Patient Satisfaction with Women vs Men Surgical Interns and Senior Residents

Abstract

INTRODUCTION: Patient satisfaction with surgical resident care is not well characterized. This study aimed to understand whether patient evaluation of surgical trainees varies by gender. METHODS: General surgery inpatients were invited to evaluate surgical resident care using a modified Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) after positively identifying photos of surgical trainees. S-CAHPS items were scored by the “top-box” method. Patient evaluations of women vs men were stratified by training level and compared. RESULTS: Ninety-one percent of approached patients participated (n = 324/357, mean age = 62.2 years, 50.3% male). Patient demographics, pain level, and attitudes towards resident care were similar between those evaluating women vs men trainees. Women surgical interns were recognized by patients at a lower rate than men (75% vs 87.2%, p=.01). S-CAHPS scores for women vs men interns were equivalent except for spending sufficient time with the patient (75.6% vs 88.0%, p = 0.02). For senior residents (PGY3-PGY5), there was no difference in patient recognition of women vs men (83.9% vs 85.2%, p = 0.91) or in any S-CAHPS domain (all p > 0.05). CONCLUSION: Gender differences in patient evaluation of surgical trainees are resolved by the senior years, with patients reporting the quality of care of women and men senior surgical residents to be equivalent across all S-CAHPS domains. Future work should aim to understand how to best incorporate patient evaluation into trainee assessment to support development, including a focus on ensuring patients recognize and understand the role of resident care providers regardless of gender. Table 1. - Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey Scores of Women vs Men Surgical Trainees S-CAHPS item Patient evaluations indicating top-box score, women vs men interns (%) p Value, Fisher’s exact test Patient evaluations indicating top-box score, women vs men senior residents (%) p Value, Fisher’s exact test Using any number from 0 to 10, where 0 is the worst intern doctor/senior resident possible and 10 is the best intern doctor/senior resident possible, what number would you use to rate all your care from this trainee? 51.2 vs 56.8 .42 60.3 vs 54.1 .32 Would you recommend this intern doctor/senior resident to your friends and family? 78.5 vs 84.7 .28 86.3 vs 87.8 .85 During your stay in the hospital, did this intern doctor/senior resident listen carefully to you? 90.5 vs 94.6 .29 95.8 vs 96 1.0 During your stay in the hospital, did this intern doctor/senior resident spend enough time with you? 75.6 vs 88.0 .02 88.1 vs 89.2 .85 During your stay in the hospital, did this intern doctor/senior resident encourage you to ask questions? 78.1 vs 81.4 .61 92.4 vs 84.9 .08 During your stay in the hospital, did this intern doctor/senior resident show respect for what you had to say? 95.2 vs 97.0 .48 99.2 vs 96.0 .14 During your stay in the hospital, did this intern doctor/senior resident discuss the outcome of your surgery with you? 60.0 vs 70.6 .13 85.6 vs 89.0 .45 During your stay in the hospital, did this intern doctor/senior resident make sure you were physically comfortable or had enough pain relief? 77.8 vs 81.2 .61 93.3 vs 85.6 .05 Evaluations that received top-box scores across all 8 S-CAHPS items, % 32.1 vs 38.0 .41 48.3 vs 38.0 .11