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The Effects of Gender Stereotypes and Bias on the Developing Academic Surgeon

Myers, Sara (2020) The Effects of Gender Stereotypes and Bias on the Developing Academic Surgeon. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Factors contributing to the underrepresentation of females in surgery are incompletely understood. Specifically, gender stereotypes and bias require further evaluation. The projects described in this dissertation aim to elucidate how negative stereotypes about women and gender bias in the training environment impact the professional development of aspiring academic surgeons.
First, a semi-structured interview methodology was used to explore how gender shapes the experiences of surgery residents. This study, which was anchored to residents’ self-identification with the surgical profession, found that fewer female residents self-identified as “surgeon” (11.1% versus 37.5%, p<0.01). Residents felt that patients and physicians more frequently disregarded female residents' professional role (p< 0.01). Female residents more often reported aggressive behaviors from attendings and support staff, lack of mentorship, discomfort, feeling pressured to participate in unprofessional behaviors, and having difficulty completing tasks.
To further explore these findings, a multi-center study was conducted using validated survey subscales to evaluate how gender bias in the training milieu is related to academic engagement. The association between perception of pro-male gender bias and career engagement differed significantly by gender (interaction p-value= 0.04); perceiving gender bias was associated with lower career engagement among women (coefficient -0.19; 95%CI -1.05,0.66; p=0.64) but higher career engagement among men (coefficient 0.75; 95% CI 0.1, 1.49; p=0.04).
Finally, a multi-center randomized controlled trial determined how activating or protecting against stereotype threat, i.e., the risk of confirming negative stereotypes about a group with which one identifies, affects technical skill performance, a key competency metric for surgeons. The association between stereotype threat activation and Fundamentals of Laparoscopic Surgery (FLS) assessment score was similar in men and women (interaction p-value = 0.83). The association between stereotype threat activation and FLS scores did, however, differ by gender across levels of susceptibility to stereotype threat (interaction coefficient -35.2; 95%CI -60.8, -9.7; p=0.01). Higher susceptibility to stereotype threat was associated with lower FLS score among women who received a trigger of stereotype threat (coefficient -9.9; 95% CI 21.3, -1.5, p=0.04). Among men with higher susceptibility to stereotype threat, evoking negative stereotypes about women was associated with higher FLS score (coefficient 5.2; 95% CI -7.9, 18.3; p=0.42).
Gender bias and negative stereotypes about women influence the professional development of burgeoning academic surgeons. Academic institutions should mitigate factors that emphasize surgery as a masculine profession and impart coping strategies to female residents for gender-specific deterrents.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Myers, Saramyerssp@upmc.eduspm93
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairSwitzer,
Thesis AdvisorRosengart,
Committee MemberNeal,
Committee MemberHausmann,
Committee MemberNorman,
Committee MemberAbebe,
Date: 1 May 2020
Date Type: Publication
Defense Date: 5 March 2020
Approval Date: 1 May 2020
Submission Date: 26 March 2020
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 103
Institution: University of Pittsburgh
Schools and Programs: School of Medicine > Clinical and Translational Science
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Gender, stereotype threat, academic surgery
Date Deposited: 01 May 2020 16:37
Last Modified: 01 May 2022 05:15


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