No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Gender differences in medical graduates' assessment of their personal attributes
Abstract
As part of the planning process for a new undergraduate curriculum for King's, a profile of the type of doctor which the Medical School wishes to produce was defined.
To investigate, in a sample of medical graduates, their perceptions of the personal attributes they had developed by the time of qualification which the Curriculum Steering Group had identified as being 'desirable' in a doctor.
Five cohorts of doctors who had qualified from the King's College School of Medicine and Dentistry between 1985/86 and 1989/90 (n = 478).
Postal questionnaire survey.
371 replied, a response rate of 78%. In most cases the respondents felt they had acquired the attributes at least partially, by qualification. Gender differences in responses were found for nine of the sixteen attributes. The men felt better equipped with 'leadership potential', 'spirit of curiosity', 'tolerance of ambiguity and uncertainty' compared to the women who felt more confident in their 'ability to inspire confidence in others', 'ability to listen', 'ability to work in a team', 'caring and compassionate nature', 'motivation' and 'satisfactory at interpersonal relationships in professional life'. There were no significant differences for 'ability to recognize own limitations and strengths', 'capacity for self-audit', 'excitement with the subject of medicine', 'open-mindedness' and 'perseverance'. Most graduates agreed these attributes were 'desirable' in a doctor, the women feeling more strongly than the men about 'open-mindedness'.
The findings are consistent with current theories which relate to personality differences between men and women and socialization during early upbringing.
... A meta-analytic review of medical consultations found that female doctors are more likely to adopt a patient-centred communication style [35]. It has also been demonstrated that women doctors have greater interpersonal skills, which lead to empathic relationships [36][37][38]. These interpersonal skills may encourage the patient to be more forthcoming with regards to salient clinical information, enabling the doctor to correctly diagnose and manage the presenting ailment. ...
... A further hypothesis is that male and female doctors differ in values, and that these values lead to different motivations, which in turn influence achievement. Female doctors have been shown to have higher personrelated values [37,39,40], and one study found that performance in a clinical setting was predicted by person-related values held by the doctor [39]. It could also be that the design of the exam favours female candidates, perhaps examiners of clinical assessments may be unfairly biased towards female candidates or against male candidates. ...
Background: There is much discussion about the sex differences that exist in medical education. Research from the United Kingdom (UK) and United States has found female doctors earn less, and are less likely to be senior authors on academic papers, but female doctors are also less likely to be sanctioned, and have been found to perform better academically and clinically. It is also known that international medical graduates tend to perform more poorly academically compared to home-trained graduates in the UK, US, and Canada. It is uncertain whether the magnitude and direction of sex differences in doctors’ performance is variable by country. We explored the association between doctors’ sex and their performance at a large international high-stakes clinical examination: the Membership of the Royal Colleges of Physicians (UK) Practical Assessment of Clinical Examination Skills (PACES). We examined how sex differences varied by the country in which the doctor received their primary medical qualification, the country in which they took the PACES examination, and by the country in which they are registered to practise. // Methods: Seven thousand six hundred seventy-one doctors attempted PACES between October 2010 and May 2013. We analysed sex differences in first time pass rates, controlling for ethnicity, in three groups: (i) UK medical graduates (N = 3574); (ii) non-UK medical graduates registered with the UK medical regulator, the General Medical Council (GMC), and thus likely to be working in the UK (N = 1067); and (iii) non-UK medical graduates without GMC registration and so legally unable to work or train in the UK (N = 2179). // Results: Female doctors were statistically significantly more likely to pass at their first attempt in all three groups, with the greatest sex effect seen in non-UK medical graduates without GMC registration (OR = 1.99; 95% CI = 1.65-2.39; P < 0.0001) and the smallest in the UK graduates (OR = 1.18; 95% CI = 1.03-1.35; P = 0.02). // Conclusions: As found in a previous format of this examination and in other clinical examinations, female doctors outperformed male doctors. Further work is required to explore why sex differences were greater in non-UK graduates, especially those without GMC registration, and to consider how examination performance may relate to performance in practice.
... A meta-analytic review of medical consultations found that female doctors are more likely to adopt a patient-centred communication style [35]. It has also been demonstrated that women doctors have greater interpersonal skills, which lead to empathic relationships [36][37][38]. These interpersonal skills may encourage the patient to be more forthcoming with regards to salient clinical information, enabling the doctor to correctly diagnose and manage the presenting ailment. ...
