519 - Microaggressions: the female physician experience in a pediatric academic center. A qualitative study

Poster Number: 519
Publication Number: 519.575

Background: Female physicians experience microaggressions in the workplace. Microaggressions occur daily and impact mental health, workplace satisfaction and burnout. Microaggressions experienced by physicians may negatively impact patient care and the learning environment. Limited studies to date have focused on microaggressions in female-dominated specialties and microaggressions in the clinical setting. A deeper understanding of how microaggressions impact physicians, learners and patients in the clinical work environment is essential to implement positive culture change.

Objective: This study aimed to understand how microaggressions are understood and experienced by female physicians in a pediatric academic setting and to describe the impact of these microaggressions on the clinical work environment.

Design/Methods: We conducted in-depth individual interviews with 24 female-identifying staff pediatricians engaged in clinical work at an urban academic paediatric hospital in Canada. Convenience sampling was initially used, followed by secondary purposeful sampling to ensure a wide demographic of participants (see table). Interviews were completed virtually between March 2021 and December 2021. Interview transcripts were transcribed and analyzed for recurrent and emergent themes using grounded theory methodology. A coding structure was developed to track the types of microaggressions experienced and their impact on participants and their work environment. Qualitative data analysis software (NVivo) was employed to organize and manage the data.

Results: Most female physicians provided multiple examples of microaggressions of all types including environmental, micro-assaults, micro-insults, and micro-invalidations. Examples of microaggressions included clinical decisions being questioned, being publicly scolded, and being on the receiving end of condescending comments or sexualized comments. Participants reported that microaggressions affected their career trajectories, clinical decision making, and self-identity. Participants identified barriers to reducing microaggressions, including cultural expectations, power structures, and a lack of awareness. Participants described labelling of the event, allyship, and diverse leadership as supportive and helpful for addressing microaggressions.

Conclusion(s): Microaggressions are pervasive within the clinical work environment in an academic pediatric hospital setting. Significant systemic changes are required to improve the culture of academic medicine.