The effect of gender on operative autonomy in general surgery residents

Procedural Learning and Safety Collaborative

Research output: Contribution to journalArticle

Abstract

Background: Despite an increasing number of women in the field of surgery, bias regarding cognitive or technical ability may continue to affect the experience of female trainees differently than their male counterparts. This study examines the differences in the degree of operative autonomy given to female compared with male general surgery trainees. Methods: A smartphone app was used to collect evaluations of operative autonomy measured using the 4-point Zwisch scale, which describes defined steps in the progression from novice (“show and tell”) to autonomous surgeon (“supervision only”). Differences in autonomy between male and female residents were compared using hierarchical logistic regression analysis. Results: A total of 412 residents and 524 faculty from 14 general surgery training programs evaluated 8,900 cases over a 9-month period. Female residents received less autonomy from faculty than did male residents overall (P <.001). Resident level of training and case complexity were the strongest predictors of autonomy. Even after controlling for potential confounding factors, including level of training, intrinsic procedural difficulty, patient-related case complexity, faculty sex, and training program environment, female residents still received less operative autonomy than their male counterparts. The greatest discrepancy was in the fourth year of training. Conclusion: There is a sex-based difference in the autonomy granted to general surgery trainees. This gender gap may affect female residents’ experience in training and possibly their preparation for practice. Strategies need to be developed to help faculty and residents work together to overcome this gender gap.

Original languageEnglish (US)
JournalSurgery (United States)
DOIs
StatePublished - Jan 1 2019

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Education
Sex Characteristics
Logistic Models
Regression Analysis
Smartphone
Surgeons

ASJC Scopus subject areas

  • Surgery

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The effect of gender on operative autonomy in general surgery residents. / Procedural Learning and Safety Collaborative.

In: Surgery (United States), 01.01.2019.

Research output: Contribution to journalArticle

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title = "The effect of gender on operative autonomy in general surgery residents",
abstract = "Background: Despite an increasing number of women in the field of surgery, bias regarding cognitive or technical ability may continue to affect the experience of female trainees differently than their male counterparts. This study examines the differences in the degree of operative autonomy given to female compared with male general surgery trainees. Methods: A smartphone app was used to collect evaluations of operative autonomy measured using the 4-point Zwisch scale, which describes defined steps in the progression from novice (“show and tell”) to autonomous surgeon (“supervision only”). Differences in autonomy between male and female residents were compared using hierarchical logistic regression analysis. Results: A total of 412 residents and 524 faculty from 14 general surgery training programs evaluated 8,900 cases over a 9-month period. Female residents received less autonomy from faculty than did male residents overall (P <.001). Resident level of training and case complexity were the strongest predictors of autonomy. Even after controlling for potential confounding factors, including level of training, intrinsic procedural difficulty, patient-related case complexity, faculty sex, and training program environment, female residents still received less operative autonomy than their male counterparts. The greatest discrepancy was in the fourth year of training. Conclusion: There is a sex-based difference in the autonomy granted to general surgery trainees. This gender gap may affect female residents’ experience in training and possibly their preparation for practice. Strategies need to be developed to help faculty and residents work together to overcome this gender gap.",
author = "{Procedural Learning and Safety Collaborative} and Meyerson, {Shari L.} and Odell, {David D.} and Zwischenberger, {Joseph B.} and Mary Schuller and Williams, {Reed G.} and Bohnen, {Jordan D.} and Dunnington, {Gary L.} and Laura Torbeck and Mullen, {John T.} and Mandell, {Samuel P.} and Choti, {Michael A.} and Eugene Foley and Chandrakanth Are and Chandrakanth Are and Jeffrey Chipman and Jennifer Choi and Meier, {Andreas H.} and Smink, {Douglas S.} and Terhune, {Kyla P.} and Wise, {Paul E.} and Nathaniel Soper and Keith Lillemoe and Fryer, {Jonathan P.} and George, {Brian C.}",
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AU - Meyerson, Shari L.

AU - Odell, David D.

AU - Zwischenberger, Joseph B.

AU - Schuller, Mary

AU - Williams, Reed G.

AU - Bohnen, Jordan D.

AU - Dunnington, Gary L.

AU - Torbeck, Laura

AU - Mullen, John T.

AU - Mandell, Samuel P.

AU - Choti, Michael A.

AU - Foley, Eugene

AU - Are, Chandrakanth

AU - Are, Chandrakanth

AU - Chipman, Jeffrey

AU - Choi, Jennifer

AU - Meier, Andreas H.

AU - Smink, Douglas S.

AU - Terhune, Kyla P.

AU - Wise, Paul E.

AU - Soper, Nathaniel

AU - Lillemoe, Keith

AU - Fryer, Jonathan P.

AU - George, Brian C.

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