83 Gender at the Head of the Bed: Does Gender Bias Exist in the Evaluation of Emergency Medicine Residents' Leadership Skills During Medical Resuscitations?

One of the most challenging skill sets emergency medicine (EM) residents must develop during training is to become competent team leaders (TL) during critical medical resuscitations. Although medical knowledge and technical skills are required to be an effective TL, non-technical skills including leadership, communication, and teamwork behavior are also crucial. Research exists that suggests that implicit gender bias may impact the evaluation of female residents, especially in agentic specialties such as EM. The purpose of this is to see if gender bias exists in the way that EM residents are evaluated by EM nurses and faculty in their role as TL during medical resuscitations. Two of the principle investigators (LW, DC) reviewed twenty videotaped medical resuscitations and from these chose four (two with female residents as TL and two with males) as well run resuscitations. They then individually rated these videos using a previously validated score sheet for leadership skills during resuscitations. When the two investigators ratings for the videos were compared, there was very good inter-rater agreement with a kappa > 0.72. These videos were then observed by groups of EM nurses and attending physicians. These observers were asked to the same scoring sheet and were also asked to circle adjectives that they felt described the TL. Observers were blinded to the purpose of the study. Data from the score sheets was entered into Excel by one investigator (LW). Both qualitative and quantitative analysis were performed on the data. The video resuscitations performed by female EM residents were seen by 83 EM nurses and faculty whereas the resuscitations performed by male EM residents were watched by 94. There was no significant difference in how the male and female residents were rated as TLs (2.25 versus 2.38, p=0.75). However, interesting trends appeared when analyzing the adjectives used to describe the residents. Male and female residents were equally likely to be called authoritative, self-confident, and assertive. Female residents, however, were more likely to be identified as active and collaborative. Only male residents were described as cold and only female residents were described as impatient. Female and male EM residents were viewed as being equally effective as leaders in this study. They were both seen to have important behaviors of leaders including self-confidence and assertiveness but female residents were more likely to be described as active and collaborative.