A survey-based assessment of attending surgeons’ experiences with intervening against discrimination toward surgical trainees

Abstract Purpose Discriminatory behaviors against surgical trainees have been documented in surgical learning environments. These experiences have major impacts on career satisfaction, progression and attrition. Our objective was to explore attendings’ experiences of witnessing discrimination, knowledge of strategies for intervening when witnessing discrimination, intervention behaviors, and facilitators and barriers to such intervention. Methods A survey was developed to gather information on whether respondents have witnessed discrimination against surgical trainees, types of intervention behaviors, reasons for their decisions to intervene or not, responses to discriminatory scenarios, preferences for training in intervention strategies, experiences with training, and demographics. The survey was distributed via email to attending surgeons across four institutions for a total of 355 survey invitations. Results We received 102 responses (29% response rate). Respondents witnessed discrimination against trainees from patients (66%), medical staff (49%) and other attendings (30%). Eighty-seven participants responded to engaging and completing intervention programs that taught upstander intervention skills. 61% were aware of intervention programs, and 40% were not aware of such programs. 63% of participants engaged in intervention training, and 37% did not complete training. Of the 87 participants, 26% felt very knowledgeable about intervention skills, and 29% felt very confident in intervening. In performing chi-square tests, there were significant differences between awareness and completion of programs and feeling confident and knowledgeable about intervening. Conclusions Education on intervening when witnessing discrimination against trainees is needed for attending surgeons to increase their awareness of and confidence in using effective intervention behaviors.