Siegelman Jeffrey N, Lall Michelle, Lee Lindsay, Moran Tim P, Wallenstein Joshua, Shah Bijal
J Grad Med Educ. 2018 Aug;10(4):411-415. doi: 10.4300/JGME-D-18-00059.1.
Gender-related disparities persist in medicine and medical education. Prior work has found differences in medical education assessments based on gender.
We hypothesized that gender bias would be mitigated in a simulation-based assessment.
We conducted a retrospective cohort study of emergency medicine residents at a single, urban residency program. Beginning in spring 2013, residents participated in mandatory individual simulation assessments. Twelve simulated cases were included in this study. Rating forms mapped milestone language to specific observable behaviors. A Bayesian regression was used to evaluate the effect of resident and rater gender on assessment scores. Both 95% credible intervals (CrIs) and a Region of Practical Equivalence approach were used to evaluate the results.
Participants included 48 faculty raters (25 men [52%]) and 102 residents (47 men [46%]). The difference in scores between male and female residents (M = -0.58, 95% CrI -3.31-2.11), and male and female raters (M = 2.87, 95% CrI -0.43-6.30) was small and 95% CrIs overlapped with 0. The 95% CrI for the interaction between resident and rater gender also overlapped with 0 (M = 0.41, 95% CrI -3.71-4.23).
In a scripted and controlled system of assessments, there were no differences in scores due to resident or rater gender.
医学及医学教育中与性别相关的差异依然存在。先前的研究发现，医学教育评估中存在基于性别的差异。
我们假设在基于模拟的评估中，性别偏见会得到缓解。
我们对一个城市住院医师培训项目中的急诊医学住院医师进行了一项回顾性队列研究。从2013年春季开始，住院医师参加强制性的个人模拟评估。本研究纳入了12个模拟病例。评分表将里程碑式语言与特定的可观察行为相对应。采用贝叶斯回归来评估住院医师和评分者性别对评估分数的影响。同时使用95%可信区间（CrIs）和实际等效区域方法来评估结果。
参与者包括48名教员评分者（25名男性[52%]）和102名住院医师（47名男性[46%]）。男性和女性住院医师之间的分数差异（M = -0.58，95% CrI -3.31 - 2.11）以及男性和女性评分者之间的分数差异（M = 2.87，95% CrI -0.43 - 6.30）很小，且95% CrIs与0重叠。住院医师和评分者性别之间相互作用的95% CrI也与0重叠（M = 0.41，95% CrI -3.71 - 4.23）。
在一个有脚本且可控的评估系统中，住院医师或评分者的性别对分数没有影响。
