (mean, 15.3 years). Attendings were\ndiverse in terms of race\/ethnicity. Strategic approaches to\ngender-based challenges clustered around three themes:\nfemale attendings (1) actively position themselves as\nphysician team leaders, (2) consciously work to manage\ngender-based stereotypes and perceptions, and (3)\nintentionally identify and embrace their unique qualities.\nCONCLUSION: Female attendings manage their roles\nas women in medicine through specific strategies to\nboth navigate complex gender dynamics and role model\napproaches for learners. Journal of Hospital Medicine\n2020;15:XXX-XXX. \u00a9 2020 Society of Hospital Medicine<\/jats:p>","DOI":"10.12788\/jhm.3471","type":"journal-article","created":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T10:09:54Z","timestamp":1595412594000},"page":"454-460","source":"Crossref","is-referenced-by-count":8,"title":["Strategies of Female Teaching Attending Physicians to Navigate\nGender-Based Challenges: An Exploratory Qualitative Study"],"prefix":"10.1002","volume":"15","author":[{"given":"Nathan","family":"Houchens","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha","family":"Quinn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Molly","family":"Harrod","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel T","family":"Cronin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Hartley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjay","family":"Saint","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7,22]]},"reference":[{"key":"ref0","unstructured":"1. More ES. Restoring the Balance: Women Physicians and the Profession of Medicine, 1850-1995. Harvard University Press; 1999."},{"key":"ref1","unstructured":"2. Table A-7.2: Applicants, first-time applicants, acceptees, and matriculants to U.S. medical schools by sex, 2010-2011 through 2019-2020. Association of American Medical Colleges. Published October 4, 2019. Accessed December 13, 2019. https:\/\/www.aamc.org\/system\/files\/2019-10\/2019_FACTS_Table_A-7.2.pdf"},{"key":"ref2","unstructured":"3. Table 3: Distribution of full-time faculty by department, rank, and gender, 2015. Association of American Medical Colleges. Published December 31, 2015. Accessed September 14, 2019. https:\/\/www.aamc.org\/download\/481182\/data\/2015table3.pdf"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"4. Shrier DK, Zucker AN, Mercurio AE, Landry LJ, Rich M, Shrier LA. Generation to generation: discrimination and harassment experiences of physician mothers and their physician daughters. J Womens Health (Larchmt). 2007;16(6):883-894. https:\/\/doi.org\/10.1089\/jwh.2006.0127","DOI":"10.1089\/jwh.2006.0127"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"5. Osborn EH, Ernster VL, Martin JB. Women\u2019s attitudes toward careers in academic medicine at the University of California, San Francisco. Acad Med. 1992;67(1):59-62. https:\/\/doi.org\/10.1097\/00001888-199201000-00012","DOI":"10.1097\/00001888-199201000-00012"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"6. Komaromy M, Bindman AB, Haber RJ, Sande MA. Sexual harassment in medical training. N Engl J Med. 1993;328(5):322-326. https:\/\/doi.org\/10.1056\/nejm199302043280507","DOI":"10.1056\/nejm199302043280507"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"7. Bickel J, Ruffin A. Gender-associated differences in matriculating and graduating medical students. Acad Med. 1995;70(6):552-529. https:\/\/doi.org\/10.1097\/00001888-199506000-00021","DOI":"10.1097\/00001888-199506000-00021"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"8. Larsson C, Hensing G, Allebeck P. Sexual and gender-related harassment in medical education and research training: results from a Swedish survey. Med Educ. 2003;37(1):39-50. https:\/\/doi.org\/10.1046\/j.1365-2923.2003.01404.x","DOI":"10.1046\/j.1365-2923.2003.01404.x"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"9. Cochran A, Hauschild T, Elder WB, Neumayer LA, Brasel KJ, Crandall ML. Perceived gender-based barriers to careers in academic surgery. Am J Surg. 2013;206(2):263-268. https:\/\/doi.org\/10.1016\/j.amjsurg.2012.07.044","DOI":"10.1016\/j.amjsurg.2012.07.044"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"10. Heilman ME. Description and prescription: how gender stereotypes prevent women\u2019s ascent up the organizational ladder. J Soc Issues. 2002;57(4):657-674. https:\/\/doi.org\/10.1111\/0022-4537.00234","DOI":"10.1111\/0022-4537.00234"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"11. Amon MJ. Looking through the glass ceiling: a qualitative study of STEM women\u2019s career narratives. Front Psychol. 