We aimed to describe the current evidence for interventions to enhance gender equality and equity in academic medicine. We also wished to characterise the nature of the interventions, who delivered them and whether they seek to ‘fix the women’, or target issues at organisational and systemic levels.

We extracted data using a form developed for the study and applied the Template for Intervention Description and Replication (TIDieR) and Morahan frameworks to describe and characterise interventions. We used the Quality Assessment with Diverse Studies (QUADS) tool to critically appraise included studies.

We searched five electronic databases in November 2022 and August 2023 (Medline (OVID), Embase, CINAHL, Web of Science, Google Scholar) and undertook handsearching.

We included qualitative or quantitative original studies published in full that described any new intervention designed to enhance gender equality/equity in recruitment, retention or promotion in academic medicine. The settings were Schools/Faculties of Medicine in Higher Education Institutions. The population of interest was female clinical academics/physician scientists.

Data were extracted by one researcher using an Excel form specifically designed for this study with a second researcher applying the form to a subset of seven studies; significant agreement was achieved. Four researchers applied the TIDieR framework to the included studies. Due to the small number of studies and significant heterogeneity, it was not possible to perform a meta-analysis.

The search of electronic databases yielded 1747 studies. A further 62 were identified through handsearching. Following removal of duplicates, 764 articles were screened for eligibility, and 199 full-text articles were screened. Of these, 27 met the inclusion criteria.

The most commonly reported interventions were career development or leadership skills programmes, followed by mentorship and multifaceted interventions. Most papers reported positive findings, but many relied on subjective measures. Robustly designed studies often reported mixed findings. The majority of interventions aimed to ‘fix the women’, with few addressing inequality at organisational level.

Acknowledging the possibility of publication delay, we found that despite strong evidence of the negative effects of the pandemic on women’s research productivity, there were no new interventions designed to mitigate this. Many existing interventions create ‘institutional housekeeping’ by relying on women for their delivery. This can result in failure, especially during a crisis like COVID. Most studies were low to moderate quality. More robust research and a more holistic approach are needed, moving away from ‘fixing the women’ to address the organisational and systemic structures which underpin inequality.

CRD42023391086.

High quality handover is critical for patient safety and care continuity. Existing practice is based on a weak evidence base in which the patient voice is poorly captured. The aim of this study was to identify outcomes of importance to patients, families and carers regarding interventions to improve in-hospital handover between healthcare practitioners.

A rapid systematic review of qualitative literature was carried out after prospective registration with PROSPERO and was reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines.

The Ovid MEDLINE database was searched.

Qualitative or mixed-methods studies reporting patient, family or caregiver perspectives on in-hospital handovers were eligible for inclusion.

Synthesis was informed by the best-fit framework approach using a published taxonomy of handover-related outcomes and the Core Outcome Measures in Effectiveness Trials taxonomy. Outcomes were reported according to two distinct types of handover: bedside (patient-involved) and provider-focused (patient-uninvolved).

A total of 34 studies, including 1262 participants across a range of specialties and predominantly high-income settings, were analysed. 53 bedside and 31 provider-focused handover outcomes were identified according to four domains; adverse events, quality of patient care, quality of handover and patient/caregiver satisfaction. Bedside handover studies frequently reported outcomes relating to patient engagement and communication with healthcare staff. One study was carried out in a low income country; however, outcomes identified were broadly similar.

These findings expand the known outcomes for evaluating handover interventions and highlight the importance of prioritising the patient and public perspective in research. This work will contribute to developing a core outcome set for trials in surgical handover but can also be applied to handover practices for any other discipline within the hospital environment.

CRD42023493367.