new research reveals 30 critiques

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05-02-2023 STRONG FEMALE LEAD

New research reveals the 30 critiques holding women back from leadership that most men will never hear

Three female PhDs say their research demonstrates that practically any characteristic can be proclaimed problematic to question a woman’s competence and suitability for leadership.

[Images: akinbostanci/Getty Images; Leontura/Getty Images]

BY  Amber L. Stephenson ,  Amy Diehl ,  and  Leanne M. Dzubinski 6 minute read

A recent study of the 33 biggest multilateral institutions found that of 382 leaders in their history only 47 have been women. And the percentage of women running Fortune 500 companies has only just recently crested a meager 10%.

As researchers we wondered why institutions consistently fail to promote women to top jobs. Our recent study of 913 women leaders from four female-dominated industries in the U.S. (higher education, faith-based nonprofits, law, and healthcare) sheds light on this pernicious problem. As we found, there’s always a reason why women are “never quite right” for leadership roles.

Women are criticized so often and on so many things that they are acculturated to receiving such disparagement, taking it seriously, and working to make improvements. And any individual woman may take it personally, believing the criticism directed at her to be warranted.

But our research reveals that the problem lies elsewhere. Virtually any characteristic can be leveraged against a woman in a discriminatory fashion. Such criticisms often relate to facets of women’s identity in an overt or subtle way, such as race , age , parental status , attractiveness , and physical ability .

Effectively, the surface-level critique functions as a “red herring,” distracting from the inherent gender bias driving the encounter. This type of treatment is so common that we have called it “we want what you aren’t” discrimination .

More specifically, our research revealed 30 different characteristics and qualities of a woman’s identity that emerged as points of criticism creating barriers to women’s success. The clear message to women is that—whatever they are—they are “never quite right.”

Age was a consistent challenge for women leaders in our study. Some of our respondents reported being considered too young to lead, while others indicated being too old hindered them from advancing.

However, being middle-aged didn’t help women’s career prospects either. A physician shared: “I am middle-aged, and men my age are seen as mature leaders and women my age as old.”

Parental status—having children or being childless—emerged as another point of criticism. A higher-education leader described how people assume she “can’t take on a bigger role ‘because of the kids,’” which made her feel that she needed “to work extra hard” to show that she could be both a dedicated mother and a leader.

On the other hand, a childless physician was expected to “work harder/more, accomplish more” than other female colleagues. Mothers were also bypassed for career opportunities, as happened to a single divorced lawyer who was the mother of preschoolers, “due to a perception by my male bosses that I cannot or should not handle [larger matters].”

Likewise, pregnancy was problematic, particularly for lawyers in our study. There was doubt that women would come back to work after maternity leave. Some were no longer given good assignments, while others were forced to quit private practice or work part time. One lawyer described the loss of confidence from bosses:

“Once you are pregnant or trying to have kids, the way management views you deteriorates. The opposite thing happens for male coworkers. I’ve seen it in so many law firms it’s impossible to argue it was just coincidence or based on merit.”

Simply planning on having kids was enough to invoke bias. A woman in higher education reported being denied promotion because she would need maternity leave for hypothetical future children.

Women of color were targets of subtle bias. An African American faith-based leader described being “invisible” and regularly “talked over” by white men. A Native American higher-education executive described being misperceived as weak, “when in fact we are practicing ‘respect’ for ourselves and others.” And a Filipina physician described facing role incredulity , as people assumed that she was “a nurse, and not a doctor and a division chief at that.”

Even physical ability and health played into the women’s experiences. Physical disabilities led to assumptions of not being capable. One higher-education leader who uses a crutch was questioned by men about the way she walks and has been told “to hide my cane, especially for photographs,” as she said.

Regarding health, there were double standards around the way men and women with illnesses were treated. A physician developed ovarian cancer while serving as an officer in the public health service. She explained, “The plan was to discharge me . . . even though men with prostate cancer didn’t have to go through that.”

The women leaders in our study were considered too young or too old. They were too short or too tall, too pretty or too unattractive or too heavy. They had too much education or not enough or their degrees were not from the “right” schools. They suffered from disrespect and misperceptions due to race, color, or ethnicity. Whether they had children or were childless, the women were expected to work harder than men to prove their worth. Women were held back from leadership opportunities due to being single, married, or divorced. There was no personality trait sweet spot, as introverted women were not seen as leaders and extraverted women were viewed as aggressive. The effect, then, means women leaders are “never quite right.”

Organizations that fail to promote and support women in their top roles miss out on performance gains . Fortunately, there are concrete steps that organizational leaders, allies, and individual women can take to mitigate this “never quite right” bias, aiding women’s workplace advancement.

“Flip it to test it”

Leaders can be particularly effective in thwarting sexist criticisms toward women. It’s not about changing the behavior of women—who are the recipients of the unfair treatment—but it is about changing the behaviors of those who justify their actions as somehow merited. Many criticisms fail the “ flip it to test it ” method miserably. Ask yourself, would the following statements ever be said about a man?