2017;8:236. https:\/\/doi.org\/10.3389\/fpsyg.2017.00236","DOI":"10.3389\/fpsyg.2017.00236"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"12. Choo EK, van Dis J, Kass D. Time\u2019s up for medicine? only time will tell. N Engl J Med. 2018;379(17):1592-1593. https:\/\/doi.org\/10.1056\/nejmp1809351","DOI":"10.1056\/nejmp1809351"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"13. Adesoye T, Mangurian C, Choo EK, et al. Perceived discrimination experienced by physician mothers and desired workplace changes: a cross-sectional survey. JAMA Intern Med. 2017;177(7):1033-1036. https:\/\/doi.org\/10.1001\/jamainternmed.2017.1394","DOI":"10.1001\/jamainternmed.2017.1394"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"14. Hu YY, Ellis RJ, Hewitt DB, et al. Discrimination, abuse, harassment, and burnout in surgical residency training. N Engl J Med. 2019;381(18):1741-1752. https:\/\/doi.org\/10.1056\/nejmsa1903759","DOI":"10.1056\/NEJMsa1903759"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"15. Irby DM. How attending physicians make instructional decisions when conducting teaching rounds. Acad Med. 1992;67(10):630-638. https:\/\/doi.org\/10.1097\/00001888-199210000-00002","DOI":"10.1097\/00001888-199210000-00002"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"16. Houchens N, Harrod M, Moody S, Fowler K, Saint S. Techniques and behaviors associated with exemplary inpatient general medicine teaching: an exploratory qualitative study. J Hosp Med. 2017;12(7):503-509. https:\/\/doi.org\/10.12788\/jhm.2763","DOI":"10.12788\/jhm.2763"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"17. Houchens N, Harrod M, Fowler KE, Moody S, Saint S. How exemplary inpatient teaching physicians foster clinical reasoning. Am J Med. 2017;130(9):1113.e1\u20101113.e8. https:\/\/doi.org\/10.1016\/j.amjmed.2017.03.050","DOI":"10.1016\/j.amjmed.2017.03.050"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"18. Saint S, Harrod M, Fowler KE, Houchens N. How exemplary teaching physicians interact with hospitalized patients. J Hosp Med. 2017;12(12):974-978. https:\/\/doi.org\/10.12788\/jhm.2844","DOI":"10.12788\/jhm.2844"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"19. Beckett L, Nettiksimmons J, Howell LP, Villablanca AC. Do family responsibilities and a clinical versus research faculty position affect satisfaction with career and work-life balance for medical school faculty? J Womens Health (Larchmt). 2015;24(6):471-480. https:\/\/doi.org\/10.1089\/jwh.2014.4858","DOI":"10.1089\/jwh.2014.4858"},{"key":"ref19","unstructured":"20. Underrepresented in Medicine Definition. Association of American Medical Colleges. Accessed February 2, 2019. https:\/\/www.aamc.org\/what-we-do\/mission-areas\/diversity-inclusion\/underr..."},{"key":"ref20","unstructured":"21. Patton MQ. Qualitative Research and Evaluation Methods. 3rd ed. Sage Publications; 2002."},{"key":"ref21","unstructured":"22. Harder B. 2019-20 Best Hospitals Honor Roll and Medical Specialties Rankings. U.S. News and World Report - Health. Accessed January 6, 2018. https:\/\/health.usnews.com\/health-care\/best-hospitals\/articles\/best-hospi..."},{"key":"ref22","unstructured":"23. Internal Medicine Residency Programs. Doximity. Accessed January 6, 2018. https:\/\/residency.doximity.com\/programs?residency_specialty_id=39&sort_b..."},{"key":"ref23","unstructured":"24. Member Groups Sections. American Medical Association. Accessed January 6, 2018. https:\/\/www.ama-assn.org\/member-groups-sections"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"25. Elo S, Kyngas H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107-115. https:\/\/doi.org\/10.1111\/j.1365-2648.2007.04569.x","DOI":"10.1111\/j.1365-2648.2007.04569.x"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"26. Edmunds LD, Ovseiko PV, Shepperd S, et al. Why do women choose or reject careers in academic medicine? A narrative review of empirical evidence. Lancet. 2016;388(10062):2948-2958. https:\/\/doi.org\/10.1016\/s0140-6736(15)01091-0","DOI":"10.1016\/s0140-6736(15)01091-0"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"27. Magrane D, Helitzer D, Morahan P, et al. Systems of career influences: a conceptual model for evaluating the professional development of women in academic medicine. J Womens Health (Larchmt). 