The influence of patient gender on medical students' care: Evaluation during an objective structured clinical examination. (May 2023)

• Record Type: Journal Article
• Authors: Le Boudec, Joana; Félix, Sylvie; Gachoud, David; Monti, Matteo; Barazzoni, Mirjam Schuler; Clair, Carole
• Is Part Of: Patient education and counseling. Volume 110(2023)
• Publication Date: 2023-05
• Subjects: AAD ascending aorta dissection -- CT computed tomography -- GAD generalized anxiety disorder -- OSCE objective structured clinical examination -- SP standardized patients; Inclusive patient care -- Gender -- Students -- Objective structured clinical examination -- Diagnosis -- Management -- Stereotypes -- Bias; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2023.107655
• Languages: English
• ISSNs: 0738-3991

Abstract

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. Highlights: Correct diagnosis of general anxiety disorder is more likely to be made in women than in men by medical students. Physical symptoms associated with generalized anxiety disorder were less asked for in women than in men by medical students. Medical students recognized the emergency of ascending aortic dissection more often in women, who were also better examined.