PS6-04: THE INTERACTION EFFECT OF ROLE AND GENDER ON PSYCHOLOGICAL SAFETY
Nathaniel A Lee, MD1, Nital Appelbaum, PhD2, Sally Santen, MD, PhD2, Amelia Grover, MD, FACS1, Stephanie Goldberg, MD, FACS1; 1VCU Health, 2VCU School of Medicine
Background: Psychological safety is the belief that one can speak up without fear of negative consequences. This measure has been correlated to well-being and other metrics regarding perceptions of the work environment. We aimed to investigate the interaction between gender and role on metrics for well-being and perceptions of the work environment.
Methods: Between May-June 2018, a Department of Surgery surveyed its housestaff and faculty on well-being (i.e., perceived stress, positive indicators of well-being, negative indicators of well-being) and perceptions of the work environment (i.e., perceived organizational support, psychological safety) via paper and electronic survey. A 2x2 ANOVA was conducted to determine whether there was an interaction effect between gender (Male, Female) and role (Resident, Attending) for well-being and work environment composite scores. Further interaction effects were conducted at the scale-item level for constructs with significant differences to identify areas for improvement.
Results: 50 Surgery residents and 41 Surgery attendings completed our survey with their gender identified across four divisions. Of the five scale measures, there was an interaction effect between role and gender on psychological safety. Female attendings (3.27±0.98) had significantly lower psychological safety compared to female residents (3.75±0.44), male residents (3.87±0.58), and male attendings (4.05±0.49), F(1,87)=6.03, p=.016, partial eta squared=.065. Three of seven psychological safety scale-items reflected more negative perceptions for female attendings: “If you make a mistake in my department, it is often held against you, F(1,87)=4.60, p=.035”, “People in my department sometimes reject others for being different, F(1,87)=9.25, p=.003”, and “No one in my department would deliberately act in a way that undermines my efforts, F(1,87)=9.30, p=.003”.
Conclusions: Further investigation is needed to identify methods of facilitating the transition to an attending role for female residents, considering this transition correlated with increased safety for male residents and decreased safety for females. Qualitative interviewing may provide context to situations threatening psychological safety. Longitudinal assessment starting in graduate medical education and into attending practice may demystify why such an interaction effect is prominent in Surgery, allowing targeted interventions to abrogate this affect.