title: Improving interprofessional collaboration: evaluation of implicit attitudes in the surgeon-nurse relationship.
abstract: BACKGROUND
  Optimizing the surgeon-nurse relationship to improve interprofessional communication is increasingly recognized as an essential component of patient care. The increasing number of women surgeons has altered the surgeon-nurse dynamic, which has traditionally been a male-female relationship. In particular, this shift has raised the issue of whether implicit perceptions regarding gender and demeanor influence the interactions between surgeons and nurses. Therefore, the purpose of this study was to understand nurses' implicit perceptions of surgeons, with a particular focus on gender and gender-normative demeanor. We defined two types of demeanor: communal, which is classically associated with women and includes being supportive and nurturing, and agentic, which is a male-associated trait that includes being direct and assertive.
  
  
  METHODS
  We administered surveys to 1701 nurses at the main campus of our institution. Each survey had one of eight possible scenarios; all began with a short description of a surgeon who was described as accomplished and well-trained, then varied by surgeon gender (male/female), surgeon demeanor (agentic/communal) and type of surgery (breast cancer/lung cancer). Using a 0 to 5 scale, respondents rated their perception of the surgeon through five questions. These five items were averaged to create a composite perception score scaled from 0 to 5.
  
  
  RESULTS
  We received 493 surveys. The overall average perception score was 3.8±0.99. Respondents had a statistically significant preference for the communal surgeon (4.1±0.91) versus the agentic surgeon (3.6±1.0, p<0.001). There were no significant main effects of surgeon gender or surgery type.
  
  
  CONCLUSIONS
  Nurses demonstrated a significant preference for communal surgeons, regardless of surgeon gender.
authors.affiliation: School of Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Hillary J
authors.initials: HJ
authors.lastname: Braun
authors.affiliation: Research and Development in Medical Education, University of California, San Francisco, San Francisco, CA, USA; Department of Surgery, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Patricia S
authors.initials: PS
authors.lastname: O'Sullivan
authors.affiliation: School of Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Marie N
authors.initials: MN
authors.lastname: Dusch
authors.affiliation: Department of Nursing, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Sheila
authors.initials: S
authors.lastname: Antrum
authors.affiliation: Department of Surgery, University of California, San Francisco, San Francisco, CA, USA. Electronic address: nancy.ascher@ucsfmedctr.org.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Ascher
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003299:Cooperative Behavior; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D010465:Perception; D019555:Physician-Nurse Relations; D012737:Sex Factors; D063507:Sexism / Q000523:psychology; D066231:Surgeons / Q000523:psychology*
keywords: Interprofessional; Nurse; Surgeon