• He needs to smile more .
• Men are going to have kids and not want to work .
• Since Larry has prostate cancer, he can no longer fulfill his job duties.

The clear answer is no. Leaders can infuse awareness of this simple, yet effective, tool to reduce such bias-laden criticisms. And workplace allies can help stop unfair criticism of women by calling it out.

Constructive career-enhancing feedback

Women are almost one and a half times more likely to receive negative feedback that is subjective rather than constructive and objective feedback. Men are often given a clearer idea of where they excel and opportunities for improvement whereas women are given vague feedback that often focuses on qualities like communication style. Even when using formal performance evaluation rubrics, a disparity remains.

Developmental feedback to women focuses on operational tasks, coping with politics, developing resilience, being cooperative, and building confidence. Developmental feedback to men focuses on setting a vision, leveraging power and politics, being assertive, and displaying confidence. Leaders can reduce the gender-biased framing by encouraging all employees to develop both sets of skills.

Do not take it personally

For individual women, hear us when we say, “It’s not you.” We women are conditioned to accept feedback and internalize it as something to “fix” about ourselves. If you are criticized, consider whether it is objective, constructive, and warranted. Disregard identity-based criticisms that are part of a larger pattern of bias against women.

Our research demonstrates that practically any characteristic can be proclaimed problematic for a woman leader to question her competence and suitability for leadership. It takes deliberate effort, but we can turn the message to women from “We want what you aren’t” into “We want what you are.” Doing so will advance women in the workplace and profit the entire organization.

Amy Diehl, PhD , is chief information officer at Wilson College and a gender equity researcher, speaker, and consultant. She is coauthor of Glass Walls: Shattering the Six Gender Bias Barriers Still Holding Women Back at Work . 

Leanne M. Dzubinski, PhD, is acting dean of the Cook School of Intercultural Studies and associate professor of intercultural education at Biola University, and a prominent researcher on women in leadership. She is coauthor of Glass Walls: Shattering the Six Gender Bias Barriers Still Holding Women Back at Work .

Amber L. Stephenson, PhD, is an associate professor of management and director of healthcare management programs in the David D. Reh School of Business at Clarkson University. Her research focuses on how professional identity influences attitudes and behaviors and how women leaders experience gender bias.

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ABOUT THE AUTHORS

Amy Diehl, PhD is chief information officer at Wilson College and a gender equity researcher and speaker. She is coauthor of Glass Walls: Shattering the Six Gender Bias Barriers Still Holding Women Back at Work .   More

Leanne M. Dzubinski, PhD is professor of leadership and director of the Beeson International Center at Asbury Seminary, and a prominent researcher on women in leadership   More

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New Research Reveals the 30 Critiques Holding Women Back From Leadership that Most Men Will Never Hear

Published on June 6, 2023

A recent study of the 33 biggest multilateral institutions found that of 382 leaders in their history, only 47 have been women. And the percentage of women running Fortune 500 companies has only just recently crested a meager 10%.

As researchers, we wondered why institutions consistently fail to promote women to top jobs. Our recent study of 913 women leaders from four female-dominated industries in the U.S. (higher education, faith-based nonprofits, law, and healthcare) sheds light on this pernicious problem. As we found, there’s always a reason why women are “never quite right” for leadership roles.

Women are criticized so often and on so many things that they are acculturated to receiving such disparagement, taking it seriously, and working to make improvements. And any individual woman may take it personally, believing the criticism directed at her to be warranted.

But our research reveals that the problem lies elsewhere. Virtually any characteristic can be leveraged against a woman in a discriminatory fashion. Such criticisms often relate to facets of women’s identity in an overt or subtle way, such as race , age , parental status , attractiveness , and physical ability .

Read more…

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Harvard research reveals the #1 key to living longer and happier.

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The top insight from the Harvard study is that close relationships and social connections are ... [+] crucial for our well-being as we age.

The longest study ever conducted on human happiness has revealed some fascinating insights about what really leads to health and fulfillment over a lifetime. I had the opportunity to find out more from the director of the 80-year Harvard Study of Adult Development, Dr. Robert Waldinger , as Chester Elton and I interviewed Bob on the Anxiety at Work podcast.

Dr. Waldinger is professor of psychiatry at Harvard Medical School and author of the important new book “ The Good Life .” For more than 80 years, researchers like Bob have tracked the lives of people as part of this study. The project has followed participants from adolescence into old age, collecting data on their physical and mental health, jobs, relationships, and more.

Here’s what Dr. Waldinger says are foundational elements leading to happiness and a good, long life:

Relationships are Key to Health and Happiness

The #1 insight from the Harvard study is that close relationships and social connections are crucial for our well-being as we age. Having supportive and nurturing relationships is a buffer against life’s stresses and protects overall health. According to Dr. Waldinger, good relationships "keep us healthier and happier." People with more robust social connections showed lower rates of diabetes, arthritis, cognitive decline, and other chronic conditions. The researchers hypothesize that close relationships act as "stress regulators"—they help our bodies calm down and return to equilibrium after being revved up by challenging events.

