Department of Surgery, Medstar Georgetown University Hospital, Washington, DC.
Department of General Surgery, Thomas Jefferson University Hospitals, Philadelphia, PA.
Ann Surg. 2024 Jan 1;279(1):167-171. doi: 10.1097/SLA.0000000000006074. Epub 2023 Aug 11.
The aim of this study was to examine the association between race, experience of microaggressions, and implicit bias in surgical training.
There is persistent underrepresentation of specific racial and ethnic groups in the field of surgery. Prior research has demonstrated significant sex differences among those who experience microaggressions during training. However, little research has been conducted on the association between race and experiences of microaggressions and implicit bias among surgical trainees.
A 46-item survey was distributed to general surgery residents and residents of surgical subspecialties through the Association of Program Directors in Surgery listserv and social media platforms. The questions included general information/demographic data and information about experiencing, witnessing, and responding to microaggressions during surgical training. The primary outcome was the prevalence of microaggressions during surgical training by self-disclosed race. Secondary outcomes were predictors of and adverse effects of microaggressions.
A total of 1624 resident responses were obtained. General surgery residents comprised 825 (50.8%) responses. The female-to-male ratio was nearly equal (815:809). The majority of respondents identified as non-Hispanic White (63.4%), of which 5.3% of residents identified as non-Hispanic Black, and 9.5% identified as Hispanic. Notably, 91.9% of non-Hispanic Black residents (n=79) experienced microaggressions. After adjustment for other demographics, non-Hispanic Black residents were more likely than non-Hispanic White residents to experience microaggressions [odds ratio (OR): 8.81, P <0.001]. Similar findings were observed among Asian/Pacific Islanders (OR: 5.77, P <0.001) and Hispanic residents (OR: 3.35, P <0.001).
Race plays an important role in experiencing microaggressions and implicit bias. As the future of our specialty relies on the well-being of the pipeline, it is crucial that training programs and institutions are proactive in developing formal methods to address the bias experienced by residents.
本研究旨在探讨种族、微侵犯经历和外科培训中的内隐偏见之间的关系。
特定种族和族裔群体在外科学领域的代表性仍然不足。先前的研究表明，在培训期间经历微侵犯的人群中存在显著的性别差异。然而，关于外科受训者的种族与微侵犯经历和内隐偏见之间的关系的研究甚少。
通过外科医师培训主任协会的列表服务和社交媒体平台向普通外科住院医师和外科专业住院医师分发了一份包含 46 个项目的调查问卷。这些问题包括一般信息/人口统计数据以及在外科培训期间经历、目睹和回应微侵犯的信息。主要结果是根据自我报告的种族，外科培训期间微侵犯的发生率。次要结果是微侵犯的预测因素和不良后果。
共获得 1624 名住院医师的回复。普通外科住院医师占 825 名（50.8%）。男女比例几乎相等（815:809）。大多数受访者自认为是非西班牙裔白人（63.4%），其中 5.3%的住院医师为非西班牙裔黑人，9.5%为西班牙裔。值得注意的是，91.9%的非西班牙裔黑人住院医师（n=79）经历过微侵犯。在校正其他人口统计学因素后，非西班牙裔黑人住院医师比非西班牙裔白人住院医师更有可能经历微侵犯[优势比（OR）：8.81，P <0.001]。在亚裔/太平洋岛民（OR：5.77，P <0.001）和西班牙裔住院医师（OR：3.35，P <0.001）中也观察到类似的发现。
种族在外侵犯经历和内隐偏见中起着重要作用。由于我们专业的未来依赖于管道的健康，培训计划和机构积极制定正式方法来解决住院医师所经历的偏见至关重要。
