E. M. Corsini1, J. G. Luc2, K. G. Mitchell1, N. S. Turner1, A. A. Vaporciyan1, M. B. Antonoff1 1University Of Texas MD Anderson Cancer Center,Thoracic And Cardiovascular Surgery,Houston, TX, USA 2University Of British Columbia,Cardiovascular Surgery,Vancouver, BRITISH COLUMBIA, Canada
Introduction:
While recent attention has been directed toward exploring differential treatment of male versus female health care professionals in the hospital setting, detailed understanding is lacking regarding those circumstances which may contribute to display of bias. The operating room (OR) provides a unique setting in which to examine these biases, which are of particular interest given the changing face of surgery in recent years. We sought to evaluate the presence of sex-based biases of OR staff in response to surgeon behaviors, as well as explore predictors of such bias.
Methods:
We performed a prospective, randomized study in which OR personnel, including registered nurses (RN), surgical technologists (ST), and surgical assistants (SA), were asked to assess questionable surgeon behaviors across a standardized set of 5 scenarios via online survey. Respondents were randomized to surveys that either described a female or male surgeon, with all other aspects of the survey identical. For each scenario, respondents were asked to identify the behavior as Acceptable; Unacceptable but would ignore; Unacceptable and would confront surgeon directly; or Unacceptable and would report to OR management. Detailed demographic information was also collected. Analyses compared respondents’ assessments of surgeon behaviors with the sex of the surgeon and respondent characteristics; χ2 was used to identify associations among these variables.
Results:
3,186 respondents completed the survey (response rate=4.5%), among whom 81% were female, 54% were RN, 21% were SA, and 15% were ST. Assessed across all scenarios, likelihood to write up the surgeon was predicted by job role: ST, RN, and SA reported surgeons with frequencies of 65.5%, 53.2%, and 48.8%, respectively (p=0.008). Moreover, ST were also more likely to specifically report female surgeons (p=0.006) than other OR staff, (Table). When scenarios were evaluated individually, there were participants who reported female surgeons more frequently than males, including staff at academic hospitals (p=0.031), staff with more than 15 years’ experience (p=0.005), and male RN (p=0.034). Similarly, certain groups found particular behaviors more appropriate when they were exhibited by a male, rather than female, surgeon, including millennial respondents (p=0.011).
Conclusion:
Role appears to be predictive of sex bias in the OR, with ST evaluating behaviors of female surgeons more critically than males. More subtle implicit sex biases may exist between other OR staff and surgeons, yet such attitudes are complex and may not be uniformly present. Additional investigations are needed to determine the interpersonal and task-related circumstances which may accentuate these biases.
