Interpersonal Interactions and Biases in Orthopaedic Surgery Residency: Do Experiences Differ Based on Gender?

• Published in: Clinical orthopaedics and related research 2023-02, Vol.481 (2), p.369-378
• Main Authors: Sobel, Andrew D., Lavorgna, Tessa R., Ames, S. Elizabeth, Templeton, Kimberly J., Mulcahey, Mary K.
• Format: Article
• Language: English
• Subjects: Bias; Collaboration; Diversity & Disparities in Musculoskeletal Care, Workforce, and Education Guest Editors Kimberly J. Templeton Md and Kris Radcliff Md; Female; Gender; Humans; Internship and Residency; Male; Orthopedic Procedures; Orthopedics; Patients; Perception; Perceptions; Reproducibility of Results; Sexual Harassment; Social interactions; Surgeons; Surgery; Surveys; Surveys and Questionnaires; Training; United States; Women
• ISSN: 0009-921X; 1528-1132
• DOI: 10.1097/CORR.0000000000002457

Women residents are underrepresented in orthopaedic surgery. The causes of the deficit of women in orthopaedic surgery are multifactorial, but by identifying the perceptions of women in orthopaedic residency training and comparing them with the perceptions of men, we can improve our understanding of ways to enhance the recruitment of qualified and diverse candidates. (1) What differences exist in the perceived experiences of residents identifying as women and men regarding professional, social, and personal interactions during residency training? (2) Are there differences in the percentage of women and men residents who have experienced harassment or discrimination in preresidency interviews, and are there differences in the type of harassment or discrimination experienced? A survey was generated using Academy of Critical Care: Development, Evaluation, and Methodology guidelines. Two focus groups with seven attending orthopaedic surgeons who participate in the Collaborative Orthopaedic Education Research Group and who are experts on gender diversity in orthopaedics were held to improve survey validity. The survey included binary-response, Likert, and free-text questions on the perception of professional, social, and personal interactions held by the resident being surveyed. The questions focused on a respondent's perception of interactions with staff members, patients, resident colleagues, and attending surgeons, as well as sexual harassment. Program directors at 10 selected Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic residency programs that participate in the Collaborative Orthopaedic Education Research Group shared the survey with residents at their institutions. There were 95 programs in the Collaborative Orthopaedic Education Research Group at the time this survey was distributed. In this program, directors or other interested teaching faculty in orthopaedic residency programs voluntarily participate to discuss and develop quality research on resident and fellow education. These 95 programs account for 46% of the ACGME-accredited programs in the United States at the time the survey was created and distributed. The 10 residency programs had a total of 232 enrolled residents; 15% (34) identified as women. This gender distribution models the national sample of orthopaedic residents. Survey reliability was assessed by calculating the Cronbach alpha after determining the variance in each relevant (nondemographic) surv