Berger Yael, Buseck Alison, Imtiaz Sayed, Horn Callie, Khajoueinejad Nazanin, Macfie Rebekah, Cohen Noah, Sarpel Umut
Beilinson Medical Center, 39 Jabotinski Street Petah-Tikva, Israel.
Division of Surgical Oncology, The Icahn School of Medicine at Mount Sinai, 425 W 59th Street 7th Floor, New York, NY, USA.
Surg Open Sci. 2023 Sep 12;16:28-32. doi: 10.1016/j.sopen.2023.09.004. eCollection 2023 Dec.
Participant characteristics are known to affect group discourse and discussion outcomes. In medicine, many decisions are made by group consensus, therefore an understanding of these factors is highly relevant. We aimed to measure the effects of participant characteristics on tumor board discussions.
We performed a prospective, multi-institution, quantitative study of multi-disciplinary virtual tumor board meetings. Participant characteristics included age, gender, and clinical discipline. Outcomes of interest were speech events, duration, and discourse style. Participant impressions was assessed by a post-hoc survey.
A total of 361 cases were discussed across 32 virtual meetings. Of the 283 attendees, 66.4 % were women, and all moderators were men. Women comprised 43 % of the 54 speakers, thus speaking less than male attendees ( < 0.001). No significant differences were detected in the duration or style of speech between men and women. Women participants commented more frequently on cases where the clinical attending was a woman (4.09 comments by women vs. 2.99 comments by men, < 0.001), and less frequently when the attending was a man (2.48 comments by women vs. 3.20 comments by men, p < 0.001). On post hoc survey, men responded that they introduced ideas, guided discussions, and succeeded in influencing decisions significantly more than women reported that they did.
Women physicians were underrepresented in tumor boards as moderators, speakers, and attendings of record. Women physicians commented less on men physicians' patients. Women felt less impactful than their men counterparts, despite having the same duration and style of speech. Prompted participation, moderator feedback, talking points, and limiting the number of cases can be used to balance representation in discussions.
已知参与者特征会影响小组讨论及讨论结果。在医学领域,许多决策是通过小组共识做出的,因此了解这些因素至关重要。我们旨在衡量参与者特征对肿瘤病例讨论会的影响。
我们对多学科虚拟肿瘤病例讨论会进行了一项前瞻性、多机构的定量研究。参与者特征包括年龄、性别和临床学科。感兴趣的结果包括言语事件、时长和话语风格。通过事后调查评估参与者的印象。
在32次虚拟会议中总共讨论了361个病例。在283名与会者中,66.4%为女性,所有主持人均为男性。女性占54名发言者中的43%,因此发言少于男性与会者(<0.001)。未发现男性和女性在发言时长或风格上存在显著差异。女性参与者对临床主治医生为女性的病例评论更频繁(女性评论4.09次,男性评论2.99次,<0.001),而对临床主治医生为男性的病例评论较少(女性评论2.48次,男性评论3.20次,p<0.001)。在事后调查中,男性表示他们提出想法、引导讨论并成功影响决策的程度明显高于女性的自我报告。
在肿瘤病例讨论会上,女性医生作为主持人、发言者和记录在案的与会者的比例较低。女性医生对男性医生的患者评论较少。尽管发言时长和风格相同,但女性感觉自己的影响力不如男性同行。可以通过鼓励参与、主持人反馈、谈话要点以及限制病例数量来平衡讨论中的代表性。