Publications by authors named "RB Levine"

Background: Gender inequity persists in high-level leadership within academic medicine. Understanding the perspectives of early career women faculty could clarify how to recruit and support women who pursue high-level leadership. This study explored the specific priorities and concerns that may influence the recruitment of women leaders in the future.

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Impostor phenomenon (IP) describes feelings of inadequacy often experienced by individuals struggling to internalize success despite evidence to the contrary. IP is common in medicine and can be experienced as a cycle following exposure to an achievement-focused task, leading to fear of being found out as an impostor. Prior research describes IP characteristics, yet few studies have identified factors that mitigate IP among medical residents.

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Article Synopsis
  • The Early Career Women's Leadership Program (ECWLP) aims to increase women's representation in high-level leadership roles in academic medicine by enhancing their confidence and leadership skills through seminars over six months.
  • After participating, women reported significant improvements in their leadership confidence, negotiation skills, and alignment of personal and professional goals, with many feeling reduced conflict between leadership aspirations and family obligations.
  • Key barriers identified included lack of networking opportunities, transparency in leadership, and a competitive culture, while supportive elements of the program included self-reflection and tactical planning.
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Despite decades of faculty professional development programs created to prepare women for leadership, gender inequities persist in salary, promotion, and leadership roles. Indeed, men still earn more than women, are more likely than women to hold the rank of professor, and hold the vast majority of positions of power in academic medicine. Institutions demonstrate commitment to their faculty's growth by investing resources, including creating faculty development programs.

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Importance: Women remain underrepresented in ophthalmology and gender-based disparities exist in salary, grant receipt, publication rates, and surgical volume throughout training and in practice. Although studies in emergency medicine and general surgery showed mixed findings regarding gender differences in Accreditation Council for Graduate Medical Education (ACGME) Milestones ratings, limited data exist examining such differences within ophthalmology.

Objective: To examine gender differences in ophthalmology ACGME Milestones.

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Purpose: Recognizing the similarities between the skills an actor needs and those required of a physician in clinical communication, medical educators have begun to create drama-based interventions to teach communication skills. The purpose of this scoping review was to summarize existing educational interventions that use drama training to teach medical trainees communication skills.

Method: The authors searched PubMed, CINAHL Plus, Embase, ERIC, and Web of Science Core Collection multiple times beginning in March 2020 through March 2022.

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Women comprise almost one-third of academic medicine faculty 60 years of age and older. Gender disparities have been documented across many measures in medicine, including salary, promotion rates, and leadership positions and may impact long-term career and retirement decisions. The authors sought to describe gender differences in retirement decisions among late-career, full-time medical school faculty.

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Serotonin plays an important role in the development of brainstem circuits that control breathing. Here, we test the hypothesis that developmental nicotine exposure (DNE) alters the breathing-related motor response to serotonin (5HT). Pregnant rats were exposed to nicotine or saline, and brainstem-spinal cord preparations from 1- to 5-day-old pups were studied in a split-bath configuration, allowing drugs to be applied selectively to the medulla or spinal cord.

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Mindfulness practice has been shown to have many positive benefits for patients, clinicians, and trainees. Mindfulness fosters compassion, connection, and enhanced clinical reasoning and can reduce burnout among clinicians. A primary focus of mindfulness is present-moment awareness and may be achieved through openness, curiosity, perspective-taking, and letting go of judgment.

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Background: Women remain underrepresented in top leadership positions in academic medicine. In business settings, a person with power and influence actively supporting the career advancement of a junior person is referred to as a sponsor and sponsorship programs have been used to diversify leadership. Little is known about how sponsorship functions in academic medicine.

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Nicotine exposure during the fetal and neonatal periods [developmental nicotine exposure (DNE)] is associated with ineffective upper airway protective reflexes in infants. This could be explained by desensitized chemoreceptors and/or mechanoreceptors, diminished neuromuscular transmission or altered synaptic transmission among central neurons, as each of these systems depend in part on cholinergic signaling through nicotinic AChRs (nAChRs). Here, we showed that DNE blunts the response of the genioglossus (GG) muscle to nasal airway occlusion in lightly anesthetized rat pups.

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The mammalian tongue contains eight muscles that collaborate to ensure that suckling, swallowing, and other critical functions are robust and reliable. Seven of the eight tongue muscles are innervated by hypoglossal motoneurons (XIIMNs). A somatotopic organization of the XII motor nucleus, defined in part by the mechanical action of a neuron's target muscle, has been described, but whether or not XIIMNs within a compartment are functionally specialized is unsettled.

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Women in academic medicine are not attaining parity with men in several domains. This issue is not only one of fairness; some funding agencies are requesting data on gender benchmarking. However, most published reports on gender disparities have not included examination of trends or actionable recommendations to address them.

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Despite national efforts to expand women's health education, internal medicine (IM) residents remain unprepared to provide comprehensive care to women. The objectives of this scoping review are to provide an overview of published women's health curricula in IM residency programs and to identify potential areas for improvement. Studies were identified using PubMed, Embase, Cochrane Library, Scopus, Education Resources Information Center (ERIC), Web of Science, and MedEdPORTAL.