Don't Just Let Friendships Happen, Be Proactive

More than 40 percent of adults say they feel lonely some or all of the time. The participants who actively cultivated relationships over their lifetimes reaped rewards. But they didn’t just let things happen. They made plans with friends, reached out to people, and joined community and social groups. These folks weren’t just posting online and hoping for “likes”; as Dr. Waldinger observed, "The people who were most successful at this didn’t just leave it to chance." He noted that they intentionally nurtured their in-person social connections.

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Marriage Has Its Ups and Downs But Provides Lifelong Support

The study found that marital satisfaction was important to long-term happiness but does often follow a U-shaped curve over time. People are happiest when first getting together, and then satisfaction declines when children come along, rebounds when kids leave home, and drops again if adult children return to live at home. Overall, though, having a supportive spouse through life’s journey provided tangible mental and physical health benefits. Marriage offers partners emotional support through stressful events and can help build resilience.

Take Care of Your Body for the Long Haul

The Harvard study found that participants who exercised regularly and maintained their physical health throughout their lives were more able to thrive well into old age. One of the centenarians profiled in the research offered this advice: "Take care of your body like you're going to need it for 100 years."

Other researchers have come to similar conclusions about the essential role relationships play in wellbeing. Social neuroscientist John Cacioppo found that loneliness activates the body’s stress response and can lead to chronic inflammation. His research highlights the balancing role relationships play in regulating our nervous system. Likewise, behavioral economist Arthur Brooks has studied the intersection of happiness, relationships, and purpose. He validates the Harvard study’s finding that "taking care of our relationships" is critical, and that "our connections with others are nourishment for body, mind and soul."

As a practicing Zen Master, Dr. Waldinger brings a unique perspective on the role relationships play in wellbeing. He noted that his Zen training, which focuses on studying the self and seeking enlightenment, offers a complementary window into human experience alongside his Harvard research that has examined the lives of others. He summarizes his findings in this way: "Loneliness kills. Social connections are as important to our long-term health as diet and exercise."

While many ingredients go into a fulfilling life, the Harvard study clarifies that relationships are foundational. So, who have you connected with today?

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Research: Customer Referrals Are Contagious

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Referred customers not only buy more but also refer 30–57% more new customers than others.

New research reveals the surprising power of “referral contagion,” where referred customers not only buy more but also refer 30-57% more new customers than others. This phenomenon, observed across industries, is driven by social factors like the perception of referring as appropriate and the tendency to befriend similar people. A simple experiment, reminding referred customers of their referral origin, increased successful referrals by 21%, highlighting the potential for leveraging referral psychology to boost program effectiveness. These findings call for businesses to re-evaluate their investment in referral programs, considering the amplified potential of referred customers. While some risks exist, such as the spread of negative perceptions, they can be mitigated with a balanced marketing approach.

Referrals have long been known to be effective due to the trust customers place in recommendations from friends and family. However, our new research suggests that customer referrals are even more valuable than marketers and researchers once believed.

• RG Rachel Gershon is an assistant professor of marketing at the Haas School of Business at the University of California, Berkeley.
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New Research Reveals a Key to Reducing Feelings of Regret

Francesco Carta fotografo / Getty

Key Takeaways

• When making decisions, people tend to overestimate the appeal of the choices not made, which increases regret.
• If able to see the reality of the forgone alternative, or second choice, individuals report less feelings of regret.
• These findings may inform psychotherapy approaches to address regret more effectively.

Everyone has feelings of regret , but changing how these feelings are approached may help people move forward. A new study published in Psychological Science found that participants had more regret with idealized forgone alternatives.

A forgone alternative refers to the second choice that people eventually reject when making a decision. People tend to overestimate its appeal when compared to the reality of the choice they selected.

Such insights on how humans process regret hold promise for engaging individuals in the therapeutic work to address regretful feelings.

Understanding the Research

Research was done based on a total of four studies where feelings of regret were compared between cases where individuals were able to see the realities of their second choices, and cases where those realities were not revealed.

These findings demonstrate a tendency to overestimate the appeal of the second choice that is ultimately rejected in comparison to the reality of the decision that was actually made.

Researchers note that these findings contradict earlier studies, which had suggested that individuals may be more regretful after learning about the alternate outcome, but the sample was limited to only Amazon MTurk workers.

While environmental factors, such as the size of the set of choices and the uncertainty of potential outcomes, may impact the feelings that result from a decision, researchers suggest that more realistic perspectives regarding forgone alternatives may reduce regret.

Moving Forward from Regretful Decisions

Licensed clinical social worker, Iris Waichler, MSW, LCSW , who specializes in grief , loss, regret, caregiving, anxiety and eldercare, says, "Their research contradicts previous research. They found that knowledge of an unchosen outcome helps stem the degree of regret."

Waichler explains, "People often overestimate that the unchosen path would have had a better outcome, which heightens feelings of regret. Revealing the unchosen outcome corrects these misconceptions. They also found that the chosen options are frequently overestimated."

