Gender Bias in the Evaluation of Surgical Performance: Results of a Prospective Randomized Trial

Authors

Mara B Antonoff
Hope Feldman
Jessica G Y Luc
Paula I Iaeger
M Laura Rubin
Liang Li
Ara A Vaporciyan

Publication Date

2-1-2023

Journal

Annals of Surgery

DOI

10.1097/SLA.0000000000005015

PMID

34171877

PMCID

PMC11970970

PubMedCentral® Posted Date

4-4-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Objective: The study aims to determine the influence of trainee gender on assessments of coronary anastomosis performance.

Summary of background data: Understanding the impact of gender bias on the evaluation of trainees may enable us to identify and utilize assessment tools that are less susceptible to potential bias.

Methods: Cardiothoracic surgeons were randomized to review the video performance of trainees who were described by either male or female pronouns. All participants viewed the same video of a coronary anastomosis and were asked to grade technique using either a Checklist or Global Rating Scale (GRS). Effect of trainee gender on scores by respondent demographic was evaluated using regression analyses. Inter-rater reliability was assessed using the Cronbach's alpha.

Results: 103 cardiothoracic surgeons completed the Checklist (trainee gender: male n=50, female n=53) and 112 completed the GRS (trainee gender: male n=56, female n=56). For the Checklist, male cardiothoracic surgeons who were in practice < 10 years ( P = 0.036) and involved in training residents ( P = 0.049) were more likely to score male trainees higher than female trainees. The GRS demonstrated high inter-rater reliability across male and female trainees by years and scope of practice for the respondent (alpha >0.900) when compared to the Checklist assessment tool.

Conclusions: Early career male surgeons may exhibit gender bias against women when evaluating trainee performance of coronary anastomoses. The GRS demonstrates higher interrater reliability and robustness against gender bias in the assessment of technical performance than the Checklist, and such scales should be emphasized in educational evaluations.

Keywords

Humans, Male, Female, Internship and Residency, Reproducibility of Results, Sexism, Prospective Studies, Educational Measurement, Clinical Competence

Published Open-Access

yes

Recommended Citation

Antonoff, Mara B; Feldman, Hope; Luc, Jessica G Y; et al., "Gender Bias in the Evaluation of Surgical Performance: Results of a Prospective Randomized Trial" (2023). Faculty, Staff and Student Publications. 4723.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/4723