The domino effect: the impact of gender on operative self-efficacy
Background Studies suggest that there are key differences in operative experience based on a trainee’s gender. A large-scale self-efficacy (SE) survey, distributed to general surgery residents after the American Board of Surgery In-Training Examination in 2020, found that female gender was associate...
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| Veröffentlicht in: | Surgical endoscopy 2023-12, Vol.37 (12), p.9461-9466 |
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| creator | Jensen, Rachel M. Anand, Ananya Kearse, LaDonna E. Korndorffer, James R. |
| description | Background
Studies suggest that there are key differences in operative experience based on a trainee’s gender. A large-scale self-efficacy (SE) survey, distributed to general surgery residents after the American Board of Surgery In-Training Examination in 2020, found that female gender was associated with decreased SE in graduating PGY5 residents for all 4 laparoscopic procedures included on the survey (cholecystectomy, appendectomy, right hemicolectomy, and diagnostic laparoscopy). We sought to determine whether these differences were reflected at the case level when considering operative performance and supervision using an operative assessment tool (SIMPL OR).
Methods
Supervision and performance data reported through the SIMPL OR platform for the same 4 laparoscopic procedures included in the SE survey were aggregated for residents who were PGY5s in 2020. Independent
t
-tests and multiple linear regression were used to determine the relationship between trainee gender and supervision/performance ratings.
Results
For laparoscopic cases in aggregate (
n
= 2708), male residents rated their performance higher than females (3.57 vs. 3.26,
p
|
| doi_str_mv | 10.1007/s00464-023-10378-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2864156142</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2864156142</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-a1cc4c35419c74fd409c500ce2e7b22fc6cd4a092b90492defbfcb48e59993b13</originalsourceid><addsrcrecordid>eNp9kE1LxDAQhoMo7vrxBzxIwYuXaL7aNN508QsWvKzn0KaTtUvb1KQr7L83a1cFD54GZp55Z3gQOqPkihIirwMhIhOYMI4p4TLHbA9NqeAMM0bzfTQlihPMpBITdBTCikRe0fQQTbjMlKSMTNHd4g2SyrV15xKwFsxwkwyxVbd9YYbE2WQJXQU-cV3ievDFUH9AEqCxOOK1KczmBB3YoglwuqvH6PXhfjF7wvOXx-fZ7RwbLtMBF9QYYXgqqDJS2EoQZVJCDDCQJWPWZKYSBVGsVPFNVoEtrSlFDqlSipeUH6PLMbf37n0NYdBtHQw0TdGBWwfN8kzQNKOCRfTiD7pya9_F7yKlVEppxtJIsZEy3oXgwere123hN5oSvTWsR8M6GtZfhvU2-nwXvS5bqH5WvpVGgI9AiKNuCf739j-xn65ahNQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2899511625</pqid></control><display><type>article</type><title>The domino effect: the impact of gender on operative self-efficacy</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Jensen, Rachel M. ; Anand, Ananya ; Kearse, LaDonna E. ; Korndorffer, James R.</creator><creatorcontrib>Jensen, Rachel M. ; Anand, Ananya ; Kearse, LaDonna E. ; Korndorffer, James R.</creatorcontrib><description>Background
Studies suggest that there are key differences in operative experience based on a trainee’s gender. A large-scale self-efficacy (SE) survey, distributed to general surgery residents after the American Board of Surgery In-Training Examination in 2020, found that female gender was associated with decreased SE in graduating PGY5 residents for all 4 laparoscopic procedures included on the survey (cholecystectomy, appendectomy, right hemicolectomy, and diagnostic laparoscopy). We sought to determine whether these differences were reflected at the case level when considering operative performance and supervision using an operative assessment tool (SIMPL OR).
Methods
Supervision and performance data reported through the SIMPL OR platform for the same 4 laparoscopic procedures included in the SE survey were aggregated for residents who were PGY5s in 2020. Independent
t
-tests and multiple linear regression were used to determine the relationship between trainee gender and supervision/performance ratings.
Results
For laparoscopic cases in aggregate (
n
= 2708), male residents rated their performance higher than females (3.57 vs. 3.26,
p
< 0.001, 1 = critical deficiency, 5 = exceptional performance) and reported less supervision (3.15 vs. 2.85,
p
< 0.001, 1 = show and tell, 4 = supervision only); similar findings were seen when looking at attending reports of resident supervision and performance. A multiple linear regression model showed that attending gender did not significantly predict resident-reported supervision or performance levels, while case complexity and trainee gender significantly affected both supervision and performance (
p
< 0.001).
