J. A. Thompson-Burdine1, D. C. Sutzko1, V. C. Nikolian1, A. Boniakowski1, P. E. Georgoff1, K. A. Prabhu1, N. Matusko1, R. M. Minter2, G. Sandhu1 1University Of Michigan,Department Of Surgery,Ann Arbor, MI, USA 2University Of Texas Southwestern Medical Center,Department Of Surgery,Dallas, TX, USA
Introduction: Optimizing intraoperative education is critical for development of autonomous residents. Faculty entrustment decisions determine the degree to which a resident gains intraoperative responsibility. Entrustment and entrustability are part of a dual educational responsibility, however little empirical evidence exists evaluating how gender influences faculty-resident entrustment decisions in the operating room. Studies involving perception-based autonomy measurement tools report gender inequities. We sought to assess gender dynamics of entrustment behaviors using OpTrust, a 3rd-party objective measurement tool.
Methods: From September 2015 – June 2017, researchers observed elective surgical cases at the University of Michigan and rated entrustment behaviors using OpTrust, a validated tool designed to assess progressive entrustment in the operating room (OR). Purposeful sampling was used to generate variation in operation type, case difficulty, faculty-resident pairings, faculty experience, and resident training level.
Results: 56 faculty and 73 residents were observed across 225 surgical cases from four surgical specialties: general, plastic, thoracic, and vascular surgery. Independent samples t-tests did not detect a significant difference in faculty entrustment scores by resident gender (F=2.54 vs M=2.35, p=.117). Furthermore, no difference was found in resident entrustability scores between women and men (2.32 vs 2.22, p=.393).
Conclusion: Using OpTrust scores, we found that gender does not appear to influence faculty entrustment in the OR. Faculty entrustment scores for women and men residents are consistent. This indicates that during the intraoperative interaction, faculty are not extending entrustment or opportunities for autonomy differently based on gender. The difference between 3rd-party objective entrustment measurement and perception-based autonomy measurements may be attributed to factors outside of the discrete intraoperative interaction that may contribute to gender bias and confound self-assessment. While it is encouraging that faculty entrustment behaviors in the operating room are impartial, future research is needed to identify and measure perioperative elements that inform resident autonomy and which may contribute to gender inequities for residents.