Since the study highlighted two important factors that influence the outcome—the size of the choice of options and the degree of uncertainty associated with the potential outcomes—Waichler notes that more selections and greater ambiguity may produce a higher level of regret.

Waichler explains, "The type of environment influences the outcome based on this research. Readers can apply this in some situations in their lives like choosing a job or finding a partner. However, the study points out that often in real life, there is not an opportunity to learn the results of the outcomes of the paths that were not chosen." 

Iris Waichler, MSW, LCSW

You can't change a past decision and focusing on the regret will compromise your ability to make present decisions. Use a bad choice to learn how to be more effective in making future decisions.

Since foregone alternatives are life choices that were seriously considered but not taken, Waichler notes that if the decision made does not turn out the way people wanted or expected, they tend to overestimate the results of the foregone alternative.

"This heightens the level of regret," she says.

Waichler highlights, "People sometimes tell themselves there is only one right or wrong decision, which, often, is not the case. Life choices are complex and have many layers. Making a bad decision may cause people to question their judgment or their self-knowledge which often causes self-recrimination , increases self-doubts, and heightens anxiety."

The small sample size is a limitation, according to Waichler, who says, "It is a controlled environment that does not always mimic real-life. They controlled what participants learned about foregone alternatives, supplying them with information that influenced their level of regret."

As a therapist, Waichler dissuades clients from obsessing over regrets. "You can't change a past decision and focusing on the regret will compromise your ability to make present decisions. Use a bad choice to learn how to be more effective in making future decisions," she says.

By taking time to consider how you cope with regrets, Waichler asks, "Do you assign blame to yourself or others? Do you give yourself permission to forgive and move forward when the next decision arises?"

Give yourself time to recover and heal from a previous bad decision. Making decisions when you are in a bad place emotionally may result in more negative outcomes.

In reminding yourself that you are human and everyone makes mistakes, Waichler recommends self-compassion . "Tell yourself you have gained knowledge from past experiences and this will help you make better decisions in the present and future," she says.

Waichler highlights, "Give yourself time to recover and heal from a previous bad decision. Making decisions when you are in a bad place emotionally may result in more negative outcomes."

By closely examining how regret affects you emotionally, Waichler asks, "Could you or would you have done things differently or were there factors that were out of your control that impacted the outcome? How will you use this knowledge to make better decisions in the future?" 

Through analysis and self-reflection regarding how regret influences the way you will behave in the future and the thought processes you will rely on, Waichler believes that individuals can cope more effectively.

Idealizing Alternate Outcomes Heightens Regret

Psychotherapist with  Mindpath Health , Taish Malone, LPC, PhD, says, "Counterfactual thinking is when we imagine alternate choices and or outcomes based off our own suppositions." 

Malone explains, "Upward counterfactual thinking assumes that things could have been better than they actually are, and this type of counterfactual thinking is the foundation of regret."

This self-referential quality should prompt readers to consider how their perceptual distortions dictate the lasting effects a missed opportunity has on them, according to Malone.

"There is a correlation between the number of options, whether perceived or actual, and the probability, occurrence, and weight of the regret felt," she says. 

Regret was also found to be more intense when it stemmed from force, and Malone notes that force influences regret intensity and suggests an overestimation of the alternate choices as being more favorable.

Malone highlights, "Those with negative distortions, self-doubt , and low confidence are likely candidates for higher exaggeratedly negative forgone experience. Personality has been seen as a great predictor of regret."

Many personality psychologists agree on the five traits of extraversion ,  agreeableness ,  openness ,  conscientiousness , and  neuroticism ,  and Malone notes that higher scores of neuroticism were indicative of those who had a higher probability of regret.

Malone explains, "This can explain why some have a proclivity towards having stronger regret generally fueled by rigid psychological vulnerability and distress with depression or anxiety."

Taish Malone, LPC, PhD

This understanding should help people to understand that they shape their experiences by the mindset they have.

These findings may expand the knowledge that romanticizing the alternate outcomes is a common psychological distortion that many who have deep regrets experience, according to Malone. "Once again, the reality is not the antecedent of the regret intensity, but the perception," she says.

Malone highlights, "This understanding should help people to understand that they shape their experiences by the mindset they have."

Seeking counseling to become more mindful of adaptive aspects of emotions, cognitive flexibility, and behavior-change helps, and Malone notes that these strategies can offer alternatives to the susceptibility for negative takeaways from deeply regretful experiences.

Malone explains, "Once learned and practiced, these decision-making motivators can get people to have the confidence, resilience, and outlook to be comfortable with the way things turned out."

Individuals should understand that their outlook and the way they experience the world is malleable and largely dependent upon their own perseverance for change, according to Malone.

"I feel people feel a lot less empowered than they are, which deters many from making the necessary changes they want to see in their lives," she says.

When clients present concerns that feel unavoidable or unmanageable, Malone values the power of reminding them of their strengths so that they can reflect and see just how capable they are.

What This Means For You

As this study demonstrates, regret may be exacerbated by idealized outcomes for choices not made. If struggling to navigate such feelings, it may help to remember the difference between perception and reality, and shift expectations for the future.