Discussion
Female residents perceive themselves to be less self-efficacious at core laparoscopic procedures compared to their male colleagues. Comparison to more case-specific data confirm that female residents receive more supervision and lower performance ratings. This may create a domino effect in which female residents receive less operative independence, preventing the opportunity to establish SE. Further research should identify opportunities to break this cycle and consider gender identity beyond the male/female construct.
Graphical abstract</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-023-10378-2</identifier><identifier>PMID: 37697120</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>2023 SAGES Oral ; Abdominal Surgery ; Clinical Competence ; Education, Medical, Graduate - methods ; Female ; Females ; Gastroenterology ; Gender Identity ; General Surgery - education ; Gynecology ; Hepatology ; Humans ; Internship and Residency ; Laparoscopy ; Male ; Medical residencies ; Medicine ; Medicine & Public Health ; Proctology ; Regression analysis ; Self Efficacy ; Supervision ; Surgery ; United States</subject><ispartof>Surgical endoscopy, 2023-12, Vol.37 (12), p.9461-9466</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-a1cc4c35419c74fd409c500ce2e7b22fc6cd4a092b90492defbfcb48e59993b13</citedby><cites>FETCH-LOGICAL-c375t-a1cc4c35419c74fd409c500ce2e7b22fc6cd4a092b90492defbfcb48e59993b13</cites><orcidid>0000-0002-6753-2859</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-023-10378-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-023-10378-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37697120$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jensen, Rachel M.</creatorcontrib><creatorcontrib>Anand, Ananya</creatorcontrib><creatorcontrib>Kearse, LaDonna E.</creatorcontrib><creatorcontrib>Korndorffer, James R.</creatorcontrib><title>The domino effect: the impact of gender on operative self-efficacy</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Studies suggest that there are key differences in operative experience based on a trainee’s gender. A large-scale self-efficacy (SE) survey, distributed to general surgery residents after the American Board of Surgery In-Training Examination in 2020, found that female gender was associated with decreased SE in graduating PGY5 residents for all 4 laparoscopic procedures included on the survey (cholecystectomy, appendectomy, right hemicolectomy, and diagnostic laparoscopy). We sought to determine whether these differences were reflected at the case level when considering operative performance and supervision using an operative assessment tool (SIMPL OR).
Methods
Supervision and performance data reported through the SIMPL OR platform for the same 4 laparoscopic procedures included in the SE survey were aggregated for residents who were PGY5s in 2020. Independent
t
-tests and multiple linear regression were used to determine the relationship between trainee gender and supervision/performance ratings.
Results
For laparoscopic cases in aggregate (
n
= 2708), male residents rated their performance higher than females (3.57 vs. 3.26,
p
< 0.001, 1 = critical deficiency, 5 = exceptional performance) and reported less supervision (3.15 vs. 2.85,
p
< 0.001, 1 = show and tell, 4 = supervision only); similar findings were seen when looking at attending reports of resident supervision and performance. A multiple linear regression model showed that attending gender did not significantly predict resident-reported supervision or performance levels, while case complexity and trainee gender significantly affected both supervision and performance (
p
< 0.001).
Discussion
Female residents perceive themselves to be less self-efficacious at core laparoscopic procedures compared to their male colleagues. Comparison to more case-specific data confirm that female residents receive more supervision and lower performance ratings. This may create a domino effect in which female residents receive less operative independence, preventing the opportunity to establish SE. Further research should identify opportunities to break this cycle and consider gender identity beyond the male/female construct.
