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Deadly bias: a call for gender diversity in cardiac life support simulation training
  1. Larissa Spagnol Silverman1,
  2. Rachel Fabi2
  1. 1 Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  2. 2 Center for Bioethics and Humanities, SUNY Upstate Medical University, Syracuse, New York, USA
  1. Correspondence to Dr Rachel Fabi, Center for Bioethics and Humanities, SUNY Upstate Medical University, Syracuse 13210, New York, USA; fabir{at}

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Simulation in medical education teaches students to recognise patterns that can be life-saving. As an emergency medicine (EM) resident (LSS) and a medical educator (RF), we witness the ways in which patterns in the medical curriculum shape our future medical providers. The recognition of a dangerous pattern has brought us together to call for increased gender diversity in one of the most fundamental skills medical learners must master: cardiac life support training.

EM resident perspective

As an EM resident, I (LSS) am the clay being shaped by the medical system. In the emergency department (ED), where I hope to spend my career, chest discomfort, nausea and diaphoresis set a series of actions into motion. I am taught to fear missing a classic presentation of myocardial infarction (MI) and to keep high suspicion for life-threatening conditions. MI in women often presents with symptoms other than chest pain, which the American Heart Association (AHA) details on a page separate from general MI symptoms.1 The page emphasises that symptoms in women can be subtle and are often overlooked as acid reflux or the influenza, making recognition of MI in women especially difficult.

In the ED, over two-thirds of physicians are men.2 “I am a woman in medicine” is an inescapable part of my daily inner monologue. I feel a solidarity with my female patients. I pay attention to how I approach their pain and I look for the ways in which women downplay their symptoms. It was initially easy for me to rationalise the 2018 study findings that women treated by male …

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  • Contributors Both authors contributed equally to the conception and writing of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The views and opinions expressed are those of the authors and do not necessarily reflect those of the affiliated institutions.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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