Implicit Gender Bias Research Articles

Effect of resident and assessor gender on entrustment-based observational assessment in an internal medicine residency program

Background: Implicit gender bias leads to differences in assessment. Studies examining gender differences in resident milestone assessment data demonstrate variable results. The purpose of this study was to determine if observational entrustment scores differ by resident and assessor gender in a program of assessment based on discrete, observable skills. Methods: We analyzed overall entrustment scores and entrustment scores by Accreditation Council for Graduate Medical Education (ACGME) core competency for 238 residents (49% female) from 396 assessors (38% female) in one internal medicine residency program from July 2012 to June 2019. We conducted analyses at 1-12 months, 1-36 months, 1-6 months, 7-12 months, and 31-36 months. We used linear mixed-effect models to assess the role of resident and assessor gender, with resident-specific and assessor-specific random effect to account for repeated measures. Results: Statistically significant interactions existed between resident and assessor gender for overall entrustment at 1-12 months (p < 0.001), 1-36 months (p< 0.001), 1-6 months (p<0.001), 7-12 months (p=0.04), and 31-36 months (p<0.001). However, group differences were not statistically significant. In several instances an interaction was significant between resident and assessor gender by ACGME core competency, but there were no statistically significant group differences for all competencies at any time point. When applicable, subsequent analysis of main effect of resident or assessor gender independently of one another revealed no statistically significant differences. Conclusions: No significant differences in entrustment scores were found based on resident or assessor gender in our large, robust entrustment-based program of assessment. Determining the reasons for our findings may help identify ways to mitigate gender bias in assessment.

The Gothic Tradition in Jane Eyre and The Woman in White in Russian Translations, 1849–1860

Elements drawn from the Gothic tradition were of particular interest to the mid-nineteenth-century Russian translators of Jane Eyre and The Woman in White. That interest was stimulated by the democratization of literature, the expanding market for popular fiction, and the consequent search for models from abroad. In this article, we consider how these early translators rendered the Gothic features of these novels, and especially how they intensified and exaggerated the elements of mystery and terror. We also consider contrasts in the reviewers’ responses to Brontë’s and Collins’s texts, contrasts that we argue were based on an implicit gender bias.

Fixing the leaky pipeline: Tips to promote gender equity in Academic Medicine

Introduction: Gender equity in academic medicine is a global concern. Women physicians lag behind men in salary, research productivity, and reaching top academic rank and leadership positions. Methods: In this Global Perspective, we provide suggestions for overcoming gender bias, drawn from a multidisciplinary literature and personal experiences working as clinician educators in the international academic arena. These suggestions are not exhaustive but inform a tool kit for institutions and individuals to support the advancement of women in academic medicine. Results: Barriers include limited access to same gender role models and mentors, fewer networking opportunities, fewer nominations for awards and speakership opportunities, as well as implicit gender bias. Institutional interventions can address disparities along the career continuum focusing on scholarship, promotion and leadership opportunities. Women faculty can also seek out professional development programmes and mentorship to support their own advancement. Informal and formal networking opportunities, using a variety of platforms, including social media, can help build relationships to enhance career development and success, and provide social, emotional and professional support to women at all stages of their career. The National University Health System’s Women in Science and Healthcare project is an example of a successful group formed to empower women and foster personal and professional development. Conclusion: Successful incentives and policies need to consider local institutional and cultural contexts, as well as approaches to mitigate implicit bias. Achieving gender parity in academic medicine will promote a personally and professionally fulfilled global healthcare workforce to improve patient care and clinical outcomes worldwide.

