Who Resembles a Scientific Leader—Jack or Jill?
2018; Lippincott Williams & Wilkins; Volume: 137; Issue: 8 Linguagem: Inglês
10.1161/circulationaha.117.031295
ISSN1524-4539
AutoresChristine Kolehmainen, Molly Carnes,
Tópico(s)Mentoring and Academic Development
ResumoHomeCirculationVol. 137, No. 8Who Resembles a Scientific Leader—Jack or Jill? Free AccessArticle CommentaryPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissionsDownload Articles + Supplements ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toSupplemental MaterialFree AccessArticle CommentaryPDF/EPUBWho Resembles a Scientific Leader—Jack or Jill?How Implicit Bias Could Influence Research Grant Funding Christine Kolehmainen, MD, MS and Molly Carnes, MD, MS Christine KolehmainenChristine Kolehmainen William S. Middleton Veterans Hospital, Madison, WI (C.K.) and Molly CarnesMolly Carnes Department of Medicine (M.C.) Center for Women's Health Research (M.C.) School of Medicine and Public Health; and Department of Industrial and Systems Engineering (M.C.) Women in Science and Engineering Leadership Institute (WISELI) (M.C.), College of Engineering, University of Wisconsin-Madison Originally published20 Feb 2018https://doi.org/10.1161/CIRCULATIONAHA.117.031295Circulation. 2018;137:769–770When women advance in medicine, so does women's health. In cardiology, women have led major research studies examining and confirming sex differences in cardiovascular disease risk factors, manifestations, and outcomes, providing essential data for evidence-based approaches to women's heart health. The inclusion of women in cardiovascular research studies paralleled the entry of women physicians into cardiology. When women were absent as principal investigators, women were also missing from the tens of thousands of participants in the early cardiovascular prevention trials, including the Coronary Drug Project, Physicians Health Study, Lipid Research Clinics Coronary Primary Prevention Trial, and Multiple Risk Factors Intervention Trial (so-called MR FIT).Given the association between women entering cardiology and research in women's heart health, it is worrisome that women comprise <20% of cardiologists (the lowest percentage among internal medicine subspecialties).1 Furthermore, although female cardiologists are more likely than their male peers to practice in academic settings where most research is conducted (43% versus 34%), they are less likely in these settings to be involved in research2 or achieve the rank of full professor,1 and more likely to report lower levels of career attainment.2 Because conducting research as an independent investigator is critical for academic career advancement,3 and holding National Institutes of Health (NIH) grants is associated with the rank of full professor,1 it is important to examine NIH research award success by sex, in particular R01 awards, the gold standard of independence. With some exceptions, studies find no difference in overall award rates for men and women applying for NIH R01 (or R01 equivalent) awards (see Table I in the online-only Data Supplement). However, studies that examine new (type 1) and renewal (type 2) awards separately consistently find that women have lower type 2 success rates. Data from NIH confirm equivalent success rates for men and women applying for type 1 awards, but higher success rates for men's type 2 awards by ≈4% for nearly 20 years.Blumenthal and colleagues1 found that female cardiologists are less likely to hold the rank of full professor than their male counterparts. In their data, male and female cardiology faculty were equally likely to hold an NIH grant overall, but women held significantly fewer NIH grants between the associate and full professor ranks. This is exactly where the consequences of the sex differences in R01 renewals would manifest, because failing to renew an R01 could prevent female cardiologists from advancing to full professor. Specifically, if female and male cardiology faculty are equally likely to obtain a type 1 R01 award and launch an independent research program, they are equally likely to advance from assistant to associate professor. If women are subsequently less likely than their male peers to maintain their research program by renewing their R01s as type 2 awards, women will be less likely to advance to full professor. The negative impact of this sex gap in NIH type 2 renewals is 2-fold. A talented group of female cardiologists is blocked from attaining sequential leadership roles as division head, chair, or dean, robbing cardiology and all academic medicine of their vital perspectives, and the pool of investigators most likely to lead research on cardiovascular disease in women is diminished.The reason women are less successful than men in renewing their R01 awards is unknown. It is possible women more than men investigate areas of lower funding priority or that women conduct lower-quality research. However, irrefutable evidence demonstrates that the mere existence of sex stereotypes can unintentionally and unwittingly invoke implicitly different referent standards when judging the identical performance of a man or woman. Women are most disadvantaged by such implicit bias when being evaluated in roles that are more strongly associated with men than women.4 Implicit Association Tests confirm that both science and leadership are more strongly associated with male-gendered than female-gendered names.4 If implicit sex bias were to influence scientific peer review of R01s, it would most likely occur in review of type 2 awards, because successful applicants must be considered scientific leaders. Reviewers would implicitly invoke different referent standards for men and women in the evaluation of their performance as both a scientist and a leader, doubly disadvantaging women.Our research group has begun to examine R01 reviewers' written critiques as a window into their decision-making processes. We have found evidence that implicit sex bias could be operating in the review of type 2 R01s in 2 studies evaluating samples of critiques from investigators at the University of Wisconsin. We found that, given the