Hagen, Kate M.

Abstract Purpose This scoping review summarises five decades of research on gender bias in subjective performance evaluations of medical trainees. Method A medical librarian searched PubMed, Ovid Embase, Scopus, Web of Science and Cochrane DBSR in June 2020. Two researchers independently reviewed each abstract to determine if it met inclusion criteria (original research article investigating gender bias in subjective medical trainee evaluations by staff). References from selected articles were also reviewed for inclusion. Data were extracted from the articles, and summary statistics were performed. Results A total of 212 abstracts were reviewed, and 32 met criteria. Twenty (62.5%) evaluated residents, and 12 (37.5%) studied medical students. The majority of studies on residents were Internal Medicine ( n = 8, 40.0%) and Surgery ( n = 7, 35.0%). All studies were performed in North America and were either retrospective or observational. Nine (28.0%) were qualitative, and 24 (75.0%) were quantitative. The majority of studies were published in the last decade ( n = 21, 65.6%). Twenty (62.5%) studies documented gender bias, of which 11 (55%) found that males received higher quantitative performance evaluations and 5 (25%) found that females received higher evaluation scores. The remaining 4 (20%) reported gender differences in qualitative evaluations. Conclusions Most studies detected gender bias in subjective performance evaluations of medical trainees, with a majority favouring males. There is a paucity of studies on bias in medical education with a lack of standardised approach to investigating bias.

AbstractBackgroundThe need exists for a device that can rapidly and accurately assess mild cognitive impairment (MCI). Because the link between oculometrics and cognition is well‐documented, the Oculo‐Cognitive Addition Test (OCAT) was developed which tracks users’ eye movements as they complete a simple mental addition test.MethodOCAT consisted of 12 trials of summing three consecutive single‐digit numbers, shown separately on three consecutive screens (Figure 1). The first, second, and third screen in each trial corresponded to low, medium, and high cognitive workload. Using an infinity‐loop pattern of 24 symmetrical positions, eye movements were captured systematically in horizontal, vertical, and diagonal directions (Figure 2).MCI was simulated by exposing subjects to 5 minutes of hypoxic gas mixture (8% O2 + balance N2). 20 subjects completed OCAT in baseline (i.e. normal room air), hypoxic, and post‐baseline (i.e. 20 minutes of room air) conditions. Raw scan‐paths were collected with an eye‐tracking device. Oculometrics pertaining to fixations and saccades were extracted. Statistical significance was assessed using repeated measures ANOVA. Effect size and clinical significance was evaluated using computed Cohen’s d.ResultOCAT completion time significantly increased from baseline to hypoxia, which corresponded to a significant decrease in cerebral oxygenation from baseline to hypoxia (Figure 3). From baseline to hypoxia, saccadic latency significantly increased while saccadic velocity significantly decreased in the diagonal direction, however, results in the horizontal and vertical directions were not significant (Figure 4). Fixation time significantly increased from baseline to hypoxia in medium and high cognitive workload, but did not significantly change in low cognitive workload (Figure 5). From baseline to hypoxia, fixation size did not significantly change in any cognitive workload, however, the fluctuation in fixation size significantly increased in medium cognitive workload. From baseline to hypoxia, fixation area significantly increased in low and high cognitive workload, but did not significantly change in medium cognitive workload.ConclusionOCAT can detect subtle changes in oculometrics that correlate with MCI. This study provides rationale for providing varying degrees of cognitive load to elucidate subtle changes in oculometrics that may otherwise go undetected in neurocognitive tests that do not increase cognitive load.