Abstract
Background
Gender disparities in academic medicine continue to be pervasive. Written evaluations
of residents may provide insight into perceptions of residents by faculty, which may
influence letters of recommendation for positions beyond residency and reinforce perceived
stereotype threat experienced by trainees.
Objective
To examine language used in faculty evaluations of pediatrics residents to determine
if there are differences in language used with respect to gender of resident.
Design/Methods
All faculty evaluations of residents in 3 consecutive intern classes from 2016 to
2018 were collected and redacted for name and gender identifiers. We performed a qualitative
analysis of written comments in 2 mandatory free text sections. The study team initially
coded text collectively, generating a code book, then individually to apply the coding
scheme. Next, evaluations were unblinded to gender. Code applications were aggregated
by resident, and frequencies of code application by resident were compared by standardized
mean differences to detect imbalances between genders.
Results
A total of 448 evaluations were analyzed: 88 evaluations of 17 male residents, and
360 evaluations of 70 female residents. Codes more frequently applied to women included
“enthusiasm,” and “caring,” while codes more frequently applied to men included “intelligence,”
and “prepared.” A conceptual model was created to reflect potential impacts of these
differences using a lens of social role theory.
Conclusions
We identified differences in the way male and female residents are evaluated by faculty,
which may have negative downstream effects on female residents, who may experience
negative self-perception, differential development of clinical skills, and divergent
career opportunities as a result.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Academic PediatricsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- When a specialty becomes “Women's work”: trends in and implications of specialty gender segregation in medicine.Acad Med. 2020; 95: 1499-1506https://doi.org/10.1097/ACM.0000000000003555
- Gender differences in earnings of early- and midcareer pediatricians.Pediatrics. 2019; 144https://doi.org/10.1542/peds.2018-3955
- Satisfaction, salaries, and sustainability: results of a National Survey of Pediatric Program Directors.Acad Pediatr. 2019; 19: 11-17https://doi.org/10.1016/j.acap.2018.09.015
2018-2019 The state of women in academic medicine: exploring pathways to equity. AAMC. Available at: https://www.aamc.org/data-reports/data/2018-2019-state-women-academic-medicine-exploring-pathways-equity. Accessed August 25, 2021.
- Women in pediatrics: progress, barriers, and opportunities for equity, diversity, and inclusion.Pediatrics. 2019; 144e20192149https://doi.org/10.1542/peds.2019-2149
- Assessing gender equity in a large academic department of pediatrics.Acad Med J Assoc Am Med Coll. 2012; 87: 98-104https://doi.org/10.1097/ACM.0b013e31823be028
- Differences in lifetime earning potential between pediatric and adult physicians.Pediatrics. 2021; 148https://doi.org/10.1542/peds.2021-051194
- Gender differences in the authorship of original research in Pediatric Journals, 2001-2016.J Pediatr. 2017; 191 (e1): 244-249https://doi.org/10.1016/j.jpeds.2017.08.044
- Why do women choose or reject careers in academic medicine? A narrative review of empirical evidence.Lancet. 2016; 388: 2948-2958https://doi.org/10.1016/S0140-6736(15)01091-0
gender bias (noun) American English definition and synonyms | Macmillan Dictionary. Available at: https://www.macmillandictionary.com/us/dictionary/american/gender-bias. Accessed April 13, 2019.
