Chen Sarah, Beck Dallaghan Gary L, Shaheen Amy
University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina.
University of North Carolina at Chapel Hill, Office of Medical Education, Chapel Hill, North Carolina.
J Surg Educ. 2021 Jul-Aug;78(4):1136-1143. doi: 10.1016/j.jsurg.2020.10.011. Epub 2020 Oct 28.
To assess implicit gender bias in surgery clerkship evaluations of third-year medical students at a large, academic hospital in the Southeast.
University of North Carolina at Chapel Hill School of Medicine has multiple branch campuses where students can complete their surgical clerkship including 1 large academic center, 1 hybrid academic and community-based practice, and 3 community-based hospitals. All residents and faculty evaluations of medical students who completed the surgery clerkship from March 1, 2018 to February 28, 2019 were analyzed. Evaluations were anonymized and names and pronouns were removed to mitigate evaluator bias. A word dictionary was created guided by previous literature and categorized descriptive adjectives into 4 categories: ability, grindstone, standout, and personality traits. Adjectives used to describe students, and references to the student using gendered pronouns or gender-fair language were coded and quantified as percentage of total evaluation word content. These percentages were compared between male and female students. A subsequent analysis was completed to assess the effects of gendered pronouns on linguistic patterns.
A total of 583 evaluations from the surgery clerkship were available for 183 students (51.9% female, 48.1% male). When gender-fair language was used, there was no difference in the adjectives used to describe female and male students. Male evaluators were more likely to use female gendered pronouns compared to male gendered pronouns (3.1% vs 2.3%, p = 0.028). When gendered pronouns were present, evaluations of female students were more likely to contain grindstone adjectives but less likely to contain standout terms compared to evaluations of male students (4.4% vs 2.8%, p = 0.006; 0.6% vs 1.3%, p = 0.006).
For students who have completed their surgical clerkship, the language patterns in evaluations differ between female students and male students. When the female pronoun was used, narratives contained more grindstone adjectives and fewer standout adjectives. Our results are consistent with previous literature and may be a manifestation of "othering" or a compensatory means of describing female students. This is potential manifestation of implicit gender bias.
评估美国东南部一家大型学术医院对三年级医学生外科实习评估中的隐性性别偏见。
北卡罗来纳大学教堂山分校医学院有多个分校，学生可在这些分校完成外科实习，包括1个大型学术中心、1个学术与社区混合型医疗机构以及3家社区医院。对2018年3月1日至2019年2月28日期间完成外科实习的医学生的所有住院医师和教员评估进行分析。评估进行了匿名处理，去除了姓名和代词以减轻评估者偏差。根据以往文献创建了一个单词词典，将描述性形容词分为4类：能力、苦干、出众和个性特征。用于描述学生的形容词以及使用性别代词或性别中立语言提及学生的内容进行编码，并量化为评估单词总内容的百分比。对男女生的这些百分比进行比较。随后进行了一项分析，以评估性别代词对语言模式的影响。
共有183名学生（51.9%为女生，48.1%为男生）的583份外科实习评估可用。当使用性别中立语言时，用于描述女生和男生的形容词没有差异。与男性代词相比，男性评估者更有可能使用女性代词（3.1%对2.3%，p = 0.028）。当存在性别代词时，与对男生的评估相比，对女生的评估更有可能包含苦干类形容词，但包含出众类词汇的可能性较小（4.4%对2.8%，p = 0.006；0.6%对1.3%，p = 0.006）。
对于完成外科实习的学生，评估中的语言模式在女生和男生之间存在差异。当使用女性代词时，叙述中包含更多苦干类形容词和更少出众类形容词。我们的结果与以往文献一致，可能是“他者化”的一种表现或描述女生的一种补偿方式。这是隐性性别偏见的潜在表现。
