Unconscious Bias in Speaker Introductions at a Surgical Oncology Meeting: Hierarchy Reigns Over Gender
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ORIGINAL ARTICLE – HEALTH SERVICES RESEARCH AND GLOBAL ONCOLOGY
Unconscious Bias in Speaker Introductions at a Surgical Oncology Meeting: Hierarchy Reigns Over Gender Camille L. Stewart, MD1, James P. De Andrade, MD1, Narjust Duma, MD2, Oliver K. Ralph, MS1, Kevin Choong, MD1, Lorena Gonzalez, MD1, Natalie C. McClintock, MD3, Ethan Sandoval1, Laleh G. Melstrom, MD1, and Susanne G. Warner, MD1 Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, CA; 2Department of Medicine, Division of Hematology, Medical Oncology and Palliative Care, University of Wisconsin, Madison, WI; 3 Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA 1
ABSTRACT Background. Recent reviews of medical conferences have shown that women were less likely to receive a formal introduction compared with men. We examined speaker introductions at the Society of Surgical Oncology (SSO) annual meeting to determine whether similar biases exist within our organization. Methods. An observational study of video-archived speaker introductions at the 2018 and 2019 SSO annual meetings was conducted. Professional address was defined as professional title followed by full name or last name. Multivariable logistic regression was used to identify factors associated with form of address. Results. There were 499 speaker introductions reviewed. Speakers included 290 (58%) men and 238 (49%) postgraduate trainees (residents and fellows). A non-professional form of address was used to introduce 148 (30%) speakers and was most often used for post-graduate trainees (33%). Full professors were more likely than junior faculty to introduce speakers with a non-professional form of address (37% of full professors vs 18% of assistant professors, p \ 0.001). In multivariable regression analysis these findings persisted. Trainees were 2.8 times more likely to receive a non-professional form of address (p = 0.003). Use of a non-professional introduction did not
Ó Society of Surgical Oncology 2020 First Received: 27 April 2020 Accepted: 8 June 2020 C. L. Stewart, MD e-mail: [email protected]
significantly vary by the speaker’s nor the introducer’s gender. Conclusions. Residents and fellows were more likely to receive a non-professional form of address, and the likelihood of this increased with rising seniority of the introducer. The manner of speaker introduction did not vary by gender in our organization. More research is needed to explore the influence of these disparities on academic advancement for the next generation of surgical oncologists. Keywords Unconscious bias Implicit bias Academic surgery Academia Unconscious bias and microaggressions are subtle but real methods of marginalization in the professional workforce that are increasingly being recognized.1 Within medicine, these may manifest in the introduction of speakers at professional meetings. Use of a professional form of address such as ‘‘doctor’’ or ‘‘professor’’ while introducing a speaker implies authority of the speaker and respect by the introduc
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