S. Jones1, P. P. Parikh1, T. N. Crawford4, P. Hershberger3, A. Cochran2, L. Peterson1, G. Falls1 1Wright State University,Department Of Surgery,Dayton, OH, USA 2Ohio State University,Department Of Surgery,Columbus, OH, USA 3Wright State University,Department Of Family Medicine,Dayton, OH, USA 4Wright State University,Division Of Epidemiology And Biostatistics, Department Of Population And Public Health Sciences,Dayton, OH, USA
Introduction: Implicit biases are increasingly recognized as a wide-spread phenomenon in medicine, including surgery. In surgery, physicians and other providers of different specialties and expertise work together in an operating room (OR) that impacts lives. Any implicit biases in such dynamic environments could lead to poor satisfaction and performance of providers, which in turn may result in poor patient outcomes. The primary objective of this study was to assess perception of the lead surgeon in OR.
Methods:
The simulated scenarios used 8 different actors as lead surgeon with the combination of age (<40 vs. >55), race (white vs. black), and gender (male vs. female). An IRB approved anonymous video-based survey was distributed nationwide to surgeons, residents, OR nurses and ancillary OR staff. It included demographic questions, 3 short videos and questions regarding the perception of the situation and surgeon. The perception towards the lead surgeon was divided into favorable, unfavorable, and neutral categories. Favorable perception included the surgeon’s behavior that was thought to be commendable, acceptable, or the surgeon should have received an apology. The unfavorable perception included responses such as “inform managers of surgeon’s behavior,” “surgeon should apologize to the OR staff,” or the “surgeon should receive probation.” The participants also rated overall performance of the surgeon using a 5-star rating system.
Results:
There were 419 respondents, 53.7% were females. A higher proportion of the respondents (53.5%) were attending surgeons. Our results suggest that both gender and age are significantly associated with the perception of a lead surgeon. Older surgeons were perceived more favorably than their younger counterparts; 50.5% versus 35.6%, respectively. Similarly, male surgeons were perceived more favorably than female surgeons; 47.2 vs. 37.7 (Figure 1). The overall rating of a surgeon suggests that older surgeons were rated higher than younger (3.27 vs 3.05). While assessing the group of older surgeons in details for race, our data showed that older white males were ranked significantly higher (3.53/5) than all other group of surgeons.
Conclusion:
Widespread perception of gender bias in surgery may not be the only bias that exists in the OR. Our data shows that older surgeons, especially older white males, are perceived more favorably than any other lead surgeon. These results shed light on some of the challenges faced by young surgeons, particularly females, taking on a leadership role in OR. These results can provide insight in developing inter-professional education curriculum or training for residents, attendings and OR staff to address implicit biases and to foster cohesiveness of the surgical team in order to provide optimal patient care.
