A Values Affirmation Intervention to Improve Female Residents' Surgical Performance.

BACKGROUND Female residents in surgical training may face stereotype threat. The awareness of negative stereotypes about surgical ability based on gender may heighten stress and thus reduce performance. OBJECTIVE The main objective of this study was to assess the effectiveness of a brief stress-reducing writing exercise, known as a values affirmation, to mitigate the negative effects of stereotype threat on the performance of female surgical residents. METHODS This is a randomized, controlled trial in which 167 residents were invited to participate. A total of 45 resident volunteers, including 18 women, were randomized to the affirmation condition or the no-affirmation condition. We administered a values affirmation intervention and measured clinical evaluations data both prior to and 6 months after the intervention. RESULTS Women benefited from the affirmation. Women who had participated in the affirmation exercise earned higher clinical evaluation scores than those in the control condition (B = 0.34, P < .05). For men, performance did not differ by affirmation condition (B = -0.20, P = .35). CONCLUSIONS Our findings suggest a benefit of values affirmation for women in surgical training, as measured by performance on clinical evaluations. This suggests that a brief psychological intervention may improve on-the-job performance for women in surgery, an underrepresented group.