SDDF Abstracts 2022

**Background:** The majority of physicians in gastroenterology are men, with female physicians constituting less than 20%. As more women pursue careers in surgical fields, gender bias has been shown to negatively impact the evaluation of their technical skills. This study aimed to assess whether gender bias existed in assessing endoscopic skills of fellows performing polypectomy.

**Methods:** This was a cross-sectional study of gastroenterology consultants in Saudi Arabia. Participants were shown a video of endoscopic polypectomy through a web-based link. Participants were randomly assigned to either evaluate a hypothetical male or female fellow; both groups were shown the same video. The fellow's gender and level of training were included in the scenario. Evaluation was done using the standardised method known as the Direct Observation of Polypectomy skills (DOPyS). A scoring of 3 or more is considered desirable.

**Key Results:** Seventy-six evaluators participated in the study. The majority (88.15%) were men. Three quarters (76%) were involved in training fellows in their practice. 47% were asked to evaluate female fellows. The overall median score was 3. Although the polypectomy video was the same, participants were more likely to give the higher score of 4 to the hypothetical male fellows than female fellows (7 vs 3) (P=0.29). The evaluator's gender or age had no impact on the way they evaluated trainees. Endoscopists performing more than 30 procedures per week were more likely to score trainees of both genders lower compared to those who performed less procedures (P=0.027).

**Clinical Implications:** Female trainees had numerically lower scores while performing the same procedure compared to their male counterparts. Although this was not statistically significant, it may have been related to the relatively small sample size. The finding that high-volume endoscopists (>30 procedures/week) scored all trainees lower (P=0.027) is an important confounder that may reflect higher performance standards among more experienced practitioners. These results highlight the need for standardized, objective assessment tools in endoscopic training that minimize potential for gender bias. More studies are required to identify and address gender bias in gastroenterology. The study raises awareness about unconscious bias in procedural skill assessment, which is particularly relevant as the field seeks to increase female representation from the current <20% level.