Dataset Information

Physician Gender Differences in Processing Surgical Risk Features in Videos of Standardized Patients.

ABSTRACT: BACKGROUND:Physician gender differences exist for estimating surgical risk and recommending lung resection. This study assessed gender differences in perceived importance of health characteristics portrayed by standardized patients posing as lung resection candidates. METHODS:Physicians read a clinical vignette categorized as low, average, or high surgical risk and then viewed a video of a standardized patient exhibiting vigorous, normal, or frail behavior. The relative importance of gait speed, strength, fatigue, age, and weight loss in the videos was scored on a five-point Likert-like scale. Ratings of the importance of each were compared by gender and risk category. RESULTS:Of 73 participating physicians, 62 were male and 11 were female, 40 were thoracic surgeons, and 33 were cardiothoracic surgical trainees. All video features were scored as very important or somewhat important a majority of the time. Gait speed and strength ratings were strongly correlated (r = 0.76), followed by strength and fatigue (r = 0.52) and gait speed and fatigue (r = 0.51). Female gender was associated with significantly greater odds of rating age as very important (p = 0.040). For weight loss, the differences between genders varied significantly (females consistently rated weight loss as important, whereas ratings for men varied by risk category; p = 0.002 for the interaction). CONCLUSIONS:Physicians variably rate certain health characteristics of standardized patients as important in making surgical risk estimations. Women and men rate the importance of age and weight loss differently. These findings may help educate physicians to develop more consistent estimates of surgical risk.

SUBMITTER: Ferguson MK

PROVIDER: S-EPMC6527111 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Physician Gender Differences in Processing Surgical Risk Features in Videos of Standardized Patients.

Ferguson Mark K MK Wroblewski Kristen K Huisingh-Scheetz Megan M Thompson Katherine K Farnan Jeanne J

The Annals of thoracic surgery 20181214 4

<h4>Background</h4>Physician gender differences exist for estimating surgical risk and recommending lung resection. This study assessed gender differences in perceived importance of health characteristics portrayed by standardized patients posing as lung resection candidates.<h4>Methods</h4>Physicians read a clinical vignette categorized as low, average, or high surgical risk and then viewed a video of a standardized patient exhibiting vigorous, normal, or frail behavior. The relative importance ...[more]

PMID: 30557541

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Project description:BackgroundMedical students are expected to translate the theoretical knowledge gained during their study to practical knowledge during the clerkships. A surgical educational platform with standardized videos may be the solution. However, the effects of a structured online video-based platform in addition to the standard curriculum on students' self-reported and tested surgical knowledge during the surgical clerkship must be assessed.MethodsFourth-year medical students (n = 178) participated in a 6-week course of theoretical and practical training followed by a 10-week in-hospital clerkship in the Erasmus University Medical Center (Erasmus MC), Rotterdam, The Netherlands and 11 affiliated general hospitals. Ninety students followed the usual surgical curriculum (control group), followed by 88 students who were given voluntary access to a video-based surgical educational platform of Incision Academy (video group). At the start (T0) and end (T1) of the clerkship, both groups filled out a surgical knowledge test and a survey regarding their self-reported surgical knowledge and their access to available study sources. Supervisors were blinded and surveyed concerning students' performance and their acquired knowledge. We analyzed the data using paired and unpaired student t-tests and linear regression.ResultsAt the end of the clerkship, students in the video group indicated that they had better resources at their disposal than the control group for surgical procedures (p = 0.001). Furthermore, students in the video group showed a greater increase in self-reported surgical knowledge during their clerkship (p = 0.03) and in more objectively tested surgical knowledge (p < 0.001).ConclusionsAn online surgical educational platform with standardized videos is a valuable addition to the current surgical curriculum according to students and their supervisors. It improves their test scores and self-reported surgical knowledge. Students feel better prepared and more able to find the information necessary to complete the clerkship.Trial registrationRegistry not necessary according to ICMJE guidelines.