Public Perceptions of Physician Attire and Professionalism in the US

In recent years, casual physician attire (fleece jackets and softshell jackets) has become increasingly popular, but to our knowledge, public perceptions of these garments have not been studied. Furthermore, gender biases may result in differing expectations and perceptions of female and male physicians and may be associated with patient rapport and trust building. To characterize public perceptions of casual physician attire and implicit gender biases in public assessment of physicians' professional attire. This survey study used a population-based survey administered via Amazon Mechanical Turk from May to June 2020 among individuals aged 18 years or older who were US residents and for whom English was the primary language. Survey featuring photographs of a male or female model wearing various types of physician attire (white coat, business attire, and scrubs). Respondents' ratings of professionalism, experience, and friendliness of the male and female models in various attire and perceptions of the models' most likely health care profession. Preference scores for various outfits were calculated as the difference between the preference score for an outfit and the mean preference score for the outfit-role pairing. Of 522 surveys completed, 487 were included for analysis; the mean (SD) age of respondents was 36.2 (12.4) years, 260 (53.4%) were female, and 372 (76.4%) were White individuals. Respondents perceived models of health care professionals wearing white coats vs those wearing fleece or softshell jackets as significantly more experienced (mean [SD] experience score: white coat, 4.9 [1.5]; fleece, 3.1 [1.5]; softshell, 3.1 [1.5]; P < .001) and professional (mean [SD] professionalism score: white coat, 4.9 [1.6]; fleece, 3.2 [1.5]; softshell, 3.3 [1.5]; P < .001). A white coat with scrubs attire was most preferred for surgeons (mean [SD] preference index: 1.3 [2.3]), whereas a white coat with business attire was preferred for family physicians and dermatologists (mean [SD] preference indexes, 1.6 [2.3] and 1.2 [2.3], respectively; P < .001). Regardless of outerwear, female models in business attire as inner wear were rated as less professional than male counterparts (mean [SD] professionalism score: male, 65.8 [25.4]; female, 56.2 [20.2]; P < .001). Both the male and the female model were identified by the greater number of respondents as a physician or surgeon; however, the female model vs the male model was mistaken by more respondents as a medical technician (39 [8.0] vs 16 [3.3%]; P < .005), physician assistant (56 [11.5%] vs 11 [2.3%]; P < .001), or nurse (161 [33.1%] vs 133 [27.3%]; P = .050). In this survey study, survey respondents rated physicians wearing casual attire as less professional and experienced than those wearing a white coat. Gender biases were found in impressions of professionalism, with female physicians' roles being more frequently misidentified. Understanding disparate public perceptions of physician apparel may inform interventions to address professional role confusion and cumulative career disadvantages for women in medicine.

Anchoring Vignettes as a Method to Address Implicit Gender Bias in Patient Experience Scores

Patient experience metrics have become increasingly important in evaluations of health care organizations and physician performance. Although such measures have been touted as a way to make objective comparisons of performance, they are subject to many of the same biases as other survey instruments, including gender bias. A total of 320 surveys were conducted between February and October 2020. Surveys included vignettes describing different scenarios, and respondents were asked to rate the vignette physician in each scenario on 1 of 3 themes: listening, time, or courtesy. Three vignettes per theme were used. Half of the surveys used a male physician and half used a female physician. Using tests of difference, we compared the ratings of male and female vignette physicians. We also used a statistical technique known as anchoring vignettes to show how respondents' ratings of vignette physicians related to their ratings of their own physicians. In all 9 vignette scenarios, the male vignette physician was rated more highly than the female vignette physician. These differences were statistically significant in 2 of 9 scenarios. Male vignette physicians were given more top-box ratings than female vignette physicians. Anchoring vignettes showed a statistically nonsignificant association between vignette ratings and ratings of respondents' own physicians. Our findings revealed a pattern of higher ratings of male vignette physicians when compared to female vignette physicians, which may translate to ratings of patients' own physicians. These findings suggest that current methods to evaluate patients' experiences with their own physicians may disadvantage female physicians.

