Why gender matters in the operating room: recommendations for a research agenda

Etherington, Nicole; Boet, Sylvain

doi:10.1016/j.bja.2018.07.021

Cited by 8 publications

(8 citation statements)

References 15 publications

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“…Health-related equity characteristics are increasingly being investigated in perioperative care [10][11][12][13][14][15][16]. These characteristics may be particularly relevant in anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Sex/gender and additional equity characteristics of providers and patients in perioperative anesthesia trials: a cross-sectional analysis of the literature

Etherington

Boet

2021

Korean J Anesthesiol

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Sex and gender, among other equity-related characteristics, influence process of care and patients' outcomes. Currently, the extent to which these characteristics are considered in the anesthesia literature remains unknown. This study assesses their incorporation in randomized controlled trials (RCTs) on anaesthesia-related interventions, for both patients and healthcare providers. This is a cross-sectional analysis using an existing dataset derived from the anesthesia literature. The dataset originated from a scoping review searching MEDLINE, EMBASE, CINAHL, CENTRAL, and the Cochrane Database of Systematic reviews. RCTs investigating the effect of anesthesia-related interventions on mortality for adults undergoing surgery were included. Equity outcome measures were recorded for both patients and providers and assessed for inclusion in study design, reporting of results, and analysis of intervention effects. Three-hundred sixty-one RCTs (n patients = 144 674) were included. Most RCTs (91%) reported patient sex/gender, with 58% of patients identified as male. There were 139 studies (39%), where 70% or more of the sample was male, compared to just 14 studies (4%), where 70% or more of the sample was female. Only 10 studies (3%) analyzed results by patient sex/gender, with one reporting a significant effect. There was substantial variation in how age was reported, although nearly all studies (98%) reported some measure of age. For healthcare providers, equity-related information was never available. Better consideration of sex/gender and additional health equity parameters for both patients and providers in RCTs is needed to improve evidence quality, and ultimately, patient care and outcome.

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Section: Introductionmentioning

confidence: 99%

Sex/gender and additional equity characteristics of providers and patients in perioperative anesthesia trials: a cross-sectional analysis of the literature

Etherington

Boet

2021

Korean J Anesthesiol

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“…Hierarchical differences were highlighted in our study, but in healthcare, gender often doubles this effect (Etherington & Boet, 2018). In our vignettes, the characters were represented according to social stereotypes, with female nurses and male surgeons.…”

Section: Limitations and Future Studiesmentioning

confidence: 68%

“Doctor, please”: Educating Nurses to Speak Up With Interactive Digital Simulation Tablets

Bracq

Michinov

Duff

et al. 2021

Clinical Simulation in Nursing

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Background. Courses are developed to train on open communication. This study focuses on speaking-up for scrub nurses.Method. The scenario is implemented on digital tablets, with vignettes involving problematic behaviours of a colleague with the same or different status. The nurses (N = 33) were asked whether they would point out the error, whether they would be embarrassed, and how they would do it.Results. Nurses expressed greater embarrassment with a colleague of a different status. This is confirmed by their phrasing and the strategies they reported when speaking to the surgeon. Conclusion.The scenario was well accepted and could be used to train other health professionals.

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“… 19–24 Though power struggles in the OR have often been attributed to differences in professional training or values, 15 research increasingly suggests that sex (ie, biological, anatomical and physiological characteristics) and gender (ie, identity, behaviour, roles and relations) shape team interactions in healthcare, as well as the different practice patterns observed among female and male physicians. 25–34 …”

Section: Introductionmentioning

confidence: 99%

“…Although physician’s sex and gender have been shown to influence processes of care and outcomes in non-cardiac medical and surgical care as well as in primary cardiac care, 25 26 37–42 the role of these factors within the cardiac OR remains unclear. As such, it is necessary to quantify the effect of physician’s sex and gender on clinical processes of care and adverse patient outcomes for the cardiac OR.…”

Section: Introductionmentioning

confidence: 99%

“…Open access behaviour, roles and relations) shape team interactions in healthcare, as well as the different practice patterns observed among female and male physicians. [25][26][27][28][29][30][31][32][33][34] Cohesive teamwork and effective communication are especially important in the cardiac OR given the high acuity of cases, frequent and sudden events of haemodynamic instability, critical moments of cardiopulmonary bypass initiation and separation, and the need for precise blood pressure control during key stages of operation. Moreover, the high-risk nature of cardiac surgery makes effective teamwork and communication even more critical in this operative setting.…”

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confidence: 99%

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Impact of physician’s sex/gender on processes of care, and clinical outcomes in cardiac operative care: a systematic review

Etherington

Deng

Boet³

et al. 2020

BMJ Open

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ObjectivesThis systematic review aimed to assess the role of physician’s sex and gender in relation to processes of care and/or clinical outcomes within the context of cardiac operative care.DesignA systematic review.Data sourcesSearches were conducted in PsycINFO, Embase and Medline from inception to 6 September 2018. The reference lists of relevant systematic reviews and included studies were also searched.Eligibility criteria for selecting studiesQuantitative studies of any design were included if they were published in English or French, involved patients of any age undergoing a cardiac surgical procedure and specifically assessed differences in processes of care or clinical patient outcomes by physician’s sex or gender. Studies were screened in duplicate by two pairs of independent reviewers.Outcome measuresProcesses of care, patient morbidity and patient mortality.ResultsThe search yielded 2095 publications after duplicate removal, of which two were ultimately included. These studies involved various types of surgery, including cardiac. One study found that patients treated by female surgeons compared with male surgeons had a lower 30-day mortality. The other study, however, found no differences in patient outcomes by surgeon’s sex. There were no studies that investigated anaesthesiologist’s sex/gender. There were also no studies investing physician’s sex or gender exclusively in the cardiac operating room.ConclusionsThe limited data surrounding the impact of physician’s sex/gender on the outcomes of cardiac surgery inhibits drawing a robust conclusion at this time. Results highlight the need for primary research to determine how these factors may influence cardiac operative practice, in order to optimise provider’s performance and improve outcomes in this high-risk patient group.

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Why gender matters in the operating room: recommendations for a research agenda

Cited by 8 publications

References 15 publications

Sex/gender and additional equity characteristics of providers and patients in perioperative anesthesia trials: a cross-sectional analysis of the literature

Sex/gender and additional equity characteristics of providers and patients in perioperative anesthesia trials: a cross-sectional analysis of the literature

“Doctor, please”: Educating Nurses to Speak Up With Interactive Digital Simulation Tablets

Impact of physician’s sex/gender on processes of care, and clinical outcomes in cardiac operative care: a systematic review

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