Evaluation of Gender Differences in Ultrasound Milestone Evaluations During Emergency Medicine Residency Training: A Multicenter Study

Acuña, Josie; Stolz, Uwe; Stolz, Lori; Situ-LaCasse, Elaine; Bell, Gregory K.; Berkeley, Ross P.; Boyd, Jeremy S.; Carmody, Kristin; Fong, Tiffany; Grewal, Ekjot; Jones, Robert A.; Hilberts, SueLin; Kanter, Carolyn; Kelley, Kenneth M; Leetch, Stephen J.; Pazderka, Philip; Shaver, Erica; Stowell, Jeffrey R.; Josephson, Elaine B.; Theodoro, Daniel; Adhikari, Srikar

doi:10.1002/aet2.10397

Cited by 3 publications

(11 citation statements)

References 13 publications

(18 reference statements)

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“…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 …”

Section: Resultsmentioning

confidence: 99%

“…A summary of each study's main findings is outlined in Table 2. Seven of the 10 studies examined assessments based on the Accreditation Council for Graduate Medical Education (ACGME) EM or PEM milestones 12,15,32,35–37,39,40 . Four studies investigated and reported the impact of assessor gender on resident performance scores, and none of the studies reported a statistically significant difference in scores between female and male assessors 15,32,34,37 .…”

Section: Resultsmentioning

confidence: 99%

“…Of the seven included studies that reported quantitative results across a wide range of different assessment types, 12,32,34–37 six did not identify any differences in scores between female and male residents 32,34–37 . The study by Dayal et al 12 was the only study to report statistically significant differences attributable to gender.…”

Section: Discussionmentioning

confidence: 99%

“…All included studies were conducted in the United States, with four multicenter studies. 12,32,35,36 Nine of 10 studies focused on EM resident s, 12,15,32,34,35,[37][38][39][40] and one study was solely focused on pediatric EM (PEM) fellows. 36 A summary of each study's main findings is outlined in Table 2.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…15,32,34,37 Only three studies included a priori definitions of meaningful differences in outcomes, 32,34,37 two of which included sample size calculations. 32,34 Quantitative studies…”

Section: Study Characteristicsmentioning

confidence: 99%

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Gender differences in emergency medicine resident assessment: A scoping review

Menchetti

Eagles

Ghanem

et al. 2022

AEM Education and Training

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Background Growing literature within postgraduate medical education demonstrates that female resident physicians experience gender bias throughout their training and future careers. This scoping review aims to describe the current body of literature on gender differences in emergency medicine (EM) resident assessment. Methods We conducted a scoping review which adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews guidelines. We included research involving resident physicians or fellows in EM (population and context), which focused on the impact of gender on assessments (concept). We searched seven databases from the databases' inception to April 4, 2022. Two reviewers independently screened citations, completed full‐text review, and abstracted data. A third reviewer resolved any discrepancies. Results A total of 667 unique citations were identified; 10 studies were included, and all were conducted within the United States. Four studies reported differences in EM resident assessments attributable to gender within workplace‐based assessments (qualitative comments and quantitative scores) by both attending physicians and nonphysicians. Six studies investigating clinical competency committee scores, procedural scores, and simulation‐based assessments did not report any significant differences attributable to gender. Conclusions This scoping review found that gender bias exists within EM resident assessment most notably at the level of narrative comments typically received via workplace‐based assessments. As female EM residents receive higher rates of negative or critical comments and discordant feedback documented on assessment, these findings raise concern about added barriers female EM residents may face while progressing through residency and the impact on their clinical and professional development.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

“…15,32,34,37 Only three studies included a priori definitions of meaningful differences in outcomes, 32,34,37 two of which included sample size calculations. 32,34 Quantitative studies…”

Section: Study Characteristicsmentioning

confidence: 99%

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Gender differences in emergency medicine resident assessment: A scoping review

Menchetti

Eagles

Ghanem

et al. 2022

AEM Education and Training

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Bias in Observed Assessments in Medical Education: A Scoping Review

Ismaeel,

Pusic,

Gottlieb

et al. 2024

Acad Med

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Purpose Observed assessments are integral to medical education but may be biased against structurally marginalized communities. Current understanding of assessment bias is limited because studies have focused on single specialties, levels of training, or social identity characteristics (SIDCs). This scoping review maps studies investigating bias in observed assessments in medical education arising from trainees’ observable SIDCs at different medical training levels, with consideration of medical specialties, assessment environments, and assessment tools. Method MEDLINE, Embase, ERIC, PsycINFO, Scopus, Web of Science Core Collection, and Cochrane Library were searched for articles published between January 1, 2008, and March 15, 2023, on assessment bias related to 6 observable SIDCs: gender (binary), gender nonconformance, race and ethnicity, religious expression, visible disability, and age. Two authors reviewed the articles, with conflicts resolved by consensus or a third reviewer. Results were interpreted through group review and informed by consultation with experts and stakeholders. Results Sixty-six of 2,920 articles (2.3%) were included. These studies most frequently investigated graduate medical education (44 [66.7%]), used quantitative methods (52 [78.8%]), and explored gender bias (63 [95.5%]). No studies investigated gender nonconformance, religious expression, or visible disability. One evaluated intersectionality, with SIDCs described inconsistently. General surgery (16 [24.2%]) and internal medicine (12 [18.2%]) were the most studied specialties. Simulated environments (37 [56.0%]) were studied more frequently than clinical environments (29 [43.9%]). Bias favoring men was found more in assessments of intraoperative autonomy (5 of 9 [55.6%]), whereas clinical examination bias often favored women (15 of 19 [78.9%]). When race and ethnicity bias was identified, it consistently favored White students. Conclusions This review mapped studies of gender, race, and ethnicity bias in the medical education assessment literature, finding limited studies on other SIDCs and intersectionality. These findings will guide future research by highlighting the importance of consistent terminology, unexplored SIDCs, and intersectionality.

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