The Elephant in the Room

Author:

Alimi Yewande1,Bevilacqua Lisa A.2,Snyder Rebecca A.3,Walsh Danielle S.4,Jackson Patrick G.1,Betsy J.E.3,Altieri Maria S.5

Affiliation:

1. Department of Surgery, Medstar Georgetown University Hospital, Washington, DC

2. Department of General Surgery, Thomas Jefferson University Hospitals, Philadelphia, PA

3. Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC

4. Department of Surgery, University of Kentucky, Lexington, KY

5. Department of Surgery, University of Pennsylvania, Philadelphia, PA

Abstract

Objective: The aim of this study was to examine the association between race, experience of microaggressions, and implicit bias in surgical training. Background: There is persistent underrepresentation of specific racial and ethnic groups in the field of surgery. Prior research has demonstrated significant sex differences among those who experience microaggressions during training. However, little research has been conducted on the association between race and experiences of microaggressions and implicit bias among surgical trainees. Methods: A 46-item survey was distributed to general surgery residents and residents of surgical subspecialties through the Association of Program Directors in Surgery listserv and social media platforms. The questions included general information/demographic data and information about experiencing, witnessing, and responding to microaggressions during surgical training. The primary outcome was the prevalence of microaggressions during surgical training by self-disclosed race. Secondary outcomes were predictors of and adverse effects of microaggressions. Results: A total of 1624 resident responses were obtained. General surgery residents comprised 825 (50.8%) responses. The female-to-male ratio was nearly equal (815:809). The majority of respondents identified as non-Hispanic White (63.4%), of which 5.3% of residents identified as non-Hispanic Black, and 9.5% identified as Hispanic. Notably, 91.9% of non-Hispanic Black residents (n=79) experienced microaggressions. After adjustment for other demographics, non-Hispanic Black residents were more likely than non-Hispanic White residents to experience microaggressions [odds ratio (OR): 8.81, P<0.001]. Similar findings were observed among Asian/Pacific Islanders (OR: 5.77, P<0.001) and Hispanic residents (OR: 3.35, P<0.001). Conclusions: Race plays an important role in experiencing microaggressions and implicit bias. As the future of our specialty relies on the well-being of the pipeline, it is crucial that training programs and institutions are proactive in developing formal methods to address the bias experienced by residents.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Surgery

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Evaluating the Impact of Gender and Race on Otolaryngology Resident Experiences Across the United States;Otolaryngology–Head and Neck Surgery;2024-09-03

2. Confronting microaggressions in the medical field for a more inclusive future;Journal of Vascular Surgery: Venous and Lymphatic Disorders;2024-07

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