... A further hypothesis is that male and female doctors differ in values, and that these values lead to different motivations, which in turn influence achievement. Female doctors have been shown to have higher personrelated values [37,39,40], and one study found that performance in a clinical setting was predicted by person-related values held by the doctor [39]. It could also be that the design of the exam favours female candidates, perhaps examiners of clinical assessments may be unfairly biased towards female candidates or against male candidates. ...
Abstract Background There is much discussion about the sex differences that exist in medical education. Research from the United Kingdom (UK) and United States has found female doctors earn less, and are less likely to be senior authors on academic papers, but female doctors are also less likely to be sanctioned, and have been found to perform better academically and clinically. It is also known that international medical graduates tend to perform more poorly academically compared to home-trained graduates in the UK, US, and Canada. It is uncertain whether the magnitude and direction of sex differences in doctors’ performance is variable by country. We explored the association between doctors’ sex and their performance at a large international high-stakes clinical examination: the Membership of the Royal Colleges of Physicians (UK) Practical Assessment of Clinical Examination Skills (PACES). We examined how sex differences varied by the country in which the doctor received their primary medical qualification, the country in which they took the PACES examination, and by the country in which they are registered to practise. Methods Seven thousand six hundred seventy-one doctors attempted PACES between October 2010 and May 2013. We analysed sex differences in first time pass rates, controlling for ethnicity, in three groups: (i) UK medical graduates (N = 3574); (ii) non-UK medical graduates registered with the UK medical regulator, the General Medical Council (GMC), and thus likely to be working in the UK (N = 1067); and (iii) non-UK medical graduates without GMC registration and so legally unable to work or train in the UK (N = 2179). Results Female doctors were statistically significantly more likely to pass at their first attempt in all three groups, with the greatest sex effect seen in non-UK medical graduates without GMC registration (OR = 1.99; 95% CI = 1.65-2.39; P
... Estudos prévios demonstraram que estudantes do sexo masculino e feminino diferem quanto à escolha da especialidade durante o curso e também quanto aos fatores que influenciam suas escolhas [16][17][18] . Na grande maioria, estudantes homens são mais motivados pela renda, status e a possibilidade de atuar em áreas mais técnicas, denominados como fatores "extrínsecos" [19][20][21][22] . Já no sexo feminino, as motivações geralmente são razões humanistas e altruístas, fatores estes denominados "intrínsecos" [19][20][21][22] . ...
... Na grande maioria, estudantes homens são mais motivados pela renda, status e a possibilidade de atuar em áreas mais técnicas, denominados como fatores "extrínsecos" [19][20][21][22] . Já no sexo feminino, as motivações geralmente são razões humanistas e altruístas, fatores estes denominados "intrínsecos" [19][20][21][22] . As motivações intrínsecas estão mais relacionadas às atividades em que o paciente é o componente principal; sendo assim, as mulheres estão mais propensas a escolhas de especialidades médicas que tenham maior envolvimento com o paciente. ...
Objetivou-se identificar as especialidades mais desejadas pelos alunos de Medicina do Centro Universitário do Estado do Pará (Cesupa) e fatores determinantes dessa escolha. Trata-se de um estudo transversal, descritivo e analítico, realizado mediante aplicação de questionários a alunos do primeiro, quarto e sexto anos, no período de novembro de 2012 a março de 2013. A maioria dos alunos era do sexo masculino (59,2%), com média de idade de 22 ± 2 anos, possuindo renda familiar acima de dez salários mínimos e apresentando pelo menos um parente médico. As principais especialidades escolhidas foram: Cirurgia Plástica (10,4%), Endocrinologia (15,7%), e Oftalmologia (14,0%) no primeiro, quarto e sexto anos, respectivamente. O principal fator influenciador na escolha no primeiro ano foi a influência dos pais (17,2%), e no quarto e sexto anos o fator financeiro, com 15,8% e 22,8%, respectivamente. Conclui-se que muitos fatores influenciam a escolha de especialidades, sendo necessário buscar formas de atrair alunos para áreas de caráter mais generalista.