Feiler D, Müller-Trede J. The one that got away: Overestimation of forgone alternatives as a hidden source of regret .  Psychol Sci . 2022;33(2):314-324. doi:10.1177/09567976211032657

Power RA, Pluess M. Heritability estimates of the Big Five personality traits based on common genetic variants .  Transl Psychiatry . 2015;5(7):e604-e604. doi:10.1038/tp.2015.96

By Krystal Jagoo  Krystal Kavita Jagoo is a social worker, committed to anti-oppressive practice.

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Report critiques inclusion among film critics

Films like  Crazy Rich Asians , The Spy Who Dumped Me , BlacKkKlansman , and  The Happytime Murders  are poised to provide a much-needed dose of diversity to theaters this summer. But as audiences look to critical reviews to determine if these movies are worth the ticket price, what perspectives are available? A new study reveals that the film reviewers are unlikely to be as diverse as the casts they are critiquing.

The report, titled “ Critic's Choice? ” is the first from Associate Professor of Communication  Stacy L. Smith  and the  USC Annenberg Inclusion Initiative  to investigate inclusion among film reviewers, and examines access and opportunity for film critics. The report uses reviews of the 100 top grossing films of 2017 posted on the site Rotten Tomatoes to assess gender and race/ethnicity of critics, finding that reviewers are overwhelmingly white and male.

Only 22.2 percent of the 19,559 reviews evaluated were written by females, with 77.8 percent crafted by male critics. This represents a gender ratio of 3.5 males to every 1 female reviewer. White critics wrote 82 percent of the reviews and critics from underrepresented racial/ethnic backgrounds authored 18 percent. However, when the researchers examined both gender and underrepresented status, they found that white male critics wrote substantially more reviews (63.9 percent) than their white female (18.1 percent) or underrepresented male (13.8 percent) peers. Underrepresented female critics only wrote 4.1 percent of reviews included in the sample.

“The very individuals who are attuned to the under and misrepresentation of females on screen and behind the camera are often left out of the conversation and critiques,” said Smith, founder and director of the Annenberg Inclusion Initiative. “The publicity, marketing, and distribution teams in moviemaking have an opportunity to change this quickly by increasing the access and opportunities given to women of color as film reviewers.”

Similar results emerged when the researchers focused on individuals Rotten Tomatoes designated as “Top Critics.” Of the 3,359 reviews by top critics, 76 percent were written by males and 24 percent by females. Underrepresented top critics wrote 11.2 percent of the reviews compared to 88.8 percent by white top critics. When gender and underrepresented status were examined simultaneously, top film reviews written by white males outnumbered those by underrepresented females by nearly 27 to 1, as reviews by women of color amounted to only 2.5 percent of those by top critics while white males wrote 67.3 percent. White females wrote 21.5 percent and underrepresented male critics 8.7 percent of top reviews.

“Even among top critics, the words of white and male critics fill a greater share of the conversation than females and people of color,” said Marc Choueiti, the study’s lead author. “Re-examining the definition of a top critic or simply casting a wider net can be the opportunity to open up and diversify the voices heard in the critic space.”

The researchers assessed the percentage of female and underrepresented film reviewers for each movie studied. Not one of the 100 films achieved gender-balance in the critics pool. The 36 female-driven movies in 2017 the team identified were similarly imbalanced. Seventy percent of these films were reviewed by groups of critics in which women amounted to less than 30 percent of reviewers. Most of the 24 films with underrepresented leads were assessed by a group of critics in which 20 percent or fewer reviewers were from underrepresented backgrounds.

The percentage of women and people of color reviewing as top critics per film was also calculated. While a handful of female-driven movies achieved proportional representation of female top critics, none featured underrepresented critics in proportion to the population. Most strikingly, women of color were completely absent as top critics from 45 of the 100 films analyzed, 19 or 52.8 percent of the female-driven films assessed, and 9 or 37.5 percent of the movies with underrepresented lead characters.

“This report reveals the absence of women of color working as reviewers—especially on movies built around female and underrepresented leads,” Smith said. “We have seen the ramifications of an industry in which the content sold to audiences is created and reviewed by individuals who are primarily white men. Creating inclusive hiring practices at every stage of the filmmaking and review process is essential to meeting business imperatives and ensuring that we see diverse perspectives reflected in society.”

Critics may review multiple films throughout the year, so the researchers measured the number of individual film critics. Of the more than 1,600 individuals working throughout the year, white males were roughly half (53.2 percent), white females about a quarter (23 percent), underrepresented males were 14.8 percent, and underrepresented females were 8.9 percent of all critics. The numbers were similar for individual top critics.

It’s no surprise then, that across all critics, white males wrote the highest average number of reviews each year, at 14.3. Underrepresented male critics composed an average of 11.1, white females an average of 9.4, and underrepresented females only 5.6 reviews on average.

