Details:

Alternative Title:
Acad Med
Publisher's site:
http://dx.doi.org/10.1097/ACM.0000000000000372
Personal Author:
Kolehmainen, Christine ; Brennan, Meghan ; Filut, Amarette ; Isaac, Carol ; Carnes, Molly
Kolehmainen, Christine ; Brennan, Meghan ; Filut, Amarette ; Isaac, Carol ; Carnes, Molly Less -
Description:
Purpose

Ineffective leadership during cardiopulmonary resuscitation (“code”) can negatively affect a patient’s likelihood of survival. In most teaching hospitals, internal medicine residents lead codes. In this study, the authors explored internal medicine residents’ experiences leading codes, with a particular focus on how gender influences the code leadership experience.

Method

The authors conducted individual, semi-structured telephone or in-person interviews with 25 residents (May 2012 to February 2013) from 9 U.S. internal medicine residency programs. They audio recorded and transcribed the interviews then thematically analyzed the transcribed text.

Results

Participants viewed a successful code as one with effective leadership. They agreed that the ideal code leader was an authoritative presence; spoke with a deep, loud voice; used clear, direct communication; and appeared calm. Although equally able to lead codes as their male colleagues, female participants described feeling stress from having to violate gender behavioral norms in the role of code leader. In response, some female participants adopted rituals to signal the suspension of gender norms while leading a code. Others apologized afterwards for their counter normative behavior.

Conclusions

Ideal code leadership embodies highly agentic, stereotypical male behaviors. Female residents employed strategies to better integrate the competing identities of code leader and female gender. In the future, residency training should acknowledge how female gender stereotypes may conflict with the behaviors required to enact code leadership and offer some strategies, such as those used by the female residents in this study, to help women integrate these dual identities.


Subject:
[+]
Adult
Article
Attitude Of Health Personnel
Cardiopulmonary Resuscitation
Clinical Competence
Female
Gender Identity
Humans
Internal Medicine
Internship And Residency
Interviews As Topic
Leadership
Male
Physicians
Qualitative Research
Sex Factors
Stereotyped Behavior

Source:
Acad Med. 89(9):1276-1281.
Pubmed ID:
24979289
Pubmed Central ID:
PMC4146658
Document Type:
Journal Article
Funding:
DP4 GM096822/GM/NIGMS NIH HHS/United States ; DP4 GM96822/DP/NCCDPHP CDC HHS/United States ; R01 GM088477/GM/NIGMS NIH HHS/United States ; R01 GM88477/GM/NIGMS NIH HHS/United States
DP4 GM096822/GM/NIGMS NIH HHS/United States ; DP4 GM96822/DP/NCCDPHP CDC HHS/United States ; R01 GM088477/GM/NIGMS NIH HHS/United States ; R01 GM88477/GM/NIGMS NIH HHS/United States Less -
Place as Subject:
United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:994e73814caabf0f542a56398a76f9004a374a2bf2da5a018ef844dea9d98fc0
File Type:

Supporting Files

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  	nihms590916f1.jpg	jpeg

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