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      Gender differences in the learning and teaching of surgery: a literature review

      review-article

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          Abstract

          Objectives

          To explore evidence concerning gender differences in teaching and learning in surgery to guide future initiatives.

          Methods

          This systematic review was conducted searching in the following electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, Scopus and PubMed. All studies related to gender differences in surgical education, teaching or learning of surgery at an undergraduate level were included. Data was extracted and critically appraised. Gender differences in learning, teaching, skills acquisition, perceptions and attitudes, interest on surgery, personality and factors influencing interest in surgical careers were differentiated.

          Results

          There is an underrepresentation of women in surgical academia, due to lack of role models and gender awareness. It is not clear whether or not gender itself is a factor that affects the learning of surgical tasks. Female students pursuing a surgical career had experienced sexual harassment and gender discrimination that can have an effect on the professional identity formation and specialty choice. There are differences in personality among female and male students interested in surgery. Gender is a determining factor to choose surgery, with a consistent lower proportion of women compared interested in pursuing a surgical career. Mentoring and personality fit are important in medical student’s specialty selection. Female students are more likely to be discouraged from pursuing a surgical career by a lack of female role models.

          Conclusions

          Bias against women in surgery still exists. There is a lack of studies that investigate the role of women in the teaching of surgery.

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          Most cited references50

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          A preliminary study of empathy, emotional intelligence and examination performance in MBChB students.

          There is considerable interest in the attributes other than cognitive ability that medical students need in order to be professionally successful, with a particular focus on empathy and emotional intelligence (EI). Selection considerations have also motivated interest in such attributes as predictors of academic success. There are reports of declines in empathy in US medical students, but no comparative information is available for UK students. This study aimed to compare empathy levels in medical students in Years 2, 3 (pre-clinical) and 5 (clinical), to examine gender differences in empathy and EI, and to investigate whether EI and empathy are related to academic success. Questionnaires assessing EI and empathy were completed by students. Previous empathy scores for the Year 2 cohort were also available. Empathy trends were examined using anova; trends for the Year 2 group for whom Year 1 scores were available were examined using repeated-measures anova. Associations of EI and empathy with academic success were examined using Pearson correlation. A significant gender x cohort effect was found, with male empathy scores increasing between Years 1 and 2, whilst female scores declined. Peer ratings in Year 2 problem-based learning (PBL) groups were positively correlated with EI. Trends in levels of empathy differed by gender. The reasons for this require further investigation, particularly in relation to course content. Associations between academic performance and EI were sparse, and there were none between academic performance and empathy, but the effects of EI (and other characteristics) on PBL group functioning represent a promising area for future study.
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            Impact of hand dominance, gender, and experience with computer games on performance in virtual reality laparoscopy.

            The impact of gender and hand dominance on operative performance may be a subject of prejudice among surgeons, reportedly leading to discrimination and lack of professional promotion. However, very little objective evidence is available yet on the matter. This study was conducted to identify factors that influence surgeons' performance, as measured by a virtual reality computer simulator for laparoscopic surgery. This study included 25 surgical residents who had limited experience with laparoscopic surgery, having performed fewer than 10 laparoscopic cholecystectomies. The participants were registered according to their gender, hand dominance, and experience with computer games. All of the participants performed 10 repetitions of the six tasks on the Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) within 1 month. Assessment of laparoscopic skills was based on three parameters measured by the simulator: time, errors, and economy of hand movement. Differences in performance existed between the compared groups. Men completed the tasks in less time than women ( p = 0.01, Mann-Whitney test), but there was no statistical difference between the genders in the number of errors and unnecessary movements. Individuals with right hand dominance performed fewer unnecessary movements ( p = 0.045, Mann-Whitney test), and there was a trend toward better results in terms of time and errors among the residence with right hand dominance than among those with left dominance. Users of computer games made fewer errors than nonusers ( p = 0.035, Mann-Whitney test). The study provides objective evidence of a difference in laparoscopic skills between surgeons differing gender, hand dominance, and computer experience. These results may influence the future development of training program for laparoscopic surgery. They also pose a challenge to individuals responsible for the selection and training of the residents.
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              Conducting systematic reviews in medical education: a stepwise approach.

              As medical education research continues to proliferate, evidence syntheses will become increasingly important. The purpose of this article is to provide a concise and practical guide to the conduct and reporting of systematic reviews.   (i) Define a focused question addressing the population, intervention, comparison (if any) and outcomes. (ii) Evaluate whether a systematic review is appropriate to answer the question. Systematic and non-systematic approaches are complementary; the former summarise research on focused topics and highlight strengths and weaknesses in existing bodies of evidence, whereas the latter integrate research from diverse fields and identify new insights. (iii) Assemble a team and write a study protocol. (iv) Search for eligible studies using multiple databases (MEDLINE alone is insufficient) and other resources (article reference lists, author files, content experts). Expert assistance is helpful. (v) Decide on the inclusion or exclusion of each identified study, ideally in duplicate, using explicitly defined criteria. (vi) Abstract key information (including on study design, participants, intervention and comparison features, and outcomes) for each included article, ideally in duplicate. (vii) Analyse and synthesise the results by narrative or quantitative pooling, investigating heterogeneity, and exploring the validity and assumptions of the review itself. In addition to the seven key steps, the authors provide, information on electronic tools to facilitate the review process, practical tips to facilitate the reporting process and an annotated bibliography. © Blackwell Publishing Ltd 2012.
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                Author and article information

                Journal
                Int J Med Educ
                Int J Med Educ
                IJME
                International Journal of Medical Education
                IJME
                2042-6372
                15 June 2014
                2014
                : 5
                : 110-124
                Affiliations
                [1 ]Division of Pediatric Surgery, Department of Women’s and Children’s Health, Karolinska Institutet, Sweden
                [2 ]Department of Neuroscience, Karolinska Institutet, Sweden
                Author notes
                Correspondence: Carmen Mesas Burgos, Division of Pediatric Surgery, Department of Women’s and Children’s Health, Karolinska University Hospital, Q3:03, SE-17176 Stockholm, Sweden. Email: Carmen.Mesas.Burgos@ 123456ki.se
                Article
                5-110124
                10.5116/ijme.5380.ca6b
                4207172
                25341220
                9fb824c8-801c-4159-ae34-20d339a173f1
                Copyright: © 2014 Carmen M. Burgos et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use of work provided the original work is properly cited. http://creativecommons.org/licenses/by/3.0/

                History
                : 24 May 2014
                Categories
                review-article
                Teaching and Learning

                gender,surgery,medical education,surgical education,undergraduate,teaching and learning

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