The authors propose several solutions for groups that work with or educate critics. Most notably, they offer a set of target inclusion goals for the field. “Groups should think of the phrase 30/30/20/20—this is the U.S. population breakdown for white males, white females, underrepresented males and underrepresented females,” Smith said. “It sets a clear goal for groups who want to make sure that their ranks reflect the world in which we live.”

The report is the latest from the USC Annenberg Inclusion Initiative, and the first in a series of reports on critics. The second report will focus on differences in review content by reviewer gender and/or race/ethnicity, and a third report will examine relationships to box office performance. The newest report can be found online  here .

In the News

June 11, 2018 | Associated Press | Study finds that film critics are almost 80 percent male

June 11, 2018 | Hollywood Reporter | Film Critics Even Less Diverse Than Films, Study Finds

June 11, 2018 | Variety | Movie Critics Are Mostly White Men, Study Shows

June 13, 2018 | Hollywood Reporter | Sundance, Toronto to Allocate 20 Percent of Credentials to Underrepresented Critics, Says Brie Larson

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• v.12(3); 2021 Jun

Writing, reading, and critiquing reviews

Écrire, lire et revue critique, douglas archibald.

1 University of Ottawa, Ontario, Canada;

Maria Athina Martimianakis

2 University of Toronto, Ontario, Canada

Why reviews matter

What do all authors of the CMEJ have in common? For that matter what do all health professions education scholars have in common? We all engage with literature. When you have an idea or question the first thing you do is find out what has been published on the topic of interest. Literature reviews are foundational to any study. They describe what is known about given topic and lead us to identify a knowledge gap to study. All reviews require authors to be able accurately summarize, synthesize, interpret and even critique the research literature. 1 , 2 In fact, for this editorial we have had to review the literature on reviews . Knowledge and evidence are expanding in our field of health professions education at an ever increasing rate and so to help keep pace, well written reviews are essential. Though reviews may be difficult to write, they will always be read. In this editorial we survey the various forms review articles can take. As well we want to provide authors and reviewers at CMEJ with some guidance and resources to be able write and/or review a review article.

What are the types of reviews conducted in Health Professions Education?

Health professions education attracts scholars from across disciplines and professions. For this reason, there are numerous ways to conduct reviews and it is important to familiarize oneself with these different forms to be able to effectively situate your work and write a compelling rationale for choosing your review methodology. 1 , 2 To do this, authors must contend with an ever-increasing lexicon of review type articles. In 2009 Grant and colleagues conducted a typology of reviews to aid readers makes sense of the different review types, listing fourteen different ways of conducting reviews, not all of which are mutually exclusive. 3 Interestingly, in their typology they did not include narrative reviews which are often used by authors in health professions education. In Table 1 , we offer a short description of three common types of review articles submitted to CMEJ.

Three common types of review articles submitted to CMEJ

More recently, authors such as Greenhalgh 4 have drawn attention to the perceived hierarchy of systematic reviews over scoping and narrative reviews. Like Greenhalgh, 4 we argue that systematic reviews are not to be seen as the gold standard of all reviews. Instead, it is important to align the method of review to what the authors hope to achieve, and pursue the review rigorously, according to the tenets of the chosen review type. Sometimes it is helpful to read part of the literature on your topic before deciding on a methodology for organizing and assessing its usefulness. Importantly, whether you are conducting a review or reading reviews, appreciating the differences between different types of reviews can also help you weigh the author’s interpretation of their findings.

In the next section we summarize some general tips for conducting successful reviews.

How to write and review a review article

In 2016 David Cook wrote an editorial for Medical Education on tips for a great review article. 13 These tips are excellent suggestions for all types of articles you are considering to submit to the CMEJ. First, start with a clear question: focused or more general depending on the type of review you are conducting. Systematic reviews tend to address very focused questions often summarizing the evidence of your topic. Other types of reviews tend to have broader questions and are more exploratory in nature.

Following your question, choose an approach and plan your methods to match your question…just like you would for a research study. Fortunately, there are guidelines for many types of reviews. As Cook points out the most important consideration is to be sure that the methods you follow lead to a defensible answer to your review question. To help you prepare for a defensible answer there are many guides available. For systematic reviews consult PRISMA guidelines ; 13 for scoping reviews PRISMA-ScR ; 14 and SANRA 15 for narrative reviews. It is also important to explain to readers why you have chosen to conduct a review. You may be introducing a new way for addressing an old problem, drawing links across literatures, filling in gaps in our knowledge about a phenomenon or educational practice. Cook refers to this as setting the stage. Linking back to the literature is important. In systematic reviews for example, you must be clear in explaining how your review builds on existing literature and previous reviews. This is your opportunity to be critical. What are the gaps and limitations of previous reviews? So, how will your systematic review resolve the shortcomings of previous work? In other types of reviews, such as narrative reviews, its less about filling a specific knowledge gap, and more about generating new research topic areas, exposing blind spots in our thinking, or making creative new links across issues. Whatever, type of review paper you are working on, the next steps are ones that can be applied to any scholarly writing. Be clear and offer insight. What is your main message? A review is more than just listing studies or referencing literature on your topic. Lead your readers to a convincing message. Provide commentary and interpretation for the studies in your review that will help you to inform your conclusions. For systematic reviews, Cook’s final tip is most likely the most important– report completely. You need to explain all your methods and report enough detail that readers can verify the main findings of each study you review. The most common reasons CMEJ reviewers recommend to decline a review article is because authors do not follow these last tips. In these instances authors do not provide the readers with enough detail to substantiate their interpretations or the message is not clear. Our recommendation for writing a great review is to ensure you have followed the previous tips and to have colleagues read over your paper to ensure you have provided a clear, detailed description and interpretation.

