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.

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.

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).

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.