Project description:BACKGROUND:Previous studies have documented income differences between male and female physicians. However, the implications of these differences are unclear, since previous studies have lacked detailed data on the quantity and composition of work hours. We sought to identify the sources of these income differences using data from a novel survey of physician work and income. OBJECTIVE:To compare differences in income between male and female physicians. DESIGN:We estimated unadjusted income differences between male and female physicians. We then adjusted these differences for total hours worked, composition of work hours, percent of patient care time spent providing procedures, specialty, compensation type, age, years in practice, race, ethnicity, and state and practice random effects. PARTICIPANTS:We surveyed 656 physicians in 30 practices in six states and received 439 responses (67% response rate): 263 from males and 176 from females. MAIN MEASURE:Self-reported annual income. KEY RESULTS:Male physicians had significantly higher annual incomes than female physicians (mean $297,641 vs. $206,751; difference $90,890, 95% CI $27,769 to $154,011) and worked significantly more total hours (mean 2470 vs. 2074; difference 396, 95% CI 250 to 542) and more patient care hours (mean 2203 vs. 1845; difference 358, 95% CI 212 to 505) per year. Male physicians were less likely than female physicians to specialize in primary care (49.1 vs. 70.5%), but more likely to perform procedures with (33.1 vs. 15.5%) or without general anesthesia (84.3 vs. 73.1%). After adjustment, male physicians' incomes were $27,404 (95% CI $3120 to $51,688) greater than female physicians' incomes. CONCLUSIONS:Adjustment for multiple possible confounders, including the number and composition of work hours, can explain approximately 70% of unadjusted income differences between male and female physicians; 30% remains unexplained. Additional study and dedicated efforts might be necessary to identify and address the causes of these unexplained differences.

Project description:INTRODUCTION:Prior research demonstrates gender differences in language used in letters of recommendation. The emergency medicine (EM) Standardized Letter of Evaluation (SLOE) format limits word count and provides detailed instructions for writers. The objective of this study is to examine differences in language used to describe men and women applicants within the SLOE narrative. METHODS:All applicants to a four-year academic EM residency program within a single application year with a first rotation SLOE available were included in the sample. We used the Linguistic Inquiry and Word Count (LIWC) program to analyze word frequency within 16 categories. Descriptive statistics, chi-squared, and t-tests were used to describe the sample; gender differences in word frequency were tested for using Mann-Whitney U tests. RESULTS:Of 1117 applicants to the residency program, 822 (82%) first-rotation SLOEs were available; 64% were men, and 36% were women. We did not find a difference in baseline characteristics including age (mean 27 years), top 25 schools (22.5%), Alpha Omega Alpha Honor Medical Society rates (13%), and having earned advanced degrees (10%). The median word count per SLOE narrative for men was 171 and for women was 180 (p = 0.15). After adjusting for letter length, word frequency differences between genders were only present in two categories: social words (women: 23 words/letter; men: 21 words/letter, p = 0.02) and ability words (women: 2 words/letter; men: 1 word/letter, p = 0.04). We were unable to detect a statistical difference between men and women applicants in the remaining categories, including words representing communal traits, agentic traits, standout adjectives, grindstone traits, teaching words, and research words. CONCLUSION:The small wording differences between genders noted in two categories were statistically significant, but of unclear real-world significance. Future work is planned to evaluate how the SLOE format may contribute to this relative lack of bias compared to other fields and formats.

Project description:Risk-taking is a complex form of decision-making that involves calculated assessments of potential costs and rewards that may be immediate or delayed. Thus, making predictions about inter-individual variation in risk-taking due to personality traits, decision styles or other attributes can be difficult. The association of risk-taking with gender is well-supported; males report higher propensity for risk-taking and show higher risk-taking on tasks measuring actual risk-taking behavior. Risk-taking also appears to be associated with circadian phenotypes (chronotypes), with evening-types reporting higher levels of risk-taking-but this association may be confounded by the fact that, in certain age groups, males are more likely to be evening-types. Here, we test for gender by chronotype effects on risk-taking in young adults (n = 610) using a self-reported risk propensity questionnaire, the health domain of the DOSPERT, and a behavioral task measuring risk-taking, the Balloon Analog Risk Task (BART). Our results show that males report and take significantly more risks than females in this population. In addition, evening-type individuals have significantly higher self-reported risk propensity and tend to take more risks on the BART. Interestingly, there is no significant difference in risk propensity or risk-taking behavior across male circadian phenotypes, but evening-type females significantly report and take more risk than female intermediate and morning types. In regression analyses, we found both gender and chronotype predict risk propensity and risk-taking. Path analysis confirms that chronotype has an indirect effect on gender differences in both risk propensity and risk-taking. Furthermore, we found that trait anxiety (STAI) and sleep disturbance (PROMIS), significantly correlate with chronotype and gender in the complete dataset, but do not independently predict differences in female risk-taking. These results suggest that chronotype mediates gender effects on risk-taking and that these effects are driven primarily by morning-type females, but are not related to gender-specific differences in trait anxiety or sleep quality.

Dataset Information

Physician Gender Differences in Processing Surgical Risk Features in Videos of Standardized Patients.

Publications

Physician Gender Differences in Processing Surgical Risk Features in Videos of Standardized Patients.

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