... These differences also tend to persist after graduation. For example, Clack and Head (1999) found that male medical graduates rated themselves more highly than did female graduates in attributes related to biomedical investigation, leadership and autonomy, whereas the females rated themselves more highly in interpersonal attributes and teamwork. In the field of counselling, Fitzpatrick (1999) found that female students were less confident than males in rating their abilities and skills, and suggested that females perceived that a higher level of competence must be demonstrated in order to reach a particular standard of competence. ...
... Across the range of skills required of students using these new techniques, gender and other group or individual biases might be equalized because different components of learning-centred assessment methods are likely to benefit different groups. For example, although potentially disadvantaged in self-and peer-assessment, female students may be advantaged compared to males in relation to the ability to be an autonomous learner and readiness for self-directed learning (Kell, 2006), as well as confidence in interpersonal communication (Clack & Head, 1999; Lurie, 2007; Omigbodun & Omigbodun, 2003). Further empirical investigation of these issues, across disciplines, is needed so that instructors can ensure they use a complementary and inclusive range of assessment methods. ...
1. Abstract: The desire to improve the quality of student learning and respond to growing student diversity in higher education, combined with increasing demands for accountability of learning outcomes have led instructors to seek innovative pedagogies and alternative forms of assessment, beyond that of the traditional lecture and examination format (Angelo & Cross 1993; Frye 1999; Mowl, 1996; Shavelson & Huang, 2003). A growing body of literature supports the use of a wide range of learning-centred assessment methods. However, very few studies have investigated the impact of these innovative assessment practices, particularly with regard to student diversity. In this paper we examine potential gender bias considerations in relation to learning-centred assessment methods. Evidence from practical classroom experiences, as well as the higher education literature suggests that instructors should address potential gender biases during interactive assessment methods in order to enhance inclusivity in self- and peer- assessment learning environments. Recommendations are suggested for implementing innovative learning-centred assessment methods in the college and university classroom. We conclude by highlighting the need for more SoTL research around issues of assessment and student diversity, particularly with respect to gender, age, ethnicity, cultural, sexual orientation and socio-economic status.
... Consequently, there has been limited dialog regarding the relationships among these constructs and their appropriate applications. Furthermore, IU shares some conceptual and measurement properties with the aforementioned traits, and as a result the constructs have previously been confused and used interchangeably with IU (e.g., Clack & Head, 1999;Furnham & Ribchester, 1995;Geller, Tambor, Chase, & Holtzman, 1993;Majid & Pragasam, 1997;McCulloch, Kaul, Wagstaff, & Wheatcroft, 2005;Myers, Henderson-King, & Henderson-King, 1997). Summarizing the commonly used measures for each of the constructs will clarify their operational definitions, and how each construct is typically assessed. ...
... Finally, it is possible that conclusions drawn from prior studies may be called into question if the uncertainty constructs were confounded in them. For example, several prior studies have stated that their purpose was to examine effects of IU on psychological and behavioral outcomes, yet proceeded to assess IU with a measure of IA (e.g., Andersen & Schwartz, 1992;McCulloch et al., 2005), or to simply group the two concepts into one (i.e., ''tolerance of ambiguity and uncertainty''; Clack & Head, 1999). Given the potential differences outlined in this review, such approaches limit the conclusions that can be drawn about the true effects of IU on outcomes. ...
Abstract Individual differences in uncertainty have been associated with heightened anxiety, stress and approach-oriented coping. Intolerance of uncertainty (IU) is a trait characteristic that arises from negative beliefs about uncertainty and its consequences. Researchers have established the central role of IU in the development of problematic worry and maladaptive coping, highlighting the importance of this construct to anxiety disorders. However, there is a need to improve our understanding of the phenomenology of IU. The goal of this paper was to present hypotheses regarding the similarities and differences between IU and three related constructs - intolerance of ambiguity, uncertainty orientation, and need for cognitive closure - and to call for future empirical studies to substantiate these hypotheses. To assist with achieving this goal, we conducted a systematic review of the literature, which also served to identify current gaps in knowledge. This paper differentiates these constructs by outlining each definition and general approaches to assessment, reviewing the existing empirical relations, and proposing theoretical similarities and distinctions. Findings may assist researchers in selecting the appropriate construct to address their research questions. Future research directions for the application of these constructs, particularly within the field of clinical and health psychology, are discussed.
