K.L. Barnes is a female pelvic medicine and reconstructive surgery fellow, Department of Obstetrics and Gynecology, Division of Urogynecology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
G. Dunivan is associate professor, Department of Obstetrics and Gynecology, Division of Urogynecology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
Acad Med. 2020 Oct;95(10):1529-1538. doi: 10.1097/ACM.0000000000003569.
Though overt sexism is decreasing, women now experience subtle, often unconscious, gender bias as microaggressions. The authors sought to explore the prevalence and impact of the sexist microaggressions female surgeons experience, using a sequential exploratory mixed methods approach (January 2018-April 2018), to identify opportunities for education and prevention. First, all resident, fellow, and attending female surgeons at the University of New Mexico Health Sciences Center (UNM HSC) were invited to participate in focus groups conducted by experienced moderators using a semistructured interview guide based on the 7 Sexist Microaggressions Experiences and Stress Scale (Sexist MESS) domains. Qualitative analysis was performed using line-by-line manual coding to identify themes aligned with the Sexist MESS domains as well as other gender bias experiences of female surgeons. Next, a survey was sent to all resident, fellow, and attending female surgeons at the UNM HSC, which included the Sexist MESS questionnaire and questions related to surgeon-specific experiences of gender bias that the authors developed based on major thematic categories from the focus groups.Four focus groups of 23 female surgeons were conducted, revealing 4 themes: exclusion, increased effort, adaptation, and resilience to workplace slights. The survey response rate was 64% (65/101 surgeons). Across Sexist MESS domains, the frequency and severity of microaggressions was higher for trainees than attendings. The variables of non-White race/ethnicity, having children under 18, and fellowship training generally did not demonstrate statistical significance. This exploratory study adds to the growing body of evidence that gender bias in surgery continues and frequently manifests as microaggressions. Trainees reported the highest rates and severity of microaggressions and bias experiences. Further research should investigate how to address microaggressions, the experiences of male surgeons, the perspectives of medical students and groups who were reported as often perpetuating gender bias, and the efficacy of possible interventions.
尽管明显的性别歧视正在减少，但女性现在仍会经历微妙的、通常是无意识的性别偏见，即微侵犯。作者采用序贯探索性混合方法（2018 年 1 月至 4 月），旨在探索女外科医生经历的性别歧视微侵犯的普遍性和影响，以确定教育和预防的机会。首先，邀请新墨西哥大学健康科学中心（UNM HSC）的所有住院医师、研究员和主治女外科医生参加焦点小组，焦点小组由经验丰富的主持人主持，使用基于 7 个性别歧视微侵犯经历和压力量表（Sexist MESS）领域的半结构化访谈指南。使用逐行手动编码进行定性分析，以确定与 Sexist MESS 领域以及女外科医生其他性别偏见经历相一致的主题。接下来，向 UNM HSC 的所有住院医师、研究员和主治女外科医生发送了一份调查，其中包括 Sexist MESS 问卷和作者根据焦点小组的主要主题类别开发的与外科医生特定性别偏见经历相关的问题。进行了 4 次有 23 名女外科医生参加的焦点小组，揭示了 4 个主题：排斥、增加努力、适应和对工作场所怠慢的韧性。调查的回复率为 64%（65/101 名外科医生）。在 Sexist MESS 领域，与主治医生相比，受训者的微侵犯频率和严重程度更高。非白种人/少数民族、18 岁以下子女和奖学金培训等变量通常没有统计学意义。这项探索性研究增加了越来越多的证据，即手术中的性别偏见仍在继续，并经常表现为微侵犯。受训者报告了最高的微侵犯和偏见经历发生率和严重程度。进一步的研究应该调查如何解决微侵犯、男外科医生的经历、被报告为经常助长性别偏见的医学生和群体的观点，以及可能的干预措施的效果。
