Exploring gender and thematic differences in qualitative assessments of internal medicine resident performance
Abstract Introduction Evidence suggests gender disparities in medical education assessment, including differences in ratings of competency and narrative comments provided in resident performance assessments. This study explores how gender manifests within the content of qualitative assessments (i.e....
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Medical Education |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12909-023-04917-7 |
| _version_ | 1827329123042721792 |
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| author | Robin Klein Erin D. Snyder Jennifer Koch Anna Volerman Sarah Alba-Nguyen Katherine A Julian Vanessa Thompson Nneka N Ufere Sherri-Ann M Burnett-Bowie Anshul Kumar Bobbie Ann Adair White Yoon Soo Park Kerri Palamara |
| author_facet | Robin Klein Erin D. Snyder Jennifer Koch Anna Volerman Sarah Alba-Nguyen Katherine A Julian Vanessa Thompson Nneka N Ufere Sherri-Ann M Burnett-Bowie Anshul Kumar Bobbie Ann Adair White Yoon Soo Park Kerri Palamara |
| author_sort | Robin Klein |
| collection | DOAJ |
| description | Abstract Introduction Evidence suggests gender disparities in medical education assessment, including differences in ratings of competency and narrative comments provided in resident performance assessments. This study explores how gender manifests within the content of qualitative assessments (i.e., narrative comments or performance feedback) of resident performance. Methods Qualitative content analysis was used to explore gender-based differences in narrative comments included in faculty assessments of resident performance during inpatient medicine rotations at six Internal Medicine residency programs, 2016–2017. A blinded, multi-analyst approach was employed to identify themes across comments. Patterns in themes with resident gender and post-graduate year (PGY) were explored, focusing on PGY2 and PGY3 when residents are serving in the team leader role. Results Data included 3,383 evaluations with narrative comments of 385 men (55.2%) and 313 women residents (44.8%). There were thematic differences in narrative comments received by men and women residents and how these themes manifested within comments changed with training time. Compared to men, comments about women had a persistent relationship-orientation and emphasized confidence over training including as interns and in PGY2 and PGY3, when serving as team leader. The relationship-orientation was characterized not only by the residents’ communal attributes but also their interpersonal and communication skills, including efforts supporting others and establishing the tone for the team. Comments about women residents often highlighted confidence, including recommendations around behaviors that convey confidence in decision-making and team leadership. Discussion There were gender-based thematic differences in qualitative assessments. Comments about women resident team leaders highlight relationship building skills and urge confidence and actions that convey confidence as team leader. Persistent attention to communal skills suggests gendered expectations for women resident team leaders and a lost opportunity for well-rounded feedback to the disadvantage of women residents. These findings may inform interventions to promote equitable assessment, such as providing feedback across the competencies. |
| first_indexed | 2024-03-07T15:28:20Z |
| format | Article |
| id | doaj.art-00842897be9f48379bbd882469cfeabb |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-03-07T15:28:20Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-00842897be9f48379bbd882469cfeabb2024-03-05T16:33:08ZengBMCBMC Medical Education1472-69202023-12-0123111010.1186/s12909-023-04917-7Exploring gender and thematic differences in qualitative assessments of internal medicine resident performanceRobin Klein0Erin D. Snyder1Jennifer Koch2Anna Volerman3Sarah Alba-Nguyen4Katherine A Julian5Vanessa Thompson6Nneka N Ufere7Sherri-Ann M Burnett-Bowie8Anshul Kumar9Bobbie Ann Adair White10Yoon Soo Park11Kerri Palamara12Emory University School of MedicineDepartment of Medicine, Division of General Internal Medicine, University of Alabama Birmingham School of MedicineDepartment of Medicine, University of LouisvilleDepartments of Medicine and Pediatrics, University of ChicagoDepartment of Medicine, Division of Hospital Medicine, University of California, San FranciscoDepartment of Medicine, Division of General Internal Medicine, University of California, San FranciscoDepartment of Medicine, Division of General Internal Medicine, University of California, San FranciscoDepartment of Medicine, Division of Gastroenterology, Massachusetts General HospitalDepartment of Medicine, Endocrine Division, Massachusetts General HospitalMassachusetts General Hospital Institute of Health ProfessionsMassachusetts General Hospital Institute of Health ProfessionsDepartment of Medical Education, University of IllinoisDepartment of Medicine, Massachusetts General HospitalAbstract Introduction Evidence suggests gender disparities in medical education assessment, including differences in ratings of competency and narrative comments provided in resident performance assessments. This study explores how gender manifests within the content of qualitative assessments (i.e., narrative comments or performance feedback) of resident performance. Methods Qualitative content analysis was used to explore gender-based differences in narrative comments included in faculty assessments of resident performance during inpatient medicine rotations at six Internal Medicine residency programs, 2016–2017. A blinded, multi-analyst approach was employed to identify themes across comments. Patterns in themes with resident gender and post-graduate year (PGY) were explored, focusing on PGY2 and PGY3 when residents are serving in the team leader role. Results Data included 3,383 evaluations with narrative comments of 385 men (55.2%) and 313 women residents (44.8%). There were thematic differences in narrative comments received by men and women residents and how these themes manifested within comments changed with training time. Compared to men, comments about women had a persistent relationship-orientation and emphasized confidence over training including as interns and in PGY2 and PGY3, when serving as team leader. The relationship-orientation was characterized not only by the residents’ communal attributes but also their interpersonal and communication skills, including efforts supporting others and establishing the tone for the team. Comments about women residents often highlighted confidence, including recommendations around behaviors that convey confidence in decision-making and team leadership. Discussion There were gender-based thematic differences in qualitative assessments. Comments about women resident team leaders highlight relationship building skills and urge confidence and actions that convey confidence as team leader. Persistent attention to communal skills suggests gendered expectations for women resident team leaders and a lost opportunity for well-rounded feedback to the disadvantage of women residents. These findings may inform interventions to promote equitable assessment, such as providing feedback across the competencies.https://doi.org/10.1186/s12909-023-04917-7AssessmentGraduate medical educationGenderQualitativeInternal medicineBias |
| spellingShingle | Robin Klein Erin D. Snyder Jennifer Koch Anna Volerman Sarah Alba-Nguyen Katherine A Julian Vanessa Thompson Nneka N Ufere Sherri-Ann M Burnett-Bowie Anshul Kumar Bobbie Ann Adair White Yoon Soo Park Kerri Palamara Exploring gender and thematic differences in qualitative assessments of internal medicine resident performance BMC Medical Education Assessment Graduate medical education Gender Qualitative Internal medicine Bias |
| title | Exploring gender and thematic differences in qualitative assessments of internal medicine resident performance |
| title_full | Exploring gender and thematic differences in qualitative assessments of internal medicine resident performance |
| title_fullStr | Exploring gender and thematic differences in qualitative assessments of internal medicine resident performance |
| title_full_unstemmed | Exploring gender and thematic differences in qualitative assessments of internal medicine resident performance |
| title_short | Exploring gender and thematic differences in qualitative assessments of internal medicine resident performance |
| title_sort | exploring gender and thematic differences in qualitative assessments of internal medicine resident performance |
| topic | Assessment Graduate medical education Gender Qualitative Internal medicine Bias |
| url | https://doi.org/10.1186/s12909-023-04917-7 |
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