Mueller Anna S, Jenkins Tania M, Osborne Melissa, Dayal Arjun, O'Connor Daniel M, Arora Vineet M
J Grad Med Educ. 2017 Oct;9(5):577-585. doi: 10.4300/JGME-D-17-00126.1.
Prior research has shown a gender gap in the evaluations of emergency medicine (EM) residents' competency on the Accreditation Council for Graduate Medical Education (ACGME) milestones, yet the practical implications of this are not fully understood.
To better understand the gender gap in evaluations, we examined qualitative differences in the feedback that male and female residents received from attending physicians.
This study used a longitudinal qualitative content analysis of narrative comments by attending physicians during real-time direct observation milestone evaluations of residents. Comments were collected over 2 years from 1 ACGME-accredited EM training program.
In total, 1317 direct observation evaluations with comments from 67 faculty members were collected for 47 postgraduate year 3 EM residents. Analysis of the comments revealed that the ideal EM resident possesses many stereotypically masculine traits. Additionally, examination of a subset of the residents (those with 15 or more comments, n = 35) showed that when male residents struggled, they received consistent feedback from different attending physicians regarding aspects of their performance that needed work. In contrast, when female residents struggled, they received discordant feedback from different attending physicians, particularly regarding issues of autonomy and assertiveness.
Our study revealed qualitative differences in the kind of feedback that male and female EM residents received from attending physicians. The findings suggest that attending physicians should endeavor to provide male and female residents with consistent feedback and guard against gender bias in their perceptions of residents' capabilities.
先前的研究表明，在研究生医学教育认证委员会（ACGME）的里程碑评估中，急诊医学（EM）住院医师的能力评价存在性别差距，但其实际影响尚未完全了解。
为了更好地理解评价中的性别差距，我们研究了男性和女性住院医师从主治医生那里得到的反馈的定性差异。
本研究对主治医生在对住院医师进行实时直接观察里程碑评估期间的叙述性评论进行了纵向定性内容分析。评论是在2年时间里从1个获得ACGME认证的EM培训项目中收集的。
总共收集了67名教员对47名三年级EM住院医师的1317次带有评论的直接观察评估。对评论的分析表明，理想的EM住院医师具有许多典型的男性化特征。此外，对一部分住院医师（那些有15条或更多评论的住院医师，n = 35）的检查显示，当男性住院医师表现不佳时，他们从不同的主治医生那里得到了关于其需要改进的表现方面的一致反馈。相比之下，当女性住院医师表现不佳时，她们从不同的主治医生那里得到了不一致的反馈，特别是在自主性和自信方面的问题上。
我们的研究揭示了男性和女性EM住院医师从主治医生那里得到的反馈类型存在定性差异。研究结果表明，主治医生应努力为男性和女性住院医师提供一致的反馈，并在对住院医师能力的认知中防范性别偏见。
