Comparison of Performance Score for Female and Male Residents in General Surgery Doing Supervised Real‐Life Laparoscopic Appendectomy: Is There a Norse Shield‐Maiden Effect?

Background Gender bias may represent a threat to resident assessment during surgical training, and there have been concerns that women might be disadvantaged. There is a lack of studies investigating gender differences in ‘entry‐level’ real‐life procedures, such as laparoscopic appendectomy. We aimed to explore potential gender disparities in self‐evaluation and faculty evaluation of a basic surgical procedure performed by junior surgical residents in general surgery. Methods A structured training program in laparoscopic appendectomy was implemented before undertaking evaluation of real‐life consecutive laparoscopic appendectomies by junior residents in general surgery. Resident and faculty gender‐pairs were assessed. Intraclass correlation coefficient (ICC) was calculated using a single‐rater, consistency, 2‐way mixed‐effects model. Results A total of 165 paired sessions were completed to evaluate resident–faculty scores for the procedure. Overall, 19 residents participated (43% women) and 26 faculty (42% women) were involved. The overall correlation between faculty and residents was good (ICC > 0.8). The female–female pairs scored higher for most steps, achieving excellent (ICC ≥ 0.9) for several steps and for overall performance. Female residents were more likely to give a higher self‐evaluated score on own performance particularly if evaluated by a female faculty. Also, female trainees had highest correlation‐score with male faculty. Conclusions This study found higher performance scores in female surgical residents evaluated during real‐time laparoscopic appendectomy. No negative gender bias toward women was demonstrated. Better insight into the dynamics of gender‐based interaction and dynamics in both training, feedback and influence on evaluation during training is needed when evaluating surgical training programs.