Meaningful autonomy in general surgery training: Exploring for gender bias

Area of Science:

• Medical Education
• Surgical Training
• Gender Studies in Medicine

Background:

• Resident autonomy is crucial for surgical resident development.
• Meaningful autonomy (MA) during intraoperative procedures is a key aspect of surgical training.

Purpose of the Study:

• To analyze potential gender differences in the meaningful autonomy (MA) afforded to general surgery residents during intraoperative experiences.
• To investigate factors influencing MA in surgical trainees.

Main Methods:

• Retrospective analysis of 3574 post-operative evaluations for general surgery residents at an academic tertiary care facility.
• Utilized the Zwisch model for assessing MA, with a score of 3 or higher indicating meaningful autonomy.
• Multivariate analysis examined associations between MA and variables including case complexity, postgraduate year, rater gender, resident gender, and faculty experience.

Main Results:

• Multivariate analysis identified case complexity, postgraduate year level, and rater gender as significantly associated with MA.
• Crucially, resident gender and faculty experience did not demonstrate a significant impact on the meaningful autonomy granted to residents.
• Evaluations were completed by 52 attending surgeons (37 male, 15 female) for 35 residents (18 male, 17 female) over 28 months.

Conclusions:

• Contrary to some existing literature, this study found no significant influence of resident gender on intraoperative meaningful autonomy.
• These findings may provide a positive outlook for surgical training programs striving to implement strategies that mitigate gender bias.
• The results suggest that factors beyond resident gender play a significant role in the autonomy granted during surgical procedures.