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The Context of "Confidence": Analyzing the Term Confidence in Resident Evaluations.


ABSTRACT:

Background

Despite similar performance metrics, women medical trainees routinely self-assess their own skills lower than men. The phenomenon of a "confidence gap" between genders, where women report lower self-confidence independent of actual ability or competency, may have an important interaction with gender differences in assessment. Identifying whether there are gender-based differences in how confidence is mentioned in written evaluations is a necessary step to understand the interaction between evaluation and the gender-based confidence gap.

Objective

To analyze faculty evaluations of internal medicine (IM) residents for gender-based patterns in the use of iterations of "confidence."

Design

We performed a retrospective cohort study of all inpatient faculty evaluations of University of Pennsylvania IM residents from 2018 to 2021. We performed n-gram text-mining to identify evaluations containing the terms "confident," "confidence," or "confidently." We performed univariable and multivariable logistic regression to determine the association between resident gender and references to confidence (including comments reflecting too little confidence), adjusting for faculty gender, post-graduate year (PGY), numeric rating, and service.

Subjects

University of Pennsylvania IM residents from 2018 to 2021.

Key results

There were 5416 evaluations of IM residents (165 women [51%], 156 men [49%]) submitted by 356 faculty members (149 women [51%]), of which 7.1 % (n=356) contained references to confidence. There was a significant positive association between the mention of confidence and women resident gender (OR 1.54, CI 1.23-1.92; p<0.001), which persisted after adjustment for faculty gender, numeric rating, and PGY level. Eighty evaluations of the cohort explicitly mentioned the resident having "too little confidence," which was also associated with women resident gender (OR 1.66, CI 1.05-2.62; p=0.031).

Conclusion

Narrative evaluations of women residents were more likely to contain references to confidence, after adjustment for numerical score, PGY level, and faculty gender, which may perpetuate the gender-based confidence gap, introduce bias, and ultimately impact professional identity development.

SUBMITTER: Heath JK 

PROVIDER: S-EPMC9296754 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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The Context of "Confidence": Analyzing the Term Confidence in Resident Evaluations.

Heath Janae K JK   Alvarado Meagan E ME   Clancy Caitlin B CB   Barton Todd D TD   Kogan Jennifer R JR   Dine C Jessica CJ  

Journal of general internal medicine 20220616 9


<h4>Background</h4>Despite similar performance metrics, women medical trainees routinely self-assess their own skills lower than men. The phenomenon of a "confidence gap" between genders, where women report lower self-confidence independent of actual ability or competency, may have an important interaction with gender differences in assessment. Identifying whether there are gender-based differences in how confidence is mentioned in written evaluations is a necessary step to understand the intera  ...[more]

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