All ETDs from UAB

Advisory Committee Chair

Irena Stepanikova

Advisory Committee Members

Cindy Cain

Brenessa M Lindeman

David A Rogers

Joseph D Wolfe

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences


In medical training and throughout medical careers, women face disadvantages –especially in surgery. To better understand origins of these gender inequalities, this study examines the role of gender in surgical training, focusing on trust between faculty serving as attendings and medical residents. An environment of trust enables residents to gain handson experience and acquire practical skills during surgeries performed jointly with attendings. 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 attendings. Furthermore, seventeen attendings and ten surgery residents gave in-depth interviews. Attendings’ average entrustment was modeled using linear regression models with robust estimators, controlling for resident and attending demographic backgrounds and intraoperative factors. The results revealed gender disparities in trust. Female residents experienced a loss of trust from their attendings when performing their second to fourth surgery together, whereas male residents rapidly gained trust at the same point of their training. These findings suggest that experience in iv the operating room benefits male trainees more than female trainees in terms of faculty trust. Qualitative results indicate that gender stereotypes and biases influence attendings’ trust in female residents, thus limiting female residents’ active participation inside the operating room. These findings inform interventions to ensure equal surgical opportunities for female residents.



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