Gender Bias in Nursing Assessments of Emergency Medicine

Gender Bias in Nursing Assessments of Emergency Medicine Residents Bod J, Chandler I, Goldflam K, Tsyrulnik A, Della-Giustina D Yale-New Haven Hospital Department of Emergency Medicine Abstract Methods CLICK TO GO BACK TO KIOSK MENU Background: Implicit gender bias is medical training has been suspected both on the part of physicians and of nurses interacting with trainees. Previous investigations have demonstrated gender bias in nursing assessments of OB/GYN residents and faculty evaluations of Emergency Medicine residents. Objectives: We aimed to determine if gender bias exists in nursing assessments of Emergency Medicine residents. Survey Results Conclusion References Methods: We used a single-center, retrospective design to examine nursing assessments of PGY-1 to PGY-4 Emergency Medicine residents in an urban Level I Trauma center’s academic training program. Surveys were sent to nursing staff, who submitted anonymous evaluations of residents using a 5 -question assessment tool. Responses were graded using a five point scale for questions 1 -4. Question 5 was a binary yes/no question (Figure 1). Analysis was conducted using linear mixed models. Results: A total of 325 assessments were collected over a one year period. There were 140 evaluations for female residents (43%) and 185 for male residents (57%). 61 unique residents were included in the analysis. There existed a for one out of five questions. For Question 1, which assessed a resident’s bedside manner, there existed a statistically significant difference in scores by gender (p = 0. 035) when comparing male (mean score 4. 1) vs female (mean score 3. 62) residents. The four other questions demonstrated a trend toward female residents scoring lower than male residents, but none reached statistical significance. Conclusions: While our study looked at a small sample of resident assessments over a one year period, we found a statistically significant gender difference evident in 1/5 questions. Faculty and residents should be aware of possible gender bias when interpreting results of nursing assessments.

Gender Bias in Nursing Assessments of Emergency Medicine Residents Bod J, Chandler I, Goldflam K, Tsyrulnik A, Della-Giustina D Yale-New Haven Hospital Department of Emergency Medicine Methods Abstract Methods Survey • Study design: single-center retrospective survey evaluation • Participants: Emergency Medicine residents and Emergency Department nursing staff • Procedure: Using Survey. Monkey, nurses anonymously submitted evaluations of PGY-1 to PGY-4 EM residents (see survey tool below) • Outcomes: evaluated via Likert scale Assessment tool administered to Emergency Department nurses about Emergency Medicine residents. Results Conclusion References *1 = Significantly below expectations; 3 = Meets expectations; 5 = Significantly exceeds expectations

Gender Bias in Nursing Assessments of Emergency Medicine Residents Bod J, Chandler I, Goldflam K, Tsyrulnik A, Della-Giustina D Yale-New Haven Hospital Department of Emergency Medicine Results Abstract Methods Survey Results Conclusion References • 325 assessments were collected over a one-year period • 140 assessments for female residents (43%) and 185 for male residents (57%) • 61 unique residents included in the analysis • Program was composed of 30 (42%) female and 41 (58%) male residents. • The number of evaluations per resident ranged from 1 to 20 (median 3). • There was a statistically significant difference for Question 1 (p = 0. 035) in response when comparing male (mean score 4. 1) vs female (mean score 3. 62) residents. • No other gender comparison reached the level of statistical significance. • For all questions, female residents scored lower on average than male residents. Comparison of question responses by resident gender.

Gender Bias in Nursing Assessments of Emergency Medicine Residents Bod J, Chandler I, Goldflam K, Tsyrulnik A, Della-Giustina D Yale-New Haven Hospital Department of Emergency Medicine Conclusion Abstract Methods Survey Results Conclusion References • There is statistically significant gender difference evident in at least some assessment of emergency medicine residents by nursing staff. • Faculty and residents should be aware of possible gender bias when interpreting results of nursing assessments.

Gender Bias in Nursing Assessments of Emergency Medicine Residents Bod J, Chandler I, Goldflam K, Tsyrulnik A, Della-Giustina D Yale-New Haven Hospital Department of Emergency Medicine References Abstract 1. Beeson MS, Carter WA, Christopher TA, et al. The development of the emergency medicine milestones. Acad Emerg Med. 2013; 20(7): 7249. Methods Survey Results 2. Korte RC, Beeson MS, Russ CM, et al. Emergency Medicine Milestones Working Group, Reisdorff EJ. The emergency medicine milestones: a validation study. Acad Emerg Med. 2013; 20(7): 730– 5. 3. The Emergency Medicine Milestone Project - ACGME. The Emergency Medicine Milestone Project. https: //www. acgme. org/Portals/0/PDFs/Milestones/Emergency. Medicine. Milestones. pdf. Published July 2015. Accessed June 6, 2017. 4. Veloski J, Boex JR, Grasberger MJ, et al. Systematic review of the literature on assessment, feedback and physicians’ clinical performance: BEME Guide No. 7. Med Teach. 2006; 28: 117– 28. 5. Ogunyemi D, Gonzalez G, Fong A, et al. From the eye of the nurses: 360 -degree evaluation of residents. Journal of Continuing Education in the Health Professions. 2009; 29(2): 105 -110. Conclusion References 6. Chandler N, Henderson G, Park B, et al. Use of a 360 -Degree Evaluation in the Outpatient Setting: The Usefulness of Nurse, Faculty, Patient/Family, and Resident Self-Evaluation. Journal of Graduate Medical Education. 2010; 2(3): 430 -434. Doi: 10. 4300/jgme-d-10 -00013. 1. 7. Galvin SL, Parlier AB, Martino E, et al. Gender Bias in Nurse Evaluations of Residents in Obstetrics and Gynecology. Obstetrics & Gynecology. 2015; 126: 7 S-12 S. 8. Dayal A, O’Connor DM, Qadri U, et al. Comparison of Male vs Female Resident Milestone Evaluations by Faculty During Emergency Medicine Residency Training. JAMA Internal Medicine. 2017; 177(5): 651.