The influence of patient gender on medical students' care: Evaluation during an objective structured clinical examination

Joana Le Boudec; Sylvie Félix; David Gachoud; Matteo Monti; Mirjam Schuler Barazzoni; Carole Clair

doi:10.1016/j.pec.2023.107655

The influence of patient gender on medical students' care: Evaluation during an objective structured clinical examination

Patient Educ Couns. 2023 May:110:107655. doi: 10.1016/j.pec.2023.107655. Epub 2023 Feb 8.

Authors

Joana Le Boudec¹, Sylvie Félix², David Gachoud³, Matteo Monti⁴, Mirjam Schuler Barazzoni⁵, Carole Clair⁶

Affiliations

¹ Centre for Primary Care and Public Health, Department of Training, Research and Innovation, Lausanne, Switzerland. Electronic address: joana.le-boudec@unisante.ch.
² Faculty of Biology and Medicine, University of Lausanne, Clinical Skills Unit, Medical School, Lausanne, Switzerland. Electronic address: sylvie.felix@unil.ch.
³ Faculty of Biology and Medicine, University of Lausanne, Medical Education Unit, Lausanne, Switzerland; Department of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: david.gachoud@chuv.ch.
⁴ Faculty of Biology and Medicine, University of Lausanne, Medical Education Unit, Lausanne, Switzerland; Department of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: matteo.monti@chuv.ch.
⁵ Department Woman Mother Child, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: mirjam.schuler-barazzoni@chuv.ch.
⁶ Centre for Primary Care and Public Health, Department of Training, Research and Innovation, Lausanne, Switzerland. Electronic address: carole.clair@unisante.ch.

PMID: 36805929
DOI: 10.1016/j.pec.2023.107655

Abstract

Objectives: To assess whether men and women are evaluated and treated differently by medical students.

Methods: We evaluated patient care provided by 110 fifth-year medical students during an objective structured clinical examination (OSCE), using two clinical cases with standardized patients (SPs): generalized anxiety disorder (GAD) and ascending aortic dissection (AAD). Half of the students encountered male and half female SPs. Except for gender, the cases were identical. We compared diagnosis and treatment of male vs female SPs.

Results: Students diagnosed GAD more often in female SPs than in male SPs (diagnosis completed, partially completed, and not completed in 47%, 16% and 36% respectively vs. 22%, 20%, and 58% for male SPs, p = 0.02). The nature of symptoms was better described for male SPs. For AAD, the emergency was more frequently identified and the examination of femoral pulses better performed in female SPs.

Conclusion: Medical students have a gender bias when evaluating patients with GAD and AAD.

Practice implication: The observed gender bias in the evaluation of patients, likely leads to differences in treatment between male and female patients (i.e. under-recognition of anxiety in men). Medical schools should implement gender-sensitive medical education initiatives to improve inclusive patient care.

Keywords: Bias; Diagnosis; Gender; Inclusive patient care; Management; Objective structured clinical examination; Stereotypes; Students.

MeSH terms

Clinical Competence
Educational Measurement
Female
Humans
Male
Patient Care
Patient Simulation
Physical Examination
Sexism
Students, Medical*