• Annals of surgery · Feb 2022

    Comparative Study

    Gender Differences in Entrustable Professional Activity Evaluations of General Surgery Residents.

    • Elena P Padilla, Christopher C Stahl, Sarah A Jung, Alexandra A Rosser, Patrick B Schwartz, Taylor Aiken, Alexandra W Acher, Daniel E Abbott, Jacob A Greenberg, and Rebecca M Minter.
    • School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
    • Ann. Surg. 2022 Feb 1; 275 (2): 222229222-229.

    ObjectiveTo determine differences in entrustable professional activity (EPA) assessments between male and female general surgery residents.Summary Background DataEvaluations play a critical role in career advancement for physicians. However, female physicians in training receive lower evaluations and underrate their own performance. Competency-based assessment frameworks, such as EPAs, may help address gender bias in surgery by linking evaluations to specific, observable behaviors.MethodsIn this cohort study, EPA assessments were collected from July 2018 to May 2020. The effect of resident sex on EPA entrustment levels was analyzed using multiple linear and ordered logistic regressions. Narrative comments were analyzed using latent dirichlet allocation to identify topics correlated with resident sex.ResultsOf the 2480 EPAs, 1230 EPAs were submitted by faculty and 1250 were submitted by residents. After controlling for confounding factors, faculty evaluations of residents were not impacted by resident sex (estimate = 0.09, P = 0.08). However, female residents rated themselves lower by 0.29 (on a 0-4 scale) compared to their male counterparts (P < 0.001). Within narrative assessments, topics associated with resident sex demonstrated that female residents focus on the "guidance" and "supervision" they received while performing an EPA, while male residents were more likely to report "independent" action.ConclusionsFaculty assessments showed no difference in EPA levels between male and female residents. Female residents rate themselves lower by nearly an entire post graduate year (PGY) level compared to male residents. Latent dirichlet allocation -identified topics suggest this difference in self-assessment is related to differences in perception of autonomy.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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