Gender Differences Among Milestone Assessments in a National Sample of Pediatric Emergency Medicine Fellowship Programs

Zuckerbraun, Noel S.; Levasseur, Kelly; Kou, Maybelle; Rose, Jerri A.; Roskind, Cindy G.; Vu, Tien; Baghdassarian, Aline; Leonard, Kathryn; Shabanova, Veronika; Langhan, Melissa L.

doi:10.1002/aet2.10543

Cited by 4 publications

(13 citation statements)

References 17 publications

(42 reference statements)

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“…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%

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

Section: Study Characteristicsmentioning

confidence: 99%

“…Overall, neither study found educationally significant differences in milestone scores between male and female residents/fellows, as the differences fell within the same "functional level" of a milestone rating and were therefore unlikely to represent an educationally meaningful difference or difference in ability. 35,36…”

Section: Clinical Competency Committee Milestone Data Review (Multiso...mentioning

confidence: 99%

“…While this study was robust in terms of its large sample across multiple centers, educationally meaningful outcome differences were not defined a priori to facilitate a clear interpretation of the identified differences in ACGME milestone scores. While the remaining six studies investigating quantitative score differences across multiple assessment types (simulation cases, procedures, and CCC outcomes) 32,[34][35][36][37] did not report any statistically significant differences in both singlecenter and multicenter settings, only three of these studies included an a priori definition of educationally meaningful outcome differences, 32,34,37 and only two reported sample size calculations. 32,34 Therefore, it is difficult know whether the remaining studies were sufficiently powered to detect differences attributable to gender.…”

Section: Quantitative Assessment Datamentioning

confidence: 99%

“…While these findings do not discredit the existence of gender bias in EM, they do suggest that perhaps these workplace-based differences, when taken together with other forms of assessment data, may not impact downstream summative outcomes at the CCC level. 35,36 Previous studies have postulated that implicit bias and shifting role expectations may be factors influencing rater cognition 40 leading to gender bias in assessors' ratings of performance and written comments. Additionally, these factors may influence the design of workplace-based assessment tools further contributing to gender differences if, for example, the language of the rating scale anchors commend more agentic traits.…”

Section: Assessment Data Synthesismentioning

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: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Clinical Competency Committee Milestone Data Review (Multiso...mentioning

confidence: 99%

Section: Quantitative Assessment Datamentioning

confidence: 99%

Section: Assessment Data Synthesismentioning

confidence: 99%

See 3 more Smart Citations

Gender differences in emergency medicine resident assessment: A scoping review

Menchetti

Eagles

Ghanem

et al. 2022

AEM Education and Training

View full text Add to dashboard Cite

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L’influence du genre des résident·es et des professeur·es sur les évaluations de la formation médicale fondée sur les compétences en anesthésie

Matava

Alam

Kealey

et al. 2023

Can J Anesth/J Can Anesth

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Purpose Competency-based medical education (CBME) relies on frequent workplace-based assessments of trainees, providing opportunities for conscious and implicit biases to reflect in these assessments. We aimed to examine the influence of resident and faculty gender on performance ratings of residents within a CBME system. Methods This retrospective cohort study took place from August 2017 to January 2021 using resident assessment data from two workplace-based assessments: the Anesthesia Clinical Encounter Assessment (ACEA) and Entrustable Professional Activities (EPAs). Self-reported gender data were also extracted. The primary outcome—gender-based differences in entrustment ratings of residents on the ACEA and EPAs—was evaluated using mixed-effects logistic regression, with differences reported through odds ratios and confidence intervals (α = 0.01). Gender-based differences in the receipt of free-text comments on the ACEA and EPAs were also explored. Results In total, 14,376 ACEA and 4,467 EPA assessments were analyzed. There were no significant differences in entrustment ratings on either assessment tool between men and women residents. Regardless of whether assessments were completed by men or women faculty, entrustment rates between men and women residents were not significantly different for any postgraduate year level. Additionally, men and women residents received strengths-related and actions-related comments on both assessments at comparable frequencies, irrespective of faculty gender. Conclusion We found no gender-based differences in entrustment ratings for both the ACEA and EPAs, which suggests an absence of resident gender bias within this CBME system. Given considerable heterogeneity in rater leniency, future work would be strengthened by using rater leniency-adjusted scores rather than raw scores. Supplementary Information The online version contains supplementary material available at 10.1007/s12630-023-02454-x.

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