Kim Grace, Lodha Shweta, Wein Lulu, Fahs Lily, Allen Ariana, Rathinavelu Jay, Sharma Poonam, Fekrat Sharon
Duke University School of Medicine, Durham, North Carolina, USA.
Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
Perm J. 2024 Sep 16;28(3):107-116. doi: 10.7812/TPP/24.085. Epub 2024 Aug 28.
Prior studies have highlighted experiences of bias within resident training based on trainees' gender and race and high rates of burnout. However, few studies have addressed the intersection between bias and wellness for residents in internal medicine (IM) programs. This study explores how race, gender, and training year affect IM residents' bias experiences and well-being.
An anonymous survey with questions evaluating demographics and resident experiences of bias and perceptions of wellness and self-efficacy was distributed to 596 IM programs across the United States. Sixty-nine programs sent out the survey to their IM residents. Respondents to the survey included 176 residents. Descriptive analyses and χ tests were performed.
Responses demonstrated that gender and race impacted residents' experiences with bias and misidentification. Eighty-eight percent of women compared to 1% of men, and 89% of Black residents compared to 3% of White residents reported being misidentified as a nonphysician due to gender and race, respectively. Degrees to which residents felt they were thriving in residency, experiencing burnout, and utilizing their strengths varied significantly by gender. Residents' self-perceived burnout levels were associated with being misidentified as not being a physician due to race. Experiences with bias also increased significantly with training year.
This study provides important insights into the impact of gender, race/ethnicity, and training year on IM residents' experiences with bias and self-perception.
The findings emphasize the need for structural changes within IM residency programs to reduce experiences of bias and to better cultivate the wellness of residents.
先前的研究强调了住院医师培训中基于学员性别和种族的偏见经历以及高倦怠率。然而，很少有研究探讨内科住院医师培训中偏见与健康之间的交叉关系。本研究探讨种族、性别和培训年份如何影响内科住院医师的偏见经历和幸福感。
一项匿名调查被分发给美国各地的596个内科住院医师培训项目，该调查包含评估人口统计学、住院医师的偏见经历、健康感知和自我效能感的问题。69个项目将调查发送给其内科住院医师。调查的受访者包括176名住院医师。进行了描述性分析和χ检验。
调查结果表明，性别和种族影响住院医师的偏见经历和身份误认。分别有88%的女性和1%的男性，以及89%的黑人住院医师和3%的白人住院医师报告因性别和种族被误认非医生。住院医师在培训期间感到蓬勃发展、经历倦怠以及发挥自身优势的程度因性别而异。住院医师自我感知的倦怠水平与因种族被误认非医生有关。随着培训年份的增加，偏见经历也显著增加。
本研究为性别、种族/族裔和培训年份对内科住院医师偏见经历和自我认知的影响提供了重要见解。
研究结果强调内科住院医师培训项目需要进行结构性变革，以减少偏见经历并更好地培养住院医师的健康状况。
