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Surgeon Implicit Association of Women With Supportive Roles in Medicine
Jeremiah Alexander1, Dayal Rajagopalan, Sina Ramtin
1From the The University of Texas Dell Medical School, Austin, TX (Alexander, Rajagopalan, Ramtin, Ngoue, and Ring), and the Department of Orthopaedic Surgery, University of Tennessee College of Medicine-Chattanooga, Erlanger Orthopaedic Institute, Chattanooga, TN (Adams).
Background:
In a previous study, we documented patient implicit bias that surgeons are men. As a next step, we tested the implicit bias of surgeons that women in medicine have leading (chair, surgeon) or supporting roles (medical assistant, physician assistant).
Questions/Purpose:
(1) What is the relationship between the implicit associations and expressed beliefs of surgeons regarding women as leaders in medicine? (2) Are there factors associated with surgeon implicit association and explicit preference regarding the roles of women in medicine?
Methods:
A total of 102 musculoskeletal surgeon members of the Science of Variation Group (88 men and 12 women) completed an implicit association test (IAT) of implicit bias regarding sex and lead/support roles in medicine and a questionnaire that addressed respondent demographics and explicit preference regarding women's roles. The IAT consisted of seven rounds with five rounds used for teaching and two rounds for evaluation.
Results:
On average, there was an implicit association of women with supportive roles (D-score: -48; SD 4.7; P < 0.001). The mean explicit preference was for women in leadership roles (median: 73; interquartile ranges: 23 to 128; P < 0.001). There was a correlation between greater explicit preference for women in a leading role and greater implicit bias toward women in a supporting role (ρ = 0.40; P < 0.001). Women surgeons and shoulder and elbow specialists had less implicit bias that women have supporting roles.
Conclusion:
The observation that musculoskeletal surgeons have an explicit preference for women in leading roles in medicine but an implicit bias that they have supporting roles-more so among men surgeons-documents the gap between expressed opinions and ingrained mental processing that is the legacy of the traditional "roles" of women in medicine and surgery. To resolve this gap, we will need to be intentional about promotion of and emersion in experiences where the leader is a woman.
Level Of Evidence:
III.
Insights
Surgeons show implicit bias associating women with supportive roles, despite explicitly preferring them in leadership. This gap highlights ingrained societal perceptions that need intentional intervention to promote women in surgical leadership.
Area of Science:
- Medical sociology
- Cognitive psychology
- Surgical education
Background:
- Previous research identified patient implicit bias associating surgeons with men.
- This study investigates surgeon implicit bias regarding women's roles in medicine.
Purpose of the Study:
- To examine the relationship between surgeons' implicit associations and explicit beliefs about women in medical leadership.
- To identify factors influencing surgeon implicit bias and explicit preferences for women's roles in medicine.
Main Methods:
- 102 musculoskeletal surgeons completed an Implicit Association Test (IAT) assessing bias towards women in leading versus supporting roles.
- A questionnaire gathered demographic data and explicit preferences regarding women's roles in medicine.
- The IAT involved seven rounds, with two for evaluation.
Main Results:
- Surgeons exhibited an implicit association of women with supportive roles (D-score: -48).
- Explicit preferences favored women in leadership roles (median: 73).
- A correlation was found between higher explicit preference for women leaders and greater implicit bias towards women in supporting roles (ρ = 0.40).
- Women surgeons and shoulder/elbow specialists showed less implicit bias.
Conclusions:
- Musculoskeletal surgeons demonstrate a discrepancy between explicit preference for women leaders and implicit bias favoring women in supportive roles.
- This gap reflects ingrained societal perceptions and traditional gender roles in medicine and surgery.
- Intentional promotion and immersive experiences featuring women leaders are necessary to address this disparity.
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