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Gender Differences in Work-Based Assessment Scores and Narrative Comments After Direct Observation.

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Summary
This summary is machine-generated.

This study found gender differences in work-based assessment (WBA) ratings and narrative comments, even when controlling for resident performance. Women residents received lower entrustment ratings and more feminine-coded language in feedback compared to men.

Keywords:
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Area of Science:

  • Medical Education
  • Assessment in Healthcare

Background:

  • Prior work-based assessment (WBA) studies have not consistently shown gender differences in numeric ratings.
  • Previous research has not adequately controlled for resident performance or analyzed narrative feedback by gender.

Purpose of the Study:

  • To investigate gender-based disparities in work-based assessment (WBA) entrustment ratings.
  • To explore gender differences in narrative feedback, considering resident's known scripted performance.

Main Methods:

  • Secondary analysis of 1527 rater assessment forms (RAFs) from a randomized controlled trial on rater training.
  • Multivariable regression was used to assess gender differences in entrustment ratings, adjusting for performance and demographics.
  • Natural language processing analyzed narrative comments for gendered language (masculine, feminine, agentic, communal).

Main Results:

  • Women residents received significantly lower entrustment ratings (2.29) than men (2.54) in simulated WBA, even after adjusting for skill level (p < 0.001).
  • Feminine terms were more prevalent in narrative comments describing areas where women residents performed poorly, compared to men (β 0.45, p=0.01).
  • These linguistic differences persisted even after accounting for faculty entrustment ratings.

Conclusions:

  • This study identified significant gender differences in simulated work-based assessment (WBA) entrustment ratings, contrary to some prior research.
  • Linguistic analysis revealed gendered patterns in narrative feedback, with feminine terms more frequently associated with women residents' performance comments.
  • Findings highlight potential biases in WBA and feedback, necessitating further investigation into equitable assessment practices.