- Gender bias in resident evaluations: natural language processing and competency evaluation.Med Educ. 2022; https://doi.org/10.1111/medu.14593
- Assessing gender bias in qualitative evaluations of surgical residents.Am J Surg. 2019; 217: 306-313https://doi.org/10.1016/j.amjsurg.2018.09.029
- Gender bias in resident assessment in graduate medical education: review of the literature.J Gen Intern Med. 2019; 34: 712-719https://doi.org/10.1007/s11606-019-04884-0
- Association of gender with learner assessment in graduate medical education.JAMA Netw Open. 2020; 3e2010888https://doi.org/10.1001/jamanetworkopen.2020.10888
- Addressing unconscious bias for female clinical academics.Intern Med J. 2016; 46: 391-393https://doi.org/10.1111/imj.13022
- Committees with implicit biases promote fewer women when they do not believe gender bias exists.Nat Hum Behav. 2019; 3: 1171-1179https://doi.org/10.1038/s41562-019-0686-3
- Comparison of male vs female resident milestone evaluations by faculty during emergency medicine residency training.JAMA Intern Med. 2017; 177: 651-657https://doi.org/10.1001/jamainternmed.2016.9616
- Race and gender bias in internal medicine program director letters of recommendation.J Grad Med Educ. 2021; 13: 335-344https://doi.org/10.4300/JGME-D-20-00929.1
- Women in academic medicine: measuring stereotype threat among junior faculty.J Womens Health. 2015; 25: 292-298https://doi.org/10.1089/jwh.2015.5380
- Female surgeons as counter stereotype: the impact of gender perceptions on trainee evaluations of physician faculty.J Surg Educ. 2018; 75: 1140-1148https://doi.org/10.1016/j.jsurg.2018.01.011
- Gender differences in attending physicians’ feedback to residents: a qualitative analysis.J Grad Med Educ. 2017; 9: 577-585https://doi.org/10.4300/JGME-D-17-00126.1
- The effects of implicit gender role theories on gender system justification: fixed beliefs strengthen masculinity to preserve the status quo.J Pers Soc Psychol. 2017; 112: 98-115https://doi.org/10.1037/pspp0000124
- Social role theory of sex differences and similarities: a current appraisal.The Developmental Social Psychology of Gender. Erlbaum Publishers, Washington, DC2000: 123-174
- Pediatrc Physicians Workforce Data Book 2017-2018. Pediatric workforce trends.Spring. 2018; 3 (Available at:) (Accessed March 22, 2022)
- Three approaches to qualitative content analysis.Qual Health Res. 2005; 15: 1277-1288https://doi.org/10.1177/1049732305276687
- Social role theory.Handbook of Theories of Social Psychology. 2. SAGE Publications Ltd, Thousand Oaks, Calif2012: 458-476
- Arguments for and against standardized mean differences (effect sizes).Arch Pediatr Adolesc Med. 2022; 165: 592-596
- Using the standardized difference to compare the prevalence of a binary variable between two groups in observational research.Commun Stat - Simul Comput. 2009; 38: 1228-1234https://doi.org/10.1080/03610910902859574
- Statistical Power Analysis for the Behavioral Sciences.2nd ed. L. Erlbaum Associates, Mahwah, NJ1988
- Grounded theory in medical education research: AMEE Guide No. 70.Med Teach. 2012; 34: 850-861https://doi.org/10.3109/0142159X.2012.704439
- Cracking the code: residents’ interpretations of written assessment comments.Med Educ. 2017; 51: 401-410https://doi.org/10.1111/medu.13158
- Plenty of moustaches but not enough women: cross sectional study of medical leaders.BMJ. 2015; 351: h6311https://doi.org/10.1136/bmj.h6311
- Gender and letters of recommendation for academia: agentic and communal differences.J Appl Psychol. 2009; 94: 1591-1599https://doi.org/10.1037/a0016539
- Gender and generational influences on the pediatric workforce and practice.Pediatrics. 2014; 133: 1112-1121https://doi.org/10.1542/peds.2013-3016
- Reducing implicit gender leadership bias in academic medicine with an educational intervention.Acad Med. 2016; 91: 1143-1150https://doi.org/10.1097/ACM.0000000000001099
Article Info
Publication History
Published online: February 11, 2022
Accepted:
February 7,
2022
Received:
October 21,
2021
Footnotes
The authors have no conflicts of interest to disclose.
Identification
Copyright
Copyright © 2022 by Academic Pediatric Association
