A study of the relational aspects of the culture of academic medicine

PURPOSE: The impact of medical school culture on medical students has been well studied, but little documentation exists regarding how medical faculty experience the culture in which they work. In an ongoing project, the National Initiative on Gender, Culture and Leadership in Medicine, the authors are investigating how the existing culture of academic medical institutions supports all faculty members' ability to function at their highest potential. METHOD: The authors conducted a qualitative study of faculty in five disparate U.S. medical schools. Faculty in different career stages and diverse specialties were interviewed regarding their perceptions and experiences in academic medicine. Analysis was inductive and data driven. RESULTS: Relational aspects of the culture emerged as a central theme for both genders across all career categories. Positive relationships were most evident with patients and learners. Negative relational attributes among faculty and leadership included disconnection, competitive individualism, undervaluing of humanistic qualities, deprecation, disrespect, and the erosion of trust. CONCLUSIONS: The data suggest that serious problems exist in the relational culture and that such problems may affect medical faculty vitality, professionalism, and general productivity and are linked to retention. Efforts to create and support trusting relationships in medical schools might enhance all faculty members' efforts to optimally contribute to the clinical, education, and research missions of academic medicine. Future work will document the outcomes of a five-school collaboration to facilitate change in the culture to support the productivity of all medical faculty. © 2009 Association of American Medical Colleges.

The Modern Ordinary: Changing culture of living in Egypt’s traditional quarters at the turn of the twentieth Century

Having experienced social and political structures of the 19th century Europe, Western- educated Egyptian elite used public institutions to force legislative structures and procedures that ruled out traditional housing forms and spatial systems. This essay detects direct and indirect impact of these changes that informed the spatial change of modern living in Egypt in the first quarter of the twentieth century. It offers analysis of socio-spatial practices and change in ordinary Cairenes’ modes of everyday living, using social routine and interaction to explain spatial systems and changing house forms during the first quarter of the 20th century. In doing so, the essay utilized archival documents, accounts, formal decrees, and novels of the time as well as conducting survey of house forms and spatial organizations in Old Cairo.

Facilitating a culture of responsible and effective sharing of cancer genome data

Rapid and affordable tumor molecular profiling has led to an explosion of clinical and genomic data poised to enhance the diagnosis, prognostication and treatment of cancer. A critical point has now been reached at which the analysis and storage of annotated clinical and genomic information in unconnected silos will stall the advancement of precision cancer care. Information systems must be harmonized to overcome the multiple technical and logistical barriers to data sharing. Against this backdrop, the Global Alliance for Genomic Health (GA4GH) was established in 2013 to create a common framework that enables responsible, voluntary and secure sharing of clinical and genomic data. This Perspective from the GA4GH Clinical Working Group Cancer Task Team highlights the data-aggregation challenges faced by the field, suggests potential collaborative solutions and describes how GA4GH can catalyze a harmonized data-sharing culture.

Mouzinho da Silveira and the Political Culture of Portuguese Liberalism, 1820–1832

Liberalism as an identity and as a political ideology was non-existent in Portugal, as in most of the countries of Ibero-America, before the beginning of the nineteenth century. But the semantic development of the term ‘liberal’ in Portuguese underwent a clear and rapid mutation in the following decades. It became associated with specific meanings in relation to constitutional issues and civil law matters. While the former prevailed between 1820 and 1823, the latter were dominant in the writings of Mouzinho da Silveira and his Civil War legislation of 1832 to 1834.

Engendering a culture of quality enhancement in teaching and learning: lessons learned

Enhancing the quality of learning and teaching in higher education has been on the English national agenda for more than a decade. The Government and funding organisations have enabled universities to focus on creating a culture of excellence in learning and teaching and continuing academic and professional development. This paper describes some of the strategies that have promoted a culture of quality teaching in higher education in England and how one organisation, the University of Westminster has implemented those strategies to engender a culture of quality enhancement and continuing professional development.

Floating on the same plane: metropolis, money and the culture of abstraction

This article argues that the emergence of a trans-disciplinary discourse of ‘visual culture’ must be understood as, above all, a constitutively urban phenomenon. More specifically, it is in the historically new form of the capitalist metropolis, as described most famously by Simmel, that the ‘hyper-stimulus’ of modern visual culture has its social and spatial conditions. Paradoxically, however, it is as a result of this that visual culture studies is also intrinsically ‘haunted’ by a certain spectre of the invisible: one rooted in those forms of ‘real abstraction’ which Marx identifies with the commodity and the money form. Considering, initially, the canonical urban visual forms of the collage and the spectacle, these are each read in a certain relation to Simmel’s account of metropolitan life and of the money form, and, through this, to what the author claims are those forms of social and spatial abstraction that must be understood to animate them. Finally, the article returns to the entanglement of the visible and invisible entailed by this, and concludes by making some tentative suggestions about something like a paradoxical urban ‘aesthetic’ of abstraction on such a basis.

Managing Risk in a Culture of Rights: Providing Support and Treatment in Community-Based Settings for Persons with Intellectual Disabilities who Sexually Offend

People with intellectual disability who sexually offend commonly live in community-based settings since the closing of all institutions across the province of Ontario. Nine (n=9) front line staff who provide support to these individuals in three different settings (treatment setting, transitional setting, residential setting) were interviewed. Participants responded to 47 questions to explore how sex offenders with intellectual disability can be supported in the community to prevent re-offenses. Questions encompassed variables that included staff attitudes, various factors impacting support, structural components of the setting, quality of life and the good life, staff training, staff perspectives on treatment, and understanding of risk management. Three overlapping models that have been supported in the literature were used collectively for the basis of this research: The Good Lives Model (Ward & Gannon, 2006; Ward et al., 2007), the quality of life model (Felce & Perry, 1995), and variables associated with risk management. Results of this research showed how this population is being supported in the community with an emphasis on the following elements: positive and objective staff attitude, teamwork, clear rules and protocols, ongoing supervision, consistency, highly trained staff, and environments that promote quality of life. New concepts arose which suggested that all settings display an unequal balance of upholding human rights and managing risks when supporting this high-risk population. This highlights the need for comprehensive assessments in order to match the offender to the proper setting and supports, using an integration of a Risk, Need, Responsivity model and the Good Lives model for offender rehabilitation and to reduce the likelihood of re-offenses.