Multi-institutional study examining intraoperative entrustment and resident sex - 16/01/25

Doi : 10.1016/j.amjsurg.2024.115925

Samantha Baker ^a , Julie Evans ^b , Niki Matusko ^b , Brenessa Lindeman ^a , Sarah Jung ^c , Sebin Choi ^b , Rebecca Minter ^c , Mackenzie Cook ^d , Karen Brasel ^d, Gurjit Sandhu ^b,^⁎
^a University of Alabama at Birmingham, 1808 7th Ave S, #503U, Birmingham, AL, 35294, USA
^b University of Michigan, Alfred Taubman Health Care Center, Rm 2101, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
^c University of Wisconsin, University of Wisconsin Clinical Science Center, Dept of Surgery Admin MC, 7375, 600 Highland Avenue, Madison, WI, 53792, USA
^d Oregon Health and Science University, 3181 S.W. Sam Jackson Park Rd, Mail Code: L223, Portland, OR, 97239, USA

^⁎Corresponding author.

Abstract

Introduction

Single-site studies have found variable associations between gender and entrustment-based interactions during surgical residency. We sought to assess the relationship between resident sex and intraoperative entrustment at multiple institutions.

Methods

Surgical cases were observed at four university-based training programs. Faculty entrustment and resident entrustability were rated using OpTrust. OpTrust is a validated intraoperative entrustment measurement tool which enables trained third-party raters to objectively score resident and faculty behaviors in the operating room. Independent sample t-tests and regression analysis with cluster adjusted standard errors were used.

Results

337 cases were observed which included 149 residents (54 % female) and 97 faculty members (30 % female). There was no difference in resident entrustability based on resident sex (p = 0.30). Female residents were more likely to be involved in cases rated as more difficult (p = 0.04). At a single site, male residents scored higher on resident entrustability (p = 0.007) and faculty entrustment (p = 0.022).

Conclusion

Entrustment did not differ based on resident sex on a multi-institutional scale; however, at a single site, there was a difference; suggesting there are multi-factorial issues contributing to differences in training.

Le texte complet de cet article est disponible en PDF.

Highlights

•	Discussion around bias in training versus self-perception of skill and autonomy
•	No association between resident sex and OpTrust at a multi-intuitional level
•	Single site analysis found a difference with males scoring higher at one institution
•	Highlighting the multifactorial nature of disparities in surgical training

Le texte complet de cet article est disponible en PDF.