Graphical abstract</description><subject>2023 SAGES Oral</subject><subject>Abdominal Surgery</subject><subject>Clinical Competence</subject><subject>Education, Medical, Graduate - methods</subject><subject>Female</subject><subject>Females</subject><subject>Gastroenterology</subject><subject>Gender Identity</subject><subject>General Surgery - education</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Internship and Residency</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Medical residencies</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Proctology</subject><subject>Regression analysis</subject><subject>Self Efficacy</subject><subject>Supervision</subject><subject>Surgery</subject><subject>United States</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kE1LxDAQhoMo7vrxBzxIwYuXaL7aNN508QsWvKzn0KaTtUvb1KQr7L83a1cFD54GZp55Z3gQOqPkihIirwMhIhOYMI4p4TLHbA9NqeAMM0bzfTQlihPMpBITdBTCikRe0fQQTbjMlKSMTNHd4g2SyrV15xKwFsxwkwyxVbd9YYbE2WQJXQU-cV3ievDFUH9AEqCxOOK1KczmBB3YoglwuqvH6PXhfjF7wvOXx-fZ7RwbLtMBF9QYYXgqqDJS2EoQZVJCDDCQJWPWZKYSBVGsVPFNVoEtrSlFDqlSipeUH6PLMbf37n0NYdBtHQw0TdGBWwfN8kzQNKOCRfTiD7pya9_F7yKlVEppxtJIsZEy3oXgwere123hN5oSvTWsR8M6GtZfhvU2-nwXvS5bqH5WvpVGgI9AiKNuCf739j-xn65ahNQ</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Jensen, Rachel M.</creator><creator>Anand, Ananya</creator><creator>Kearse, LaDonna E.</creator><creator>Korndorffer, James R.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6753-2859</orcidid></search><sort><creationdate>20231201</creationdate><title>The domino effect: the impact of gender on operative self-efficacy</title><author>Jensen, Rachel M. ; Anand, Ananya ; Kearse, LaDonna E. ; Korndorffer, James R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-a1cc4c35419c74fd409c500ce2e7b22fc6cd4a092b90492defbfcb48e59993b13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>2023 SAGES Oral</topic><topic>Abdominal Surgery</topic><topic>Clinical Competence</topic><topic>Education, Medical, Graduate - methods</topic><topic>Female</topic><topic>Females</topic><topic>Gastroenterology</topic><topic>Gender Identity</topic><topic>General Surgery - education</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Internship and Residency</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Medical residencies</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Proctology</topic><topic>Regression analysis</topic><topic>Self Efficacy</topic><topic>Supervision</topic><topic>Surgery</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jensen, Rachel M.</creatorcontrib><creatorcontrib>Anand, Ananya</creatorcontrib><creatorcontrib>Kearse, LaDonna E.</creatorcontrib><creatorcontrib>Korndorffer, James R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jensen, Rachel M.</au><au>Anand, Ananya</au><au>Kearse, LaDonna E.</au><au>Korndorffer, James R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The domino effect: the impact of gender on operative self-efficacy</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2023-12-01</date><risdate>2023</risdate><volume>37</volume><issue>12</issue><spage>9461</spage><epage>9466</epage><pages>9461-9466</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Studies suggest that there are key differences in operative experience based on a trainee’s gender. A large-scale self-efficacy (SE) survey, distributed to general surgery residents after the American Board of Surgery In-Training Examination in 2020, found that female gender was associated with decreased SE in graduating PGY5 residents for all 4 laparoscopic procedures included on the survey (cholecystectomy, appendectomy, right hemicolectomy, and diagnostic laparoscopy). We sought to determine whether these differences were reflected at the case level when considering operative performance and supervision using an operative assessment tool (SIMPL OR).
Methods
Supervision and performance data reported through the SIMPL OR platform for the same 4 laparoscopic procedures included in the SE survey were aggregated for residents who were PGY5s in 2020. Independent
t
-tests and multiple linear regression were used to determine the relationship between trainee gender and supervision/performance ratings.
Results
For laparoscopic cases in aggregate (
n
= 2708), male residents rated their performance higher than females (3.57 vs. 3.26,
p
< 0.001, 1 = critical deficiency, 5 = exceptional performance) and reported less supervision (3.15 vs. 2.85,
p
< 0.001, 1 = show and tell, 4 = supervision only); similar findings were seen when looking at attending reports of resident supervision and performance. A multiple linear regression model showed that attending gender did not significantly predict resident-reported supervision or performance levels, while case complexity and trainee gender significantly affected both supervision and performance (
p
< 0.001).
Discussion
Female residents perceive themselves to be less self-efficacious at core laparoscopic procedures compared to their male colleagues. Comparison to more case-specific data confirm that female residents receive more supervision and lower performance ratings. This may create a domino effect in which female residents receive less operative independence, preventing the opportunity to establish SE. Further research should identify opportunities to break this cycle and consider gender identity beyond the male/female construct.
Graphical abstract</abstract><cop>New York</cop><pub>Springer US</pub><pmid>37697120</pmid><doi>10.1007/s00464-023-10378-2</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-6753-2859</orcidid></addata></record> |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | 2023 SAGES Oral Abdominal Surgery Clinical Competence Education, Medical, Graduate - methods Female Females Gastroenterology Gender Identity General Surgery - education Gynecology Hepatology Humans Internship and Residency Laparoscopy Male Medical residencies Medicine Medicine & Public Health Proctology Regression analysis Self Efficacy Supervision Surgery United States |
| title | The domino effect: the impact of gender on operative self-efficacy |
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