A. Wagle1, H. Chen1,2, J. Porterfield1,2, T. Wang1,2, E. P. Buczek1,3, B. Lindeman1,2 1University Of Alabama at Birmingham,School Of Medicine,Birmingham, AL, USA 2University Of Alabama at Birmingham,Department Of Surgery,Birmingham, AL, USA 3University Of Alabama at Birmingham,Department Of Otolaryngology,Birmingham, Alabama, USA
Introduction: A recent study reported that female surgeons have lower mortality rates compared to male surgeons. While others have begun to question the impact of gender on teaching and learning in the operating room, and some have reported discordance between attending and resident perceptions of autonomy and performance during a procedure, there remains insufficient knowledge about the impact of women as compared to men in the surgical environment, both as teachers and learners.
Methods: All residents performing a thyroidectomy or parathyroidectomy with 5 surgeons from October 2017-July 2018 were invited to complete an operative performance evaluation (OPE) at case completion. This consisted of supervision and performance ratings using the Zwisch scale for all steps of each operation, plus an overall rating of independence readiness. Attending surgeons completed the same survey and scores were compared using paired t-tests.
Results: A total of 198 paired attending and resident surveys from 99 parathyroidectomies and 99 thyroidectomies were received. Of the 32 resident participants, 15 were female (46.9%) and completed 110 surveys (55.6%). Of the attending surgeons, 2 were female (40%) and completed 59 surveys (29.8%). In PGY5 residents, attendings gave significantly higher ratings to females compared to males on critical operative steps (parathyroid identification 3.75 vs. 3.41, p<0.01; recurrent nerve avoidance 3.78 vs 3.34, p<0.01, respectively). Attending ratings of independence readiness for thyroidectomy were significantly higher than female residents’ self-ratings (0.71 vs. 0.52, p<0.02, respectively). For both procedures, attendings rated female PGY 5 residents as being independence ready significantly more often than male PGY 5 residents (parathyroid 0.96 vs 0.80, p = 0.02, thyroid 0.89 vs. 0.64, p<0.01, respectively). Compared to male peers, female PGY5 residents scored their performance and supervision significantly lower on 8/18 parathyroid steps and 7/20 thyroid steps, but no differences were observed between male and female PGY1 residents. Male PGY5 ratings for supervision or performance were never significantly lower than female PGY5 ratings for any thyroid or parathyroid step. Male attendings rated female residents significantly higher on more steps than male residents (76% vs. 29%, respectively, p<0.01). This was not observed in female attending ratings (female 34% vs male 37%, p = 0.77).
Conclusion: These findings suggest that gender of either learner or teacher can influence the perception of supervision and performance during a procedure. Self-rated gender differences were most pronounced in PGY-5 residents. Scores indicative of independence readiness were only affected by attending gender, with male attendings giving higher ratings to female residents.