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Is there gender bias in assessment in GME? In a study of gender & assessment, we found gender was a significant factor in faculty assessment of resident performance. But there is more to the story. A thread...
https://ja.ma/3fBXcov via @JAMANetworkOpen part of @JAMANetwork
https://ja.ma/3fBXcov via @JAMANetworkOpen part of @JAMANetwork
In this cross-sectional analysis of 3,600 evaluations from 6 US IM residency programs, we looked at assessments from Gen Med inpatient ward rotations. These are structured in teams where a PGY2 or 3 resident leads a team of interns & students in directing patient care.
Controlling for a number of variables including baseline IM-ITE, we found resident gender was a significant factor influencing assessment. Differences in scores between women and men linked to time in training or PGY.
Men’s scores had a generally positive trajectory between PGYs 1 to 3. But women’s scores showed a ‘peak and plateau’ pattern with scores peaking in PGY2 and then did not improve significantly in PGY3. This ‘peak and plateau’ was seen in all six @acgme Core Competencies.
Faculty gender was a notable factor. The ‘peak and plateau’ pattern in women’s scores was seen with women AND men faculty. Interestingly, women rated men significantly lower in PGY2 but not PGY3.
What does this mean? Our findings of differences in assessment scores btwn men & women trainees is in-line with work of @FutureDocs who found differences in Milestone attainment btwn women & men EM residents at end of training. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818781/
In our context, differences in assessment scores by gender appear in PGY2 & 3, when residents are in the role of team leader. When first in this role in PGY2, women earn higher scores. But in PGY3, women’s scores plateaued and men outscored women.
This ‘peak and plateau’ pattern may reflect a glass ceiling in resident assessment. Glass ceiling refers to invisible barriers that are more pronounced at higher professional levels and impede the trajectory of women.
Women leaders face a ‘likability penalty’ in that effective women leaders are viewed less favorably. Women residents may face this ‘likeability penalty’ as they evolve into more independent leaders later in training.
What about faculty gender? We found gender-based differences in assessment with both male and female faculty. Evidence suggests that both women and men may display gender bias and women’s own experiences with bias may influence this. See @arghavan_salles tweetorial on this.
Take homes from this multi-site study of IM resident assessment: 1. Gender was a significant factor influencing assessment, 2. Differences in assessment bwtn women & men residents linked to PGY, 3. Faculty gender plays a notable role.
Thanks to PDs and program admins @emoryimchiefs @UCSFIMChiefs @mghmedres @uabimres @MedChiefs at @EmoryDeptofMed @UCSFDGIM @MGHMedicine @UofLMed @uabmedicine @UChicagoMed. And to @macyfoundation @HollyJHumphrey and @MGH Center for Educational Innovation and Scholarship
Work by the @GenderEquityMed team of @RKleinMD @PalamaraMcgrath @NnekaUfereMD @kathy_julian @annavolerman @ekdsnyder @vthompsonmd @TheLilJeneral and S Schaeffer.
Check out the excellent commentary of this work from @EileenEReynolds and @SusanHingle.
Gender Differences in Resident Assessment https://ja.ma/395t4z6 via @JAMANetworkOpen part of @JAMANetwork
Gender Differences in Resident Assessment https://ja.ma/395t4z6 via @JAMANetworkOpen part of @JAMANetwork
Association of Gender With Learner Assessment in Graduate Medical Education https://ja.ma/2WuuJtg via @JAMANetworkOpen part of @JAMANetwork