2012;21(12):1244-1251. https:\/\/doi.org\/10.1089\/jwh.2012.3638","DOI":"10.1089\/jwh.2012.3638"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"28. Pololi LH, Civian JT, Brennan RT, Dottolo AL, Krupat E. Experiencing the culture of academic medicine: gender matters, a national study. J Gen Intern Med. 2013;28(2):201-207. https:\/\/doi.org\/10.1007\/s11606-012-2207-1","DOI":"10.1007\/s11606-012-2207-1"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"29. Krupat E, Pololi L, Schnell ER, Kern DE. Changing the culture of academic medicine: the C-Change learning action network and its impact at participating medical schools. Acad Med. 2013;88(9):1252-1258. https:\/\/doi.org\/10.1097\/acm.0b013e31829e84e0","DOI":"10.1097\/acm.0b013e31829e84e0"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"30. Viglianti EM, Oliverio AL, Cascino TM, et al. The policy gap: a survey of patient-perpetrated sexual harassment policies for residents and fellows in prominent US hospitals. J Gen Intern Med. 2019;34(11):2326-2328. https:\/\/doi.org\/10.1007\/s11606-019-05229-7","DOI":"10.1007\/s11606-019-05229-7"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"31. Hoff T, Scott S. The gendered realities and talent management imperatives of women physicians. Health Care Manage Rev. 2016;41(3):189-199. https:\/\/doi.org\/10.1097\/hmr.0000000000000069","DOI":"10.1097\/hmr.0000000000000069"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"32. Seemann NM, Webster F, Holden HA, et al. Women in academic surgery: why is the playing field still not level? Am J Surg. 2016;211(2):343-349. https:\/\/doi.org\/10.1016\/j.amjsurg.2015.08.036","DOI":"10.1016\/j.amjsurg.2015.08.036"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"33. Ahmadiyeh N, Cho NL, Kellogg KC, et al. Career satisfaction of women in surgery: perceptions, factors, and strategies. J Am Coll Surg. 2010;210(1):23-28. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2009.08.011","DOI":"10.1016\/j.jamcollsurg.2009.08.011"},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"34. Coleman VH, Power ML, Williams S, Carpentieri A, Schulkin J. Continuing professional development: racial and gender differences in obstetrics and gynecology residents\u2019 perceptions of mentoring. J Contin Educ Health Prof. 2005;25(4):268-277. https:\/\/doi.org\/10.1002\/chp.40","DOI":"10.1002\/chp.40"},{"key":"ref34","doi-asserted-by":"publisher","unstructured":"35. Viglianti EM, Oliverio AL, Meeks LM. Sexual harassment and abuse: when the patient is the perpetrator. Lancet. 2018;392(10145):368-370. https:\/\/doi.org\/10.1016\/s0140-6736(18)31502-2","DOI":"10.1016\/s0140-6736(18)31502-2"},{"key":"ref35","doi-asserted-by":"publisher","unstructured":"36. Killeen OJ, Bridges L. Solving the silence. JAMA. 2018;320(19):1979-1980. https:\/\/doi.org\/10.1001\/jama.2018.15686","DOI":"10.1001\/jama.2018.15686"},{"key":"ref36","doi-asserted-by":"publisher","unstructured":"37. Cowan AN. Inappropriate behavior by patients and their families-call it out. JAMA Intern Med. 2018;178(11):1441. https:\/\/doi.org\/10.1001\/jamainternmed.2018.4348","DOI":"10.1001\/jamainternmed.2018.4348"},{"key":"ref37","doi-asserted-by":"publisher","unstructured":"38. Shankar M, Albert T, Yee N, et al. Approaches for residents to address problematic patient behavior: before, during, and after the clinical encounter. J Grad Med Educ. 2019;11(4):371-374. https:\/\/doi.org\/10.4300\/jgme-d-19-00075.1","DOI":"10.4300\/jgme-d-19-00075.1"},{"key":"ref38","doi-asserted-by":"publisher","unstructured":"39. Eagly AH, Karau SJ. Role congruity theory of prejudice toward female leaders. Psychol Rev. 2002;109(3):573. https:\/\/doi.org\/10.1037\/0033-295x.109.3.573","DOI":"10.1037\/0033-295x.109.3.573"},{"key":"ref39","doi-asserted-by":"publisher","unstructured":"40. Ellinas EH, Fouad N, Byars-Winston A. Women and the decision to leave, linger, or lean in: predictors of intent to leave and aspirations to leadership and advancement in academic medicine. J Womens Health (Larchmt). 2018;27(3):324-332. https:\/\/doi.org\/10.1089\/jwh.2017.6457","DOI":"10.1089\/jwh.2017.6457"}],"container-title":["Journal of Hospital Medicine"],"original-title":[],"link":[{"URL":"https:\/\/mdedge-files-live.s3.us-east-2.amazonaws.com\/files\/s3fs-public\/issues\/articles\/454_houchens0831_0820_1.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T17:00:19Z","timestamp":1641056419000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.journalofhospitalmedicine.com\/jhospmed\/article\/225347\/hospital-medicine\/strategies-female-teaching-attending-physicians-navigate"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,22]]},"references-count":40,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2020,8,1]]}},"URL":"https:\/\/doi.org\/10.12788\/jhm.3471","relation":{},"ISSN":["1553-5606","1553-5592"],"issn-type":[{"value":"1553-5606","type":"electronic"},{"value":"1553-5592","type":"print"}],"subject":[],"published":{"date-parts":[[2020,7,22]]}}}