Kolehmainen Christine, Brennan Meghan, Filut Amarette, Isaac Carol, Carnes Molly
Dr. Kolehmainen is a physician, William S. Middleton Memorial Veteran's Hospital, and clinical adjunct assistant professor, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Dr. Brennan is a women's health fellow, William S. Middleton Memorial Veteran's Hospital, and clinical instructor, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Ms. Filut is research assistant, Center for Women's Health Research, University of Wisconsin, Madison, Wisconsin. Dr. Isaac is assistant professor in research, Mercer University, Atlanta, Georgia. Dr. Carnes is professor of medicine, psychiatry, and industrial and systems engineering and director, Center for Women's Health Research, University of Wisconsin, and director of women veterans health, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin.
Acad Med. 2014 Sep;89(9):1276-81. doi: 10.1097/ACM.0000000000000372.
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.
The authors conducted individual, semistructured 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 and then thematically analyzed the transcribed text.
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 counternormative behavior.
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.
心肺复苏（“急救代码”）期间无效的领导可能会对患者的生存几率产生负面影响。在大多数教学医院，内科住院医师主导急救代码工作。在本研究中，作者探讨了内科住院医师主导急救代码工作的经历，特别关注性别如何影响急救代码领导经历。
作者对来自9个美国内科住院医师培训项目的25名住院医师（2012年5月至2013年2月）进行了个人的、半结构化的电话或面对面访谈。他们对访谈进行了录音和转录，然后对转录文本进行了主题分析。
参与者将成功的急救代码视为具有有效领导的代码。他们一致认为，理想的急救代码领导者是一个有权威的人；说话声音低沉、洪亮；使用清晰、直接的沟通方式；并且看起来很冷静。尽管女性参与者与男性同事一样有能力主导急救代码工作，但她们表示，作为急救代码领导者，因不得不违反性别行为规范而感到压力。作为回应，一些女性参与者采用了一些仪式，以表明在主导急救代码工作时暂停性别规范。其他人之后会为自己的反规范行为道歉。
理想的急救代码领导体现了高度积极主动、刻板的男性行为。女性住院医师采用策略来更好地融合急救代码领导者和女性这两种相互冲突的身份。未来，住院医师培训应该认识到女性性别刻板印象可能如何与实施急救代码领导所需的行为相冲突，并提供一些策略，比如本研究中女性住院医师所采用的策略，来帮助女性融合这两种双重身份。