... In our study, female students assessed themselves higher in 'Empathy and openness' , 'Teamwork and collegiality' , and 'Knowing and maintaining own personal bounds and possibilities' than male students did. In other studies, female medical students also scored higher in self-evaluation of empathy [41], felt more confident in their ability to listen and to work as part of a team [42], and received higher scores for teamwork and knowing personal bounds in a workplace-based assessment [12]. Male students, in our study, assessed themselves more competent in 'Scientifically and empirically grounded method of working' than did female students, which has been demonstrated before in self-assessment [43]. ...
Background
Final-year undergraduate medical students often do not feel well prepared for their start of residency training. Self-assessment of competences is important so that medical trainees can take responsibility for their learning. In this study, we investigated how final-year medical students self-assessed their competences as they neared their transition to postgraduate training. The aim was to identify areas for improvement in undergraduate training.
Methods
In the academic year 2019/2020, a national online survey was sent to final-year undergraduate medical students via their respective medical schools. The survey included ten facets of competence (FOC) most relevant for beginning residents. The participants were asked to self-assess their competence for each FOC on a 5-point Likert scale (1: strongly disagree to 5: strongly agree). We established an order of self-assessed FOC performance by means and calculated paired t-tests. Gender differences were assessed with independent t-tests.
Results
A total of 1083 students from 35 medical schools completed the questionnaire. Mean age was 27.2 ± 3.1 years and 65.8% were female. Students rated their performance highest in the FOCs ‘Teamwork and collegiality’ and ‘Empathy and openness’ (97.1 and 95.0% ‘strongly agree’ or ‘agree’, respectively) and lowest in ‘Verbal communication with colleagues and supervisors’ and ‘Scientifically and empirically grounded method of working’ (22.8 and 40.2% ‘strongly disagree’, ‘disagree’, or ‘neither agree nor disagree’, respectively). Women rated their performance of ‘Teamwork and collegiality’, ‘Empathy and openness’, and ‘Knowing and maintaining own personal bounds and possibilities’ significantly higher than men did (Cohen’s d > .2), while men showed higher self-assessed performance in ‘Scientifically and empirically grounded method of working’ than women (Cohen’s d = .38). The FOCs ‘Responsibility’, ‘Knowing and maintaining own personal bounds and possibilities’, ‘Structure, work planning, and priorities’, ‘Coping with mistakes’, and ‘Scientifically and empirically grounded method of working’ revealed lower self-assessed performance than the order of FOC relevance established by physicians for beginning residents.
Conclusions
The differences between the level of students’ self-assessed FOC performance and physicians’ ranking of FOC relevance revealed areas for improvement in undergraduate medical education related to health system sciences. Final-year students might benefit from additional or better training in management skills, professionalism, and evidence-based medicine. Surveys of self-assessed competences may be useful to monitor competence development during undergraduate training.
... The studies used many kinds of questionnaires, where are highlighted demographic information, selfassessment of studies, rate of career progress, family responsibilities, the understanding of promotion criteria and the utility of mentoring and scientific societies. For the evaluation of achievements and recognition were investigated the promoting steps and other components of national and international recognition (membership in committees, chairing of conferences, publications, chair of a national organization, director of a department, editor of a journal) (Schaller 1990;Clack and Head 1999;Buckley et al. 2000). ...
EDITORS’ FOREWORD
It is a well-known fact that women are unfairly (and sometimes severely) disadvantaged in some key areas of social, political, cultural or economic life. These disadvantages are not only unjust, but sometimes also imply important economic costs for the society (i.e., the waste of talents remained untapped due to the disadvantages suffered by women). Therefore, designing and implementing successful strategies for the advancement of women in these areas is one of the most important and pressing target in contemporary world. It is no surprise that promoting equal opportunities for women is declared as an issue of utmost importance by most political platforms in the Western world and it is assumed as a key instrument in achieving the goal of a sustainable development.