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Introduction Difficult patient encounters (DPEs) are common and can lead to frustration and dissatisfaction among healthcare providers. Pediatric resident physician experiences with DPEs and curricula for enhancing necessary communication skills have not been well described. Materials and methods We used a cross-sectional survey research design for our needs assessment on resident experiences with DPEs.

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Purpose: To explore how sponsorship functions as a professional relationship in academic medicine.

Method: The authors conducted semistructured interviews with Johns Hopkins University School of Medicine faculty in 2016: department chairs (sponsors) and faculty participants of an executive leadership development program (protégés). Using editing analysis style, the authors coded interview transcripts for thematic content; a coding framework and themes were derived using an iterative process.

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We tested the hypothesis that nicotine exposure in utero and after birth [developmental nicotine exposure (DNE)] disrupts development of glycinergic synaptic transmission to hypoglossal motoneurons (XIIMNs). Glycinergic spontaneous and miniature inhibitory postsynaptic currents (sIPSC/mIPSC) were recorded from XIIMNs in brain stem slices from 1- to 5-day-old rat pups of either sex, under baseline conditions and following stimulation of nicotinic acetylcholine (ACh) receptors with nicotine (i.e.

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Algal biofuels have the potential to curb the emissions of greenhouse gases from fossil fuels, but current growing methods fail to produce fuels that meet the multiple standards necessary for economical industrial use. For example, algae grown as monocultures for biofuel production have not simultaneously and economically achieved high yields of the high-quality lipid-rich biomass desired for the industrial-scale production of bio-oil. Decades of study in the field of ecology have demonstrated that simultaneous increases in multiple functions, such as the quantity and quality of biomass, can occur in natural ecosystems by increasing biological diversity.

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Key Points: Critical homeostatic behaviours such as suckling, swallowing and breathing depend on the precise control of tongue muscle activity. Perinatal nicotine exposure has multiple effects on baseline inhibitory GABAergic neurotransmission to hypoglossal motoneurons (XIIMNs), consistent with homeostatic compensations directed at maintaining normal motoneuron output. Developmental nicotine exposure (DNE) alters how GABAergic neurotransmission is modulated by acute activation of nicotinic acetylcholine receptors, which may provide insight into mechanisms by which nicotine exposure alters motor function under conditions that result in increased release of GABA, such as hypoxia, or endogenous acetylcholine, as occurs in the transition from NREM to REM sleep, or in response to exogenous nicotine.

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Purpose: United States (US) and Canadian citizens attending medical school abroad often desire to return to the US for residency, and therefore must pass US licensing exams. We describe a 2-day United States Medical Licensing Examination (USMLE) step 2 clinical skills (CS) preparation course for students in the Technion American Medical School program (Haifa, Israel) between 2012 and 2016.

Methods: Students completed pre- and post-course questionnaires.

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Objective: When integrated behavioral health clinicians (IBHCs) and residents co-manage patients, residents may learn new approaches. We aimed to understand the effect of co-management on residents' behavioral health (BH) management learning.

Methods: Residents completed a web-based survey enquiring: whether co-management included a shared visit and/or face-to-face meeting with an IBHC, whether residents received feedback from the IBHC, and what they learned.

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Background And Objectives: Behavioral health integration (BHI) entails integrated behavioral health clinicians (IBHCs) providing care-generally for mental health and substance abuse disorders and behavioral comorbidity- within the operational functioning of primary care. Because limited data exist regarding BHI in residency, we studied its impact on resident education by examining whether increased behavioral health (BH) co-management improved residents' perceived ability to treat BH conditions.

Methods: We included residents from internal and family medicine training programs using BHI in residents' continuity clinics and assessed the level of co-management between primary care and IBHCs and the following domains: (1) confidence in managing BH conditions, (2) barriers to BH provision, (3) perception of autonomy when working with IBHCs, (4) satisfaction with the clinic, and (5) perceived educational value of BH learning modes.

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We previously showed that nicotine exposure in utero and after birth via breast milk [developmental nicotine exposure (DNE)] is associated with many changes in the structure and function of hypoglossal motoneurons (XIIMNs), including a reduction in the size of the dendritic arbor and an increase in cell excitability. Interestingly, the elevated excitability was associated with a reduction in the expression of glutamate receptors on the cell body. Together, these observations are consistent with a homeostatic compensation aimed at restoring cell excitability.

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Developmental nicotine exposure (DNE) is associated with increased risk of cardiorespiratory, intellectual, and behavioral abnormalities in neonates, and is a risk factor for apnea of prematurity, altered arousal responses and Sudden Infant Death Syndrome. Alterations in nicotinic acetylcholine receptor signaling (nAChRs) after DNE lead to changes in excitatory neurotransmission in neural networks that control breathing, including a heightened excitatory response to AMPA microinjection into the hypoglossal motor nucleus. Here, we report on experiments designed to probe possible postsynaptic and presynaptic mechanisms that may underlie this plasticity.

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