Finally, we leave you with some resources to guide your review writing. 3 , 7 , 8 , 10 , 11 , 16 , 17 We look forward to seeing your future work. One thing is certain, a better appreciation of what different reviews provide to the field will contribute to more purposeful exploration of the literature and better manuscript writing in general.

In this issue we present many interesting and worthwhile papers, two of which are, in fact, reviews.

Major Contributions

A chance for reform: the environmental impact of travel for general surgery residency interviews by Fung et al. 18 estimated the CO 2 emissions associated with traveling for residency position interviews. Due to the high emissions levels (mean 1.82 tonnes per applicant), they called for the consideration of alternative options such as videoconference interviews.

Understanding community family medicine preceptors’ involvement in educational scholarship: perceptions, influencing factors and promising areas for action by Ward and team 19 identified barriers, enablers, and opportunities to grow educational scholarship at community-based teaching sites. They discovered a growing interest in educational scholarship among community-based family medicine preceptors and hope the identification of successful processes will be beneficial for other community-based Family Medicine preceptors.

Exploring the global impact of the COVID-19 pandemic on medical education: an international cross-sectional study of medical learners by Allison Brown and team 20 studied the impact of COVID-19 on medical learners around the world. There were different concerns depending on the levels of training, such as residents’ concerns with career timeline compared to trainees’ concerns with the quality of learning. Overall, the learners negatively perceived the disruption at all levels and geographic regions.

The impact of local health professions education grants: is it worth the investment? by Susan Humphrey-Murto and co-authors 21 considered factors that lead to the publication of studies supported by local medical education grants. They identified several factors associated with publication success, including previous oral or poster presentations. They hope their results will be valuable for Canadian centres with local grant programs.

Exploring the impact of the COVID-19 pandemic on medical learner wellness: a needs assessment for the development of learner wellness interventions by Stephana Cherak and team 22 studied learner-wellness in various training environments disrupted by the pandemic. They reported a negative impact on learner wellness at all stages of training. Their results can benefit the development of future wellness interventions.

Program directors’ reflections on national policy change in medical education: insights on decision-making, accreditation, and the CanMEDS framework by Dore, Bogie, et al. 23 invited program directors to reflect on the introduction of the CanMEDS framework into Canadian postgraduate medical education programs. Their survey revealed that while program directors (PDs) recognized the necessity of the accreditation process, they did not feel they had a voice when the change occurred. The authors concluded that collaborations with PDs would lead to more successful outcomes.

Experiential learning, collaboration and reflection: key ingredients in longitudinal faculty development by Laura Farrell and team 24 stressed several elements for effective longitudinal faculty development (LFD) initiatives. They found that participants benefited from a supportive and collaborative environment while trying to learn a new skill or concept.

Brief Reports

The effect of COVID-19 on medical students’ education and wellbeing: a cross-sectional survey by Stephanie Thibaudeau and team 25 assessed the impact of COVID-19 on medical students. They reported an overall perceived negative impact, including increased depressive symptoms, increased anxiety, and reduced quality of education.

In Do PGY-1 residents in Emergency Medicine have enough experiences in resuscitations and other clinical procedures to meet the requirements of a Competence by Design curriculum? Meshkat and co-authors 26 recorded the number of adult medical resuscitations and clinical procedures completed by PGY1 Fellow of the Royal College of Physicians in Emergency Medicine residents to compare them to the Competence by Design requirements. Their study underscored the importance of monitoring collection against pre-set targets. They concluded that residency program curricula should be regularly reviewed to allow for adequate clinical experiences.

Rehearsal simulation for antenatal consults by Anita Cheng and team 27 studied whether rehearsal simulation for antenatal consults helped residents prepare for difficult conversations with parents expecting complications with their baby before birth. They found that while rehearsal simulation improved residents’ confidence and communication techniques, it did not prepare them for unexpected parent responses.

Review Papers and Meta-Analyses

Peer support programs in the fields of medicine and nursing: a systematic search and narrative review by Haykal and co-authors 28 described and evaluated peer support programs in the medical field published in the literature. They found numerous diverse programs and concluded that including a variety of delivery methods to meet the needs of all participants is a key aspect for future peer-support initiatives.

Towards competency-based medical education in addictions psychiatry: a systematic review by Bahji et al. 6 identified addiction interventions to build competency for psychiatry residents and fellows. They found that current psychiatry entrustable professional activities need to be better identified and evaluated to ensure sustained competence in addictions.