In this context, between the 10th and the 13th of September 2015, the Romanian Academy – Iași Branch and the “Gheorghe Zane” Institute for Economic and Social Research organized the International Conference “Social and Academic Policies for Women”. The conference, which took place in Iași, Romania, was organized within
“PECAFROM – Promoting Equal Opportunities in University and Academic Career for Women in Romania” SOP HRD/144/6.3/S/127928 Project, co-financed from European
Social Fund through the Sectoral Operational Programme Human Resources Development 2007-2013 and was intended and designed as an opportunity for dialog and debate for the project beneficiaries and researchers and other scholars concerned with the issues raised by the ideal of promoting equal opportunities for women. In order to
facilitate a comprehensive understanding of these issues, the conference was open to both theoretical and applied approaches from all disciplines with contributions in analyzing and investigating the problematics raised by the ideal of promoting equal opportunities
for women, from philosophy to economics, and from social to political theory. By facilitating their access to academic debates raised by the ideal of promoting equal opportunities for women, the conference constituted an important tool for realizing the main objective of PECAFROM project: that of supporting 550 women with higher
education from Romania in increasing their employment opportunities and initiating and developing an academic career. This objective was realized in the project also through three other main types of support: guidance in accessing and processing the information concerning the academic labor market; financial support and entrepreneurial assistance for starting a business; and, last but not least, support in accessing training programmes for career development.
The conference had four main sections: 1. Philosophical Foundations of Gender Policies; 2. Social & Economic Analyses of Gender Policies; 3. Gender in Rural space; and 4. Gender Ethics and Equity. Among the topics debated in these sections were: gender equity, discrimination and bias against women, gender stereotypes, work-life balance, equal economic independence, gender pay gap, gender and the labor market, gender balance in decision-making positions, women’s empowerment, or violence against women. As the title of the conference suggests, also a favorite topic was equality of
opportunity for women in academia. Is academia a place of equal opportunities for women and men? Why are women so severely under-represented in some academic disciplines like STEM fields or philosophy? Are women negatively discriminated in these fields? Do we need more women in the fields in which they are most under-represented? Which policies are best in promoting equal opportunities for women and men in academia? Is affirmative action for women a justified tool for promoting equal opportunities for developing an academic career? This volume is a collection of papers presented in the conference and includes articles dealing with the above mentioned and other related topics, such as gender (in)equality in rural space, toponymy, online environment, academia, literary canon,
education, occupations and social roles, military culture, practices of advertising etc. The volume is the second part of a book financed by European Social Fund through the Sectoral Operational Programme Human Resources Development 2007-2013 (the first part gathering some of the other main findings and conclusions of the research developed in the PECAFROM Project). We hope that the book will be found useful (and inspiring) by all those interested in women’s situation in contemporary social, political, cultural, academic, or economic life and also in promoting equal opportunities for women in all these areas.
... The pharmacy graduates' attributes and their desirability in delivering patient care was assessed by administering the validated Nova Southeastern University Pharmacy Graduate questionnaire [9]. This questionnaire has also been used and validated in medical graduates [10]. The questionnaire included 16 questions on pharmacists' attributes of a care provider and their desirability to have the attributes. ...
Pharmacists’ roles in providing patient care remain limited in Indonesia, hence this study aimed to determine the preparedness of pharmacy graduates from one university in Indonesia to deliver patient care. Pharmacy graduates (both registered pharmacists [104] and recent graduates eligible for registration [45]) were sent a validated self-administered survey. The survey sought their perceptions about whether they had acquired 16 patient care related attributes. Further, it sought their opinion on the desirability of having those attributes. Data were analysed using SPSS version 22.0. Sixteen of 104 (15.4%) registered pharmacists and 40 of 45 (88.9%) recent pharmacy graduates participated in the study. More than 50% of participants in both groups were female and most participants were aged in their 20s. Of the recent pharmacy graduates the majority perceived they had at least partially acquired four of 16 list attributes. Male and female recent graduates had significantly different beliefs about their leadership ability (p=0.004). In comparison, most registered pharmacists perceived they had 10 out of the 16 listed attributes. The findings of this study suggested that pharmacy graduates should be better prepared to deliver patient care, and that curriculum redesign with expansion of experiential learning is required.
... (37)(38)(39)(40) Female doctors may therefore be higher on personality traits that lead to them maintaining their skills and knowledge and performing better at assessments. (41)(42)(43) it has been shown that performance in a clinical setting is predicted by the person-related values held by a doctor (42). It is plausible that women's higher performance is therefore due to differences in skills and attitudes, as well as knowledge. ...
