Assessment of Autonomy in Operative Procedures Among Female and Male New Zealand General Surgery Trainees

Daniel B. Joh · Bert van der Werf · Bridget Watson · Rowan French · Simon D. Bann · Elizabeth Dennet +1 more

41 citations0/0 files storedJAMA Surgery

No readable copy stored yet — this record is metadata only.

No open-access location is known for this record yet.

Literature note Cite in a project Citation map

Diversity and Career in Medicine Innovations in Medical Education Surgical Simulation and Training

Abstract

Importance: The need for trainee sex equality within surgical training has resulted in an appraisal of the training experience in the New Zealand general surgery training program. Objective: To investigate the association between trainee sex and surgical autonomy in the operating room in the New Zealand general surgery training program. Design, Setting, and Participants: Retrospective cohort study conducted from December 10, 2012, to December 10, 2017, examining all endoscopic, major, and minor procedures performed by all New Zealand general surgery trainees in every training hospital in New Zealand. Main Outcomes and Measures: The primary outcome was the level of meaningful autonomy by each New Zealand general surgery trainee (ie, trainee as primary operator without the surgeon mentor scrubbed for the case). Outcomes were compared using multivariable analysis. Results: This study included 120 New Zealand general surgery trainees (42 women [35%] and 78 men [65%]) who were analyzed over 279.5 trainee-years (88.5 trainee-years for women and 191.0 trainee-years for men). Included were 119 380 general surgery procedures (17 465 endoscopic, 56 964 major, and 44 951 minor) in 18 hospitals. By the end of the 5-year training program, female trainees had a lower cumulative mean autonomous caseload than male trainees for endoscopic (284.0 [95% CI, 207.0-361.0] vs 352.2 [95% CI, 282.9-421.6], P = .03), major (139.9 [95% CI, 76.7-203.2] vs 198.1 [95% CI, 142.3-254.0], P = .02), and minor (456.3 [95% CI, 394.8-517.9] vs 519.9 [95% CI, 465.6-574.2], P = .007) procedures. Conclusions and Relevance: After accounting for differences among trainees, hospital type, number of female and male surgeon mentors at each hospital, and trainee seniority, female trainees performed fewer cases with meaningful autonomy compared with male trainees. These findings support the need for pragmatic solutions to address this bias and further investigations on mechanisms contributing to discrepancies.

Paper brief

Loading…

Cite this work

Citation unavailable for this work.

BibTeX RIS CSL-JSON

No public copy is stored for this record, so only the metadata is cited.

Citations in this library

Citation map →

Stored only when both papers are in the corpus — 41 citations exist upstream.

References

2009Attitudes, Training Experiences, and Professional Expectations of US General Surgery Residents 2015Perceptions of gender-based discrimination during surgical training and practice 1979Sex and Authority in the Workplace: The Causes of Sexual Inequality 2017The Effect of Gender on Resident Autonomy in the Operating room 2015Women in academic surgery: why is the playing field still not level?2019The effect of gender on operative autonomy in general surgery residents 2019A woman’s place is in theatre: women’s perceptions and experiences of working in surgery from the Association of Surgeons of Great Britain and Ireland women in surgery working group 2016Understanding and Overcoming Implicit Gender Bias in Plastic Surgery

Cited by

2021The Changing Demographics of Surgical Trainees in General and Vascular Surgery: National Trends over the Past Decade 2022Surgical Experience Disparity Between Male and Female Surgeons in Japan

Explore the map →

Papers that cite the same references — the relational fallback while embeddings are still backfilling.

Imported from OpenAlex (CC0) — nothing here is generated.