Does team leader gender matter? A Bayesian reconciliation of leadership and patient care during trauma resuscitations

Abstract

Team leadership facilitates teamwork and is important to patient care. It is unknown whether physician gender-based differences in team leadership exist. The objective of this study was to assess and compare team leadership and patient care in trauma resuscitations led by male and female physicians. Methods: We performed a secondary analysis of data from a larger randomized controlled trial using video recordings of emergency department trauma resuscitations at a Level 1 trauma center from April 2016 to December 2017. Subjects included emergency medicine and surgery residents functioning as trauma team leaders. Eligible resuscitations included adult patients meeting institutional trauma activation criteria. Two video-recorded observations for each participant were coded for team leadership quality and patient care by 2 sets of raters. Raters were balanced with regard to gender and were blinded to study hypotheses. We used Bayesian regression to determine whether our data supported gender-based advantages in team leadership. Results: A total of 60 participants and 120 video recorded observations were included. The modal relationship between gender and team leadership (β = 0.94, 95% highest density interval [HDI],-.68 to 2.52) and gender and patient care (β = 2.42, 95% HDI,-2.03 to 6.78) revealed a weak positive effect for female leaders on both outcomes. Gender-based advantages to team leadership and clinical care were not conclusively

Gender differences in emergency medicine resident assessment: A scoping review

“…Title and abstract screening excluded 646 citations, resulting in 21 records eligible for full‐text screening. Five were excluded based on study objectives, 23–27 four for study design, 28–31 one because it was a duplicate, 32 and one for not including EM residents 33 . Ten records underwent data extraction 12,15,32,34–40 …”

“I just assume they don't know that I'm the doctor”: Gender bias and professional identity development of women residents

“…Our findings are consistent with other studies that have explored challenges experienced by women residents when leading resuscitations and the ways they embody specific physical appearances to overcome these challenges (e.g., fastening their hair, adjusting their posture, and wearing a white coat). 11,12,24 Our study builds on these findings by focusing on cognitive adjustments women residents employ not only to lead resuscitations but also to provide care for patients in the ED. Women residents in our study felt pressured to adjust their mannerisms to balance a constant tension between "being a leader" or "fitting in."…”

Priority strategies to improve gender equity in Canadian emergency medicine: proceedings from the CAEP 2021 Academic Symposium on leadership

“…This can result in a loss of vital opportunity for women and non-binary trainees to exercise leadership and make independent, time-sensitive decisions. This can result in reluctance from women and non-binary physicians to take on high stakes clinical roles such as Trauma Team Leader after residency, which further compounds the issue Background: Residents believe that stereotypically masculine, highly assertive leadership styles are most effective during resuscitations [20] and are biased against female code leaders despite lack of gender-related differences in resuscitation leadership quality or clinical care [21]. Similarly, nurses rate male residents as more competent than female colleagues [22], and medical trainees rated male physicians to have better leadership skills in resuscitation scenarios despite similar objective performance [23].…”

“…Similarly, nurses rate male residents as more competent than female colleagues [22], and medical trainees rated male physicians to have better leadership skills in resuscitation scenarios despite similar objective performance [23]. In fact, studies of video-taped, real-life resuscitations show positive effects for female-led resuscitation teams for both leadership quality and patient survival [21,24]. Despite this, female trainees feel pressure to adopt more directive, assertive, stereotypically male leadership styles [20] and experience more challenges in attaining the "respect" of the broader medical team [25].…”