Persistence of Gender Bias Over Four Decades of Surgical Training

Female surgeons face gender-specific obstacles during residency training, yet longitudinal data on gender bias experienced by female surgery residents are lacking. We aimed to investigate the evolution of gender bias, identify obstacles experienced by female general surgery residents, and discuss approaches to supporting female surgeons during residency training. Between August 2019 and January 2021, we conducted a retrospective cohort study using structured telephone interviews of female graduates of the UCLA General Surgery Residency training program. Responses of early graduates (1981-2009) were compared with those of recent graduates (2010-2020). Quantitative data were compared with Fisher's exact tests and Chi-squared tests. Interview responses were reviewed to catalog gender bias, obstacles experienced by female surgeons, and advice offered to training programs to address women's concerns. Of 61 female surgery residency graduates, 37 (61%) participated. Compared to early graduates (N = 20), recent graduates (N = 17) were significantly more likely to pursue fellowship training (100% vs. 65%, p < 0.01) and have children before or during residency (65% vs. 25%, p = 0.02). A substantial proportion in each cohort experienced some form of gender bias (71% vs. 85%, p = 0.43). Compared to early graduates, recent graduates were significantly less likely to report experiencing explicit gender bias (12% vs. 50%, p = 0.02) but equally likely to report implicit gender bias (71% vs. 55%, p = 0.50). Female graduates across the decades advocated for specific measures to champion work-life balance in residency (51%), strengthen female mentorship (49%), increase childcare support (41%), and promote women into leadership positions (32%). While having children during residency has become more common and accepted over the decades, female surgery residents continue to experience implicit gender bias in the workplace. Female surgeons advocate for targeted interventions to establish systems for parental leave, address gender bias, and strengthen female mentorship.

Wearing same- and opposite-sex virtual bodies and seeing them caressed in intimate areas.

Immersive virtual reality enables people to undergo the experience of owning an artificial body and vicariously feeling tactile stimuli delivered to it. However, it is currently unknown how such experiences are modified by the sexual congruency between the human and the artificial agent. In two studies, heterosexual men (Experiment 1) and women (Experiment 2) embodied same-sex and opposite-sex avatars and were asked to evaluate the experience (e.g., pleasantness, erogeneity) of being touched on social or intimate areas of their virtual body by a male or female avatar. Electrocardiogram and galvanic skin response were also recorded. Moreover, participants' implicit and explicit gender biases were examined via a gender-potency implicit association test and the Ambivalent Sexism Inventory. When embodying a same-sex avatar, men and women rated caresses on intimate areas from an avatar of the opposite sex as more pleasant and erogenous. Conversely, body swap-that is, wearing an opposite-sex avatar-enhanced participants' perceptions of pleasantness and erogeneity for caresses on intimate areas from a same-sex toucher. This effect was stronger in men than in women. Furthermore, physiological correlates of enhanced processing of arousing stimuli predicted behavioural outcomes during the body swap illusion. Wearing an opposite-sex avatar affects one's own body representations and may have important implications on people's attitudes and implicit reactivity to touch-mediated interactions. Men seem more susceptible to this type of body swap illusion. Our paradigm may induce profound changes of cross-sex perspective-taking and provide novel tools for promoting empathy and comprehension of sex-related diversity.

The Rational Dynamics of Implicit Thought

ABSTRACT Implicit attitudes are mental states posited by psychologists to explain behaviours including implicit racial and gender bias. In this paper, I investigate the belief view of the implicit attitudes, on which implicit attitudes are a kind of implicit belief. In particular, I focus on why implicit attitudes, if they are beliefs, are often resistant to updating in light of new evidence. I argue that extant versions of the belief view do not give a satisfactory account of this phenomenon. This is because proponents of the belief view have focused on overly narrow explanations of recalcitrance in terms of belief storage. Expanding the focus of the belief view to the kinds of irrational and arational transitions between beliefs and other mental states provides compelling (if preliminary) explanations of recalcitrance.

Testing for Implicit Gender Bias among Plastic Surgeons.

Background:The aim of this study was to examine for the presence of implicit bias within the field of plastic surgery using a gender-specific Implicit Association Test (IAT), specifically looking at gender and career stereotypes.Methods:A Gender-Career/Family Implicit Association Test was developed and distributed to the international plastic surgery community. Mean scores were calculated. Respondents were provided with an automated summary interpretation of their results, categorizing association for a particular grouping of gender and career/family as a little or no, slight, moderate, or strong. Respondents were also asked a series of demographic and post-IAT questions.Results:Ninety-five responses were available for analysis. Overall, respondents showed a moderate-to-strong association of male + career / female + family compared with the reverse, which was statistically significant. Nearly half of the respondents thought they might have an implicit gender-related bias; however, 50% post-test would not change their behavior based on results, while 9.5% would.Conclusions:Plastics surgeons may have an unconscious tendency to associate men with a career and women with a family. Further steps must be taken to increase awareness and mitigate the impact of implicit gender bias.

