SLR - September 2020 - Kayla DeBlauw

Effects of Gender Bias and Stereotypes in Surgical Training: A Randomized Clinical Trial

Reference: Myers, SP, Mohini, D, Brown, JB, Lumpkin, ST, Neal, MD, Abebe, KZ, Chaumont, N, Downs-Canner, SM, Flanagan, MR, Lee, KK. Effects of Gender Bias and Stereotypes in Surgical Training: A Randomized Clinical Trial. JAMA Surg. 2020;155(7):552–560.

Scientific Literature Review 

Reviewed By: Kayla DeBlauw, DPM
Residency Program: SSM Health DePaul Hospital – St Louis, MO 

Podiatric Relevance: In academic surgery, gender disparity is unmistakable when compared to other fields. It has been shown that a women’s surgical performance decreases due to pro-male bias and negative stereotypes. There has been a lack of valid interventions that take into consideration the challenges women surgeons experience every day. Engagement, or a sense of belonging, has been shown to weaken due to negative stereotypes which certain social groups experience more than others. The purpose of this study was to explore the correlation between gender bias and career engagement, and also between gender and stereotype threat in a laparoscopic skill performance.

Methods: A randomized two-phase study of 77 general surgery residents at three campuses between August 1-15, 2018. In phase one, all 86 residents completed two identical surveys, given at day one and then again five to six months after. The surveys included questions that assessed fairness in the workplace, sense of belonging, and resilience as a couple of examples. In phase two, residents were randomized into either a stereotype threat trigger or protection against that threat before performing a Fundamentals of Laparoscopic Surgery (FLS) assessment. They then refilled out the survey with a few more questions added.

Results: There was a statistically significant difference in perception of pro-male gender bias and engagement between the two genders. Men were found to have higher career engagement scores when they had a higher perception of pro-male bias. In regards to susceptibility to stereotype threat scores on survey one, men had higher scores than women. Women were found to have higher resilience scores then men on survey one. In phase two, it was discovered that when women had a higher susceptibility to stereotype threat, there FLS scores went down, but when there was a protection against stereotype threat, the scores improved. 

Conclusions: Technical skill performance, resiliency, a sense of belonging and fairness in the workplace are all attributes that increase a person's professional success. The pro-male bias in the workplace has been shown to influence women’s under representation and decreases their sense of worth and ability, leading to a decline in capability and potentiality. Of course, when a male hears that it has been shown women perform worse than men at a skill, they will more than likely perform better at that skill. This article shows that. As a women surgeon, I think it is imperative to expunge these stereotypes and to come up with adequate interventions to help women surgeons feel like they are competent and to be able to establish a sense of belonging and self-worth.

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