same priority score, critiques for applications from women contained significantly more words of praise, whereas those from men contained more negative evaluation words. In a second sample, we found no difference in scoring or descriptors in critiques of men's and women's type 1 applications. However, women's type 2 applications had significantly worse priority scores than men's, even though more critiques of women's applications had standout adjectives (eg, excellent, outstanding) and words about their ability. These studies are consistent with the implicit application of different referent standards when evaluating R01 renewals, depending on the applicant's sex. However, experimental studies are needed to confirm whether implicit sex bias contributes to observed disparities in type 2 funding. In the meantime, avoiding semantic priming of male-gendered stereotypes is one practice that appears to reduce implicit bias. When NIH replaced male-gendered semantic primes (eg, high risk, technological breakthroughs) in the solicitation and review instructions for the NIH Director's Pioneer Award, women recipients increased from zero in 2004 to an average of ≈30% in the ensuing 12 years.Fortunately, NIH is currently undertaking a large experimental study to explore whether implicit bias enters the peer review process, and our team at the University of Wisconsin is concurrently conducting an experimental study assessing the effect of manipulating demographics of R01 applicants on the same applications. These are challenging undertakings given the amount of randomness and subjectivity involved in scientific peer review.5 However, if implicit bias is found to be influencing type 2 award success rates, then interventions can be developed, tested, and implemented.Sources of FundingDr Carnes's research on identifying and reducing stereotype-based bias in academic medicine, science, and engineering is funded by NIH grants R01 GM111002 and R35 GM122557.DisclosuresThe contents do not represent the views of the U.S. Department of Veterans Affairs or United States Government.FootnotesThe opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.http://circ.ahajournals.orgThe online-only Data Supplement is available with this article at http://circ.ahajournals.org/lookup/suppl/doi:10.1161/CIRCULATIONAHA.117.031295/-/DC1.Molly Carnes, MD, MS, University of Wisconsin-Madison, 700 Regent St, Ste 301, Madison, WI 53715. E-mail [email protected]References1. Blumenthal DM, Olenski AR, Yeh RW, DeFaria Yeh D, Sarma A, Stefanescu Schmidt AC, Wood MJ, Jena ABSex differences in faculty rank among academic cardiologists in the United States.Circulation. 2017; 135:506–517. doi: 10.1161/CIRCULATIONAHA.116.023520.LinkGoogle Scholar2. Lewis SJ, Mehta LS, Douglas PS, Gulati M, Limacher MC, Poppas A, Walsh MN, Rzeszut AK, Duvernoy CS; American College of Cardiology Women in Cardiology Leadership Council. Changes in the professional lives of cardiologists over 2 decades.J Am Coll Cardiol. 2017; 69:452–462. doi: 10.1016/j.jacc.2016.11.027.CrossrefMedlineGoogle Scholar3. Hosek SD CA, Ghosh-Dastidar B, Kofner A, Rampahl N, Scott J, Berry SH. Gender Differences in Major Federal External Grant Programs. RAND Technical Report. Santa Monica, CA: RAND Corp; 2005.Google Scholar4. Carnes M, Bartels CM, Kaatz A, Kolehmainen CWhy is John more likely to become department chair than Jennifer?Trans Am Clin Climatol Assoc. 2015; 126:197–214.MedlineGoogle Scholar5. Pier EL, Raclaw J, Kaatz A, Brauer M, Carnes M, Nathan MJ, Ford CE'Your comments are meaner than your score': score calibration talk influences intra- and inter-panel variability during scientific grant peer review.Res Eval. 2017; 26:1–14. doi: 10.1093/reseval/rvw025.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetailsCited By O'Meara K, Culpepper D, Lennartz C and Braxton J (2022) Leveraging Nudges to Improve the Academic Workplace: Challenges and Possibilities Higher Education: Handbook of Theory and Research, 10.1007/978-3-030-76660-3_9, (277-346), . Luc J, Preventza O, Moon M and Antonoff M (2020) Keep the Pipeline Open for Women Applying to Cardiothoracic Surgery, The American Surgeon, 10.1177/0003134820951478, 87:1, (162-163), Online publication date: 1-Jan-2021. O'Meara K, Culpepper D, Lennartz C and Braxton J (2021) Leveraging Nudges to Improve the Academic Workplace: Challenges and Possibilities Higher Education: Handbook of Theory and Research, 10.1007/978-3-030-66959-1_9-1, (1-71), . Murrar S, Johnson P, Lee Y and Carnes M (2021) Research Conducted in Women Was Deemed More Impactful but Less Publishable than the Same Research Conducted in Men, Journal of Women's Health, 10.1089/jwh.2020.8666, 30:9, (1259-1267), Online publication date: 1-Sep-2021. Hertz-Tang A and Carnes M (2020) Gender Stereotypes Burnout in Women Physicians, 10.1007/978-3-030-44459-4_5, (79-103), . 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Stamp N, Luc J, Ouzounian M, Bhatti F, Hici T and Antonoff M (2019) Social media as a tool to rewrite the narrative for women in cardiothoracic surgery, Interactive CardioVascular and Thoracic Surgery, 10.1093/icvts/ivy358, 28:6, (831-837), Online publication date: 1-Jun-2019. Lukela J, Ramakrishnan A, Hadeed N and Del Valle J (2019) When perception is reality: Resident perception of faculty gender parity in a university-based internal medicine residency program, Perspectives on Medical Education, 10.1007/s40037-019-00532-9, 8:6, (346-352), Online publication date: 1-Dec-2019. Hingle S, Kane G, Butkus R, Serchen J and Bornstein S (2018) Achieving Gender Equity in Physician Compensation and Career Advancement, Annals of Internal Medicine, 10.7326/L18-0390, 169:8, (591), Online publication date: 16-Oct-2018. February 20, 2018Vol 137, Issue 8 Advertisement Article InformationMetrics © 2018 American Heart Association, Inc.https://doi.org/10.1161/CIRCULATIONAHA.117.031295PMID: 29459461 Originally publishedFebruary 20, 2018 Keywordssexismcardiologistsresearch support as topicwomenbiascardiovascular diseasesPDF download Advertisement SubjectsCardiovascular DiseaseWomen, Sex, and Gender
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