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. 2025 Apr 17;68(2):E150-E159.
doi: 10.1503/cjs.006324. Print 2025 Mar-Apr.

A roadmap for surgeon leaders in improving gender equity: educational strategies, implementation, and evaluative methods

Marcia Clark  1 , Laurie A Hiemstra  2 , Sarah Kerslake  2 , Erin Boynton  2 , Claire Temple-Oberle  2
Affiliations

A roadmap for surgeon leaders in improving gender equity: educational strategies, implementation, and evaluative methods

Marcia Clark et al. Can J Surg. .

Abstract
in English, French

Background: Gender diversity is lacking in the orthopedic workforce, and patient outcomes are known to be negatively affected when gender inequity exists. Following an unpublished needs assessment, we sought to evaluate participants' proposed solutions to gender inequity faced by female orthopedic surgeons in Canada and to translate the range of solutions into a medical education model.

Methods: Open-text responses from a gender-bias survey of Canadian orthopedic surgeons who identified as women were analyzed qualitatively by 2 experts. The questions covered the domain of changes required to improve the work environment. We used the latter 2 steps of Kern's educational framework as a lens to interpret the data and generate solutions.

Results: A total of 330 eligible surgeons were approached, and 220 (67.0%) completed the survey. Respondents provided more than 14 000 words of text for analysis. Using the themes of the unpublished needs assessment, we defined broad goals and specific objectives, including raising awareness, establishing an equitable playing field, drawing attention to male privilege, developing effective mentorship, eliminating harassment, and unburdening the second shift. We present solutions via educational strategies and evaluative methods based on Kern's framework.

Conclusion: We offer a road map for improving gender diversity in orthopedic surgery, based on survey results from Canadian women in orthopedic surgery, analyzed using a gender bias framework and an educational conceptual framework. We hope that this work will improve the surgical profession and patient care.

Contexte:: On observe un manque de diversité de genres en orthopédie et les résultats chez la patientèle s’en ressentent négativement. Après une évaluation non publiée des besoins, nous avons voulu explorer les solutions proposées par les personnes y ayant participé afin d’améliorer la représentativité des femmes en orthopédie au Canada et d’intégrer ces solutions à un modèle de formation médicale.

Méthodes:: Les réponses aux questions ouvertes d’un sondage sur les préjugés sexistes en chirurgie orthopédique au Canada effectué auprès de participantes s’étant identifiées de sexe féminin ont été analysées quantitativement par 2 spécialistes. Les questions concernaient les changements requis pour améliorer l’environnement de travail. Nous avons appliqué ces 2 étapes du modèle de Kern en éducation pour interpréter les données et dégager des solutions.

Résultats:: En tout, 330 membres admissibles des effectifs en chirurgie ont été approchés et 220 (67,0 %) ont répondu au sondage. Les réponses ont totalisé plus de 14 000 mots de texte à analyser. À partir des thèmes dégagés par l’évaluation non publiée des besoins, nous avons défini des objectifs globaux et des objectifs spécifiques, notamment : sensibilisation, mise en place de conditions propices, attention portée aux privilèges impartis aux hommes, mise sur pied d’un système de mentorat, élimination du harcèlement et allègement du second quart. Nous présentons les solutions sous forme de stratégies éducatives et de méthodes d’évaluation inspirées du modèle de Kern.

Conclusion:: Nous proposons un plan pour améliorer la diversité de genres en chirurgie orthopédique à partir des résultats d’un sondage auprès de femmes actives dans cette spécialité au Canada interprétés au moyen d’une méthode d’analyse des biais sexistes et d’un cadre éducatif conceptuel. Nous espérons ainsi améliorer la pratique de la chirurgie et la qualité des soins.

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Conflict of interest statement

Competing interests: The authors report that an unrestricted research grant from Smith & Nephew and a University of Calgary, Department of Surgery grant were received in support of the Gender Diversity and Inclusion in Canadian Orthopaedics research project, which includes this and other studies. In addition, a grant was received from the University of Calgary, Office of Health & Medical Education Scholarship, Equity and Diversity and Inclusion, specific to this research undertaking. Laurie Hiemstra is an executive member of the Board of the Canadian Orthopaedic Association. No other competing interests were declared.

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