Six ways to get a grip on leveraging the expertise of Instructional Design and Technology professionals by Chen and Kleinheksel 29 provided ways to improve technology implementation by clarifying the role that Instructional Design and Technology professionals can play in technology initiatives and technology-enhanced learning. They concluded that a strong collaboration is to the benefit of both the learners and their future patients.

In his article, Seven ways to get a grip on running a successful promotions process, 30 Simon Field provided guidelines for maximizing opportunities for successful promotion experiences. His seven tips included creating a rubric for both self-assessment of likeliness of success and adjudication by the committee.

Six ways to get a grip on your first health education leadership role by Stasiuk and Scott 31 provided tips for considering a health education leadership position. They advised readers to be intentional and methodical in accepting or rejecting positions.

Re-examining the value proposition for Competency-Based Medical Education by Dagnone and team 32 described the excitement and controversy surrounding the implementation of competency-based medical education (CBME) by Canadian postgraduate training programs. They proposed observing which elements of CBME had a positive impact on various outcomes.

You Should Try This

In their work, Interprofessional culinary education workshops at the University of Saskatchewan, Lieffers et al. 33 described the implementation of interprofessional culinary education workshops that were designed to provide health professions students with an experiential and cooperative learning experience while learning about important topics in nutrition. They reported an enthusiastic response and cooperation among students from different health professional programs.

In their article, Physiotherapist-led musculoskeletal education: an innovative approach to teach medical students musculoskeletal assessment techniques, Boulila and team 34 described the implementation of physiotherapist-led workshops, whether the workshops increased medical students’ musculoskeletal knowledge, and if they increased confidence in assessment techniques.

Instagram as a virtual art display for medical students by Karly Pippitt and team 35 used social media as a platform for showcasing artwork done by first-year medical students. They described this shift to online learning due to COVID-19. Using Instagram was cost-saving and widely accessible. They intend to continue with both online and in-person displays in the future.

Adapting clinical skills volunteer patient recruitment and retention during COVID-19 by Nazerali-Maitland et al. 36 proposed a SLIM-COVID framework as a solution to the problem of dwindling volunteer patients due to COVID-19. Their framework is intended to provide actionable solutions to recruit and engage volunteers in a challenging environment.

In Quick Response codes for virtual learner evaluation of teaching and attendance monitoring, Roxana Mo and co-authors 37 used Quick Response (QR) codes to monitor attendance and obtain evaluations for virtual teaching sessions. They found QR codes valuable for quick and simple feedback that could be used for many educational applications.

In Creation and implementation of the Ottawa Handbook of Emergency Medicine Kaitlin Endres and team 38 described the creation of a handbook they made as an academic resource for medical students as they shift to clerkship. It includes relevant content encountered in Emergency Medicine. While they intended it for medical students, they also see its value for nurses, paramedics, and other medical professionals.

Commentary and Opinions

The alarming situation of medical student mental health by D’Eon and team 39 appealed to medical education leaders to respond to the high numbers of mental health concerns among medical students. They urged leaders to address the underlying problems, such as the excessive demands of the curriculum.

In the shadows: medical student clinical observerships and career exploration in the face of COVID-19 by Law and co-authors 40 offered potential solutions to replace in-person shadowing that has been disrupted due to the COVID-19 pandemic. They hope the alternatives such as virtual shadowing will close the gap in learning caused by the pandemic.

Letters to the Editor

Canadian Federation of Medical Students' response to “ The alarming situation of medical student mental health” King et al. 41 on behalf of the Canadian Federation of Medical Students (CFMS) responded to the commentary by D’Eon and team 39 on medical students' mental health. King called upon the medical education community to join the CFMS in its commitment to improving medical student wellbeing.

Re: “Development of a medical education podcast in obstetrics and gynecology” 42 was written by Kirubarajan in response to the article by Development of a medical education podcast in obstetrics and gynecology by Black and team. 43 Kirubarajan applauded the development of the podcast to meet a need in medical education, and suggested potential future topics such as interventions to prevent learner burnout.

Response to “First year medical student experiences with a clinical skills seminar emphasizing sexual and gender minority population complexity” by Kumar and Hassan 44 acknowledged the previously published article by Biro et al. 45 that explored limitations in medical training for the LGBTQ2S community. However, Kumar and Hassen advocated for further progress and reform for medical training to address the health requirements for sexual and gender minorities.

In her letter, Journey to the unknown: road closed!, 46 Rosemary Pawliuk responded to the article, Journey into the unknown: considering the international medical graduate perspective on the road to Canadian residency during the COVID-19 pandemic, by Gutman et al. 47 Pawliuk agreed that international medical students (IMGs) do not have adequate formal representation when it comes to residency training decisions. Therefore, Pawliuk challenged health organizations to make changes to give a voice in decision-making to the organizations representing IMGs.

In Connections, 48 Sara Guzman created a digital painting to portray her approach to learning. Her image of a hand touching a neuron showed her desire to physically see and touch an active neuron in order to further understand the brain and its connections.