Mediators of Gender Wage Disparity in MFT Academia

ABSTRACT Research on gender wage disparity in MFT academia finds women are consistently paid less than men faculty members. This study expands on previous research by testing if peer-reviewed publications and years in the field mediate the effect that faculty members' gender has on salary. Our results support these factors as significant parallel mediators, meaning the effect of a faculty member’s gender on salary, happens byway of peer-reviewed publications and time in the field. No direct effect was found between gender and salary, indicating that gender differences in salary are best explained though indirect pathways of implicit gender bias rather than conscious acts of gender discrimination. Implications are discussed for university administrators wanting to address salary inequities in their MFT programs.

Trends in Gender Distribution Among Authors of Research Studies in Pediatrics: 2015-2019.

* Abbreviation: IQR — : interquartile range In a previous report on the gender distribution of authors of articles published in leading pediatric journals, researchers found disparities in the proportion of articles written by women relative to men, with some closing of the gender gap from 2001 to 2016.1 In 2016, 63% of pediatricians were women; 58% of the publications had a female first author, but only 38% had a female senior author.1,2 Additionally, reports have found that female first authors are associated with female authors in the senior author position and female gender of the first or senior author is associated with a higher number of collaborating departments and institutions.1,3–6 However, to our knowledge, this report is the only study on this topic in the field of pediatrics, assessing authorship gender distribution in 5-year intervals through 2016.1 The Pediatrics editorial board is committed to addressing underrepresentation of all types, including gender differences in authorship. To begin to understand this issue, we evaluated regular articles published in Pediatrics within the past 4.5 years for female representation in authorship, the degree to which the gender of first and senior … Address correspondence to Kriti Puri, MBBS, Texas Children’s Hospital, 6651 Main St, E1420, Houston, TX 77030. E-mail: kriti.puri{at}bcm.edu

Getting Back on Their Feet: Women in Sport and Exercise Academic Network Virtual Conference, Sept 7–8, 2020

Getting Back on Their Feet: Women in Sport and Exercise Academic Network Virtual Conference, Sept 7–8, 2020

The female medical workforce.

In the UK, the proportion of female medical students has remained static over the last decade, at around 55%; however, at consultant level, only 36.6% of doctors are women. The reasons for this drop in numbers are not clear. Given the increase in number of female doctors in training, the proportion of female doctors at consultant level is lower than might be expected. This article discusses issues affecting the female medical workforce in anaesthesia, intensive care and pain medicine. It explores how gender stereotypes and implicit gender bias can affect the way women are perceived in the workplace, especially in leadership positions, and discusses health issues particular to the female medical workforce. While the issues in this article may not affect all women, the cumulative effect of being subject to gender stereotypes within a workplace not designed to accommodate the health needs of women may contribute to a work environment that may promote the attrition of women from our specialties.

The Diversity Crisis in Software Development

This special issue of IEEE Software focuses on diversity and inclusion in software development, presenting research results and best practices for making the field equitable for all. It is well documented that the industry does not provide evenhanded participation conditions. Research has shown that implicit gender biases significantly impact hiring decisions,¹ women disengage faster than men,² Palestinian tech entrepreneurs do not have access to Internet-based distribution and payment platforms,³ software developers with a visual impairment lack tools to navigate code editors,^4,5 and women are sometimes less likely to get their code accepted.⁶ Tools, processes, products, and education are not inclusive. Dimensions such as geography, gender, socioeconomic politics, age, ethnicity, and disability shape who can participate in creating technology.

