Gendering trust in general surgery training: Examining the role of trust between residents and attendings

Abstract

In medical training and throughout medical careers, women face a disadvantage –especially in surgery. To better understand its origins, this study examines the role of gender in surgical training, focusing on trust between faculty and medical residents. An environment of trust enables surgical residents to gain hands-on experience and acquire practical skills during surgeries performed jointly with faculty. In this sequential explanatory mixed-methods study, 105 surgical encounters were rated utilizing the OpTrust tool, an instrument designed to measure entrustment between surgery residents and faculty. Furthermore, seventeen attendings and ten surgery residents gave in-depth interviews. Entrustment was modeled using linear regression models with robust estimators, controlling for resident and faculty demographic background and intraoperative factors. The results revealed gender disparities in trust. Prior experience in the operating room benefited male trainees more than female trainees in terms of faculty trust. Qualitative results indicate that gender stereotypes and biases may influence attendings’ trusting behaviors toward female residents, thus limiting their active participation inside the Operating Room. These findings can inform interventions to ensure equal surgical opportunities for female residents.