Filiberto Amanda C, Abbott Kenneth L, Shickel Benjamin, George Brian C, Cochran Amalia L, Sarosi George A, Upchurch Gilbert R, Loftus Tyler J
From the Department of Surgery, University of Florida Health, Gainesville, FL.
Department of Medicine, University of Florida Health, Gainesville, FL.
Ann Surg Open. 2023 Feb 2;4(1):e256. doi: 10.1097/AS9.0000000000000256. eCollection 2023 Mar.
This study tests the null hypotheses that overall sentiment and gendered words in verbal feedback and resident operative autonomy relative to performance are similar for female and male residents.
Female and male surgical residents may experience training differently, affecting the quality of learning and graduated autonomy.
A longitudinal, observational study using a Society for Improving Medical Professional Learning collaborative dataset describing resident and attending evaluations of resident operative performance and autonomy and recordings of verbal feedback from attendings from surgical procedures performed at 54 US general surgery residency training programs from 2016 to 2021. Overall sentiment, adjectives, and gendered words in verbal feedback were quantified by natural language processing. Resident operative autonomy and performance, as evaluated by attendings, were reported on 5-point ordinal scales. Performance-adjusted autonomy was calculated as autonomy minus performance.
The final dataset included objective assessments and dictated feedback for 2683 surgical procedures. Sentiment scores were higher for female residents (95 [interquartile range (IQR), 4-100] vs 86 [IQR 2-100]; < 0.001). Gendered words were present in a greater proportion of dictations for female residents (29% vs 25%; = 0.04) due to male attendings disproportionately using male-associated words in feedback for female residents (28% vs 23%; = 0.01). Overall, attendings reported that male residents received greater performance-adjusted autonomy compared with female residents ( < 0.001).
Sentiment and gendered words in verbal feedback and performance-adjusted operative autonomy differed for female and male general surgery residents. These findings suggest a need to ensure that trainees are given appropriate and equitable operative autonomy and feedback.
本研究检验以下零假设，即女性和男性住院医师在言语反馈中的总体情绪和性别化词汇以及与表现相关的住院医师手术自主权是相似的。
女性和男性外科住院医师的培训体验可能不同，这会影响学习质量和毕业时的自主权。
一项纵向观察性研究，使用了医学专业学习促进协会的协作数据集，该数据集描述了住院医师以及上级医师对住院医师手术表现和自主权的评估，以及2016年至2021年在美国54个普通外科住院医师培训项目中进行的外科手术中上级医师言语反馈的录音。通过自然语言处理对言语反馈中的总体情绪、形容词和性别化词汇进行量化。上级医师对住院医师手术自主权和表现的评估采用5分制序数量表。经表现调整后的自主权计算为自主权减去表现。
最终数据集包括对2683例外科手术的客观评估和口述反馈。女性住院医师的情绪得分更高（95[四分位间距（IQR），4 - 100] 对比86[IQR 2 - 100]；P < 0.001）。由于男性上级医师在对女性住院医师的反馈中不成比例地使用与男性相关的词汇，女性住院医师的口述中性别化词汇的比例更高（29%对比25%；P = 0.04）（28%对比23%；P = 0.01）。总体而言，上级医师报告称，与女性住院医师相比，男性住院医师获得了更高的经表现调整后的自主权（P < 0.001）。
女性和男性普通外科住院医师在言语反馈中的情绪和性别化词汇以及经表现调整后的手术自主权存在差异。这些发现表明需要确保实习生获得适当且公平的手术自主权和反馈。