An instructional exercise in gender bias

Both men and women pursue careers in accounting equally, but the percentage of women that remain in the public accounting profession dwindles among the higher-tier and lead positions of larger firms (Association of International Certified Public Accountants (AICPA) 2019). While there are many variables that could affect this trend, one factor might be fewer advancement opportunities for women due to implicit bias within the profession. Since decisions about what positions to pursue, who to hire, and who to promote will be important choices in a student’s future accounting career, we thought it would be essential to teach awareness of gender bias in the profession and to prepare students with techniques to recognize and decode implicit gender biases. For this instructional exercise, our students participated in a simple experiment, attended a lecture with discussion on gender bias and occupational stereotypes, and reviewed and discussed the compiled data from their responses.We found that sharing the data comparisons by gender helped to spark lively discussions and create memorable learning experiences.We explore the topics of gender bias and gender coded words in an activity that was developed to test for bias and to be used to build awareness of potential gender bias in hiring or promotion activities. As the profession seeks to understand more about creating an inclusive environment to retain employees, this timely experiment to explore how implicit bias could occur in hiring and promotion is an intervention itself.

Experiences and Perceptions of Gender Discrimination and Equality among Korean Surgeons: Results of a Survey of the Korean Surgical Society.

BackgroundPrevious studies that have focused on the challenges faced by female surgeons, such as the gender pay gap, gender biases, lower likelihood of promotion, and gender differences in the perception of discrimination against women, are reviewed. A more comprehensive understanding of explicit and implicit gender discrimination and experiences and perceptions of discrimination is needed. This study aims to determine the current prevalence and degree of gender discrimination in the Korean Surgical Society and to compare the experiences and perceptions of gender discrimination between male and female surgeons.MethodsWe analyzed 400 responses from a survey sent to all members of the Korean Surgical Society. This electronic survey included 16 items on experiences of gender discrimination and 17 items on perceptions of gender discrimination. We conducted χ2 tests and binary logistic regression on the data regarding these experiences and perceptions of gender discrimination.ResultsAdjusted analyses found that female surgeons were more likely to experience gender discrimination than their male counterparts across all categories of discrimination. Further, adjusted analyses showed that female surgeons were more likely to confirm the presence of gender discrimination than male surgeons.ConclusionFemale surgeons were more likely to experience implicit and explicit gender biases and discrimination throughout all stages of their career progression. We also discovered significant gender differences in the perception of gender discrimination, as well as the experience of it. Changing the male-dominated culture and raising awareness of gender biases and discrimination among male surgeons are crucial steps toward addressing gender discrimination in surgery.

136. In Their Own words: a Qualitative Analysis of Factors Contributing to Gender Bias in Academic Advancement in Infectious Disease

BackgroundLarge and persistent inequities in academic advancement exist between men and women faculty in academic Infectious Diseases (ID). To identify and characterize beliefs about why these inequities persist in ID, we asked ID faculty members to share their thoughts and experiences with the advancement process.Characteristics of Focus Group Participants Summary of Main Emergent Themes from Focus Group Analysis MethodsWe conducted four 60-minute focus groups with ID faculty members during IDWeek 2019. We enrolled women that were diverse geographically and in academic rank (i.e., Instructor/Assistant, Associate, Full Professor). We assigned women to focus groups by rank to minimize social desirability bias across rank. Our fourth focus group included only men who were Full Professors, to capture additional perspectives about barriers to advancement and solutions. (Table 1) We analyzed focus group discussion transcripts using content analysis.ResultsWe identified nine main themes regarding inequities in academic advancement of women in ID. (Table 2) In all 4 focus groups, gender bias as a barrier to academic advancement was a major theme. Women Full Professors emphasized explicit gender bias such as sexual harassment and “predatory mentoring,” whereas women Instructors/Assistant Professors more frequently cited barriers related to implicit bias, such as obscure maternity leave policies and divisional meetings scheduled during childcare hours. Women Associate Professors cited implicit and explicit gender bias, while men Full Professors focused primarily on implicit bias. Women Instructors/Assistant Professors experienced the greatest difficulty in balancing demands of family with career, though this was a prominent theme in all groups. The perception that women less often utilize negotiation to advance themselves was a dominant theme for women Associate Professors, though all groups raised examples of this theme.ConclusionGender bias, both implicit and explicit, is an important and ongoing barrier to equitable academic advancement of women in ID. Difficulty balancing demands of family with career and gender differences in professional negotiation are also perceived barriers that can be targeted by innovative programs and interventions to address gender disparities in academic advancement.Disclosures All Authors: No reported disclosures

