Gender disparities in surgical training and assessment are described in the general surgery literature. Assessment disparities have not been explored in vascular surgery. We sought to investigate gender disparities in operative assessment in a national cohort of vascular surgery integrated residents (VIRs) and fellows (VSFs). Operative performance and autonomy ratings from the Society for Improving Medical Professional Learning (SIMPL) application database were collected for all vascular surgery participating institutions from 2018 to 2023. Logistic generalized linear mixed models were conducted to examine the association of faculty and trainee gender on faculty and self-assessment of autonomy and performance. Data were adjusted for post-graduate year and case complexity. Random effects were included to account for clustering effects due to participant, program, and procedure. One hundred three trainees (n = 63 VIRs; n = 40 VSFs; 63.1% men) and 99 faculty (73.7% men) from 17 institutions (n = 12 VIR and n = 13 VSF programs) contributed 4951 total assessments (44.4% by faculty, 55.6% by trainees) across 235 unique procedures. Faculty and trainee gender were not associated with faculty ratings of performance (faculty gender: odds ratio [OR], 0.78; 95% confidence interval [CI], 0.27-2.29; trainee gender: OR, 1.80; 95% CI, 0.76-0.43) or autonomy (faculty gender: OR, 0.99; 95% CI, 0.41-2.39; trainee gender: OR, 1.23; 95% CI, 0.62-2.45) of trainees. All trainees self-assessed at lower performance and autonomy ratings as compared with faculty assessments. However, women trainees rated themselves significantly lower than men for both autonomy (OR, 0.57; 95% CI, 0.43-0.74) and performance (OR, 0.40; 95% CI, 0.30-0.54). Although gender was not associated with differences in faculty assessment of performance or autonomy among vascular surgery trainees, women trainees perceive themselves as performing with lower competency and less autonomy than their male colleagues. These findings suggest utility for exploring gender differences in real-time feedback delivered to and received by trainees and targeted interventions to align trainee self-perception with actual operative performance and autonomy to optimize surgical skill acquisition.

中文翻译：

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全国血管外科学员队列中自主性和表现评估的性别差异

普通外科文献描述了外科培训和评估中的性别差异。尚未探讨血管手术中的评估差异。我们试图调查全国血管外科住院医师 (VIR) 和研究员 (VSF) 队列中手术评估中的性别差异。从 2018 年至 2023 年，改善医学专业学习协会 (SIMPL) 应用数据库中收集了所有血管外科参与机构的手术表现和自主性评级。采用 Logistic 广义线性混合模型来检验教师和实习生性别对教师和实习生的影响。自主性和绩效的自我评估。数据根据研究生年份和案例复杂性进行了调整。随机效应被包括在内，以解释由于参与者、项目和程序而产生的聚类效应。来自 17 个机构（n = 12 个 VIR 和 n = 13 个 VSF 项目）的 103 名学员（n = 63 VIR；n = 40 VSF；63.1% 为男性）和 99 名教员（73.7% 为男性）贡献了 4951 项总评估（其中 44.4% 为男性）。教师（55.6% 为实习生）涵盖 235 个独特程序。教师和实习生性别与教师绩效评分无关（教师性别：比值比 [OR]，0.78；95% 置信区间 [CI]，0.27-2.29；实习生性别：OR，1.80；95% CI，0.76-0.43 ）或受训者的自主性（教师性别：OR，0.99；95% CI，0.41-2.39；受训者性别：OR，1.23；95% CI，0.62-2.45）。与教师评估相比，所有学员的自我评估表现和自主性评级较低。然而，女性学员对自己的自主性（OR，0.57；95% CI，0.43-0.74）和表现（OR，0.40；95% CI，0.30-0.54）的评价均显着低于男性。尽管性别与血管外科受训人员对表现或自主权的评估差异无关，但女性受训人员认为自己的能力和自主权低于男同事。这些发现表明，探索向受训者提供和接收的实时反馈中的性别差异以及有针对性的干预措施是有用的，以使受训者的自我认知与实际手术表现和自主权相一致，从而优化手术技能的掌握。