Research Report: Implicit and Explicit Measures of Sexism Predicting Men’s Interviewing Behaviors

Implicit (Indirect measures of bias often capturing unconscious biases such as eye tracking) and explicit (direct survey measures capturing conscious biases such as the Ambivalent Sexism Inventory (ASI): Glick and Fiske, 2001) sexism were measured in men who then interviewed a female job seeker. The results of this study examined explicit outcomes of the interviews (ratings) as well as implicit outcomes (non-verbal behaviors). Higher levels of implicit gender bias (Eye tracking) was significantly related to the outcomes and was a better predictor of sexist non-verbal behaviors than the explicit measure.

Gender Representation Matters: Intervention to Solicit Medical Resident Input to Enable Equity in Leadership in Graduate Medical Education

Gender equity in leadership across academic medicine remains a concern. The case of chief resident (CR) offers an opportunity to explore novel strategies in leadership selection in graduate medical education (GME). Means of identifying potential candidates for CR often rely on faculty assessment of resident performance, yet implicit gender bias has the potential to influence this assessment. To diversify the metrics used in CR selection, an intervention was implemented to solicit resident input to identify candidates for CR at 2 U.S. internal medicine residency programs in 2018 and 2019. This involved a simple, cross-sectional survey of residents in which they were asked to identify individual residents as good candidates for consideration for CR. There were 298 of 518 internal medicine resident responses to this intervention across sites and years (mean 58.2% response rate). Nomination patterns of residents and program leaders correlated significantly (correlation coefficient 0.62, P < .001). Controlling for site and year, gender was a significant factor associated with who residents nominated for CR (β-coefficient 0.325, P = .004) with women residents more likely to identify women for CR (odds ratio 1.38, 95% confidence interval 1.11-1.73). Fifty residents nominated themselves for CR, and there was no significant difference by gender (β-coefficient 0.038, P = .91). Soliciting resident input to identify candidates for CR may enable gender representation of candidates for this position. Influencing candidate choices may be a promising way to impact leadership selection in medicine.

On the malleability of gender attitudes: Evidence from implicit and explicit measures in Tunisia

• Novel field application of an implicit association test to measure gender attitudes. • Experimental evidence on the malleability of gender attitudes in the Arab context. • A randomized video mitigates the implicit gender bias among conservative women. • Interviewer’s gender and perceived religiosity affect explicit gender attitudes more. In many regions of the world, significant parts of society are persistently unsupportive of female empowerment. The role of women is often still defined by social norms, rather than legal rights, hampering economic development. Women’s empowerment has therefore become a top priority on development agendas, also testified by an increasing number of policy interventions aiming to promote gender equality. To monitor progress in this area we need reliable data on gender attitudes. However, standard self-reported measures of gender attitudes are prone to a wide range of measurement errors and social desirability bias. In this paper we address this problem and use a new field application of the implicit association test (IAT), next to a set of standard survey questions, to measure implicit gender attitudes in Tunisia. Implicit attitudes are considered less susceptible to measurement bias and may serve to more accurately assess gender attitudes. Further, we examine the malleability of implicit gender attitudes using a randomized video intervention illustrating real-life gender reforms in Tunisia, and natural variation in interviewer characteristics with respect to gender and perceived religiosity. Our study finds that the video has no average impact on implicit (IAT-based) attitudes, which is consistent with the idea that in a highly polarized society like Tunisia such an intervention only affects specific groups in a society. We indeed find that the video mitigates the implicit gender bias only among the specific subpopulation of conservative women. We also confirm the presence of interviewer effects. Yet, impacts are more pronounced for explicit attitudes, which may suggest social desirability at work in surveys. We believe that our study may inform policymakers on the potential power of light interventions and helps improve measurements related to gender norms and attitudes.