Background:
Tests of competence are written and clinical assessments taken by doctors under investigation by the General Medical Council (GMC) who have significant performance concerns. Male doctors on average perform more poorly in clinical assessments than female doctors, and are more likely to be sanctioned. It is unclear why.
Aim:
To examine sex differences in the tests of competence assessment scores of GPs under investigation by the GMC, compared with GPs not under investigation, and whether scores mediate any relationship between sex and sanction likelihood.
Design and setting:
Retrospective cohort study of GPs' administrative tests of competence data.
Method:
Analysis of variance was undertaken to compare written and clinical tests of competence performance by sex and GP group (under investigation versus volunteers). Path analysis was conducted to explore the relationship between sex, written and clinical tests of competence performance, and investigation outcome.
Results:
On the written test, female GPs under investigation outperformed male GPs under investigation (Cohen's d = 0.28, P = 0.01); there was no sex difference in the volunteer group (Cohen's d = 0.02, P = 0.93). On the clinical assessment, female GPs outperformed male GPs in both groups (Cohen's d = 0.61, P<0.0001). A higher clinical score predicted remaining on the UK medical register without a warning or sanction, with no independent effect of sex controlling for assessment performance.
Conclusion:
Female GPs outperform male GPs on clinical assessments, even among GPs with generally very poor performance. Male GPs under investigation may have particularly poor knowledge. Further research is required to understand potential sex differences in doctors who take tests of competence and how these impact on sex differences in investigation outcomes.
... It has been observed that there are gender differences in medical students' assessment of their personal skill levels. 11 The attitude of male students towards the point that 'communication skill develops the ability to choose a P drug' was more positive. More female students preferred OSPE over animal experimentation and this could be related to the greater empathy of females towards animals. ...
The study was planned to determine the attitude of undergraduate medical students
towards the objective structured practical examination (OSPE) in pharmacology and
to investigate any influence of sex, nationality and medium of instruction at school on
these attitudes. The second year undergraduate medical students of the Manipal college
of medical sciences, Pokhara, Nepal were asked to complete a questionnaire regarding
the spotters and communication skills component of the practical examination. Students
considered OSPE a good method of practical examination. The male students agreed
more strongly that the spotters develops the ability to choose an appropriate drug
while the female students were more in favour of OSPE over animal experimentation.
The Sri Lankan students were less in favour of the introduction of stations testing
skills as part of OSPE and also disagreed strongly with the point that communication
skills should be conducted in a language other than English. Based on these
observations, changes should be made in the teaching as well as evaluation
methodologies to maximize learning.
... The pharmacy graduates attributes and their desirability in delivering patient care was assessed by administering the validated Nova Southeastern University Pharmacy Graduate questionnaire [9]. This questionnaire has also been used and validated in medical graduates [10]. The questionnaire was translated to Indonesia by the investigator then accuracy of the translation was obtained from other academics at the study university. ...
Objective: Pharmacists’ roles in providing patient care remain limited in Indonesia, hencethis study aimed to determine the preparedness of pharmacy graduates from one university in Indonesia todeliver patient care. Methods: Pharmacy graduates (both registered pharmacists [104] and recent graduateseligible for registration [45]) were sent a validated self-administered survey. The survey sought theirperceptions about whether they had acquired 16 patient care related attributes. Further, it sought theiropinion on the desirability of having those attributes.Data were analysed using SPSS version 22.0. Results:Sixteen of 104 (15.4%) registered pharmacists and 40 of 45 (88.9%) recent pharmacy graduates participatedin the study. More than 50% of participants in both groups were female and most participants were aged intheir 20s. Of the recent pharmacy graduates the majority perceived they had at least partially acquired fourof 16 list attributes. Male and female recent graduates had significantly different beliefs about their leadershipability (p=0.004). In comparison, most registered pharmacists perceived they had 10 out of the 16 listedattributes. Conclusion: The findings of this study suggested that pharmacy graduates should be better preparedto deliver patient care, and that curriculum redesign with expansion of experiential learnings required.
... As to gender differences, females generally tend to assess their own skills less favourably than males do [12,13], and similar findings have been reported in medicine. For instance, Bakken et al. found that female physicians consistently rated their abilities to apply skills in clinical research at a lower level than males did [14], whereas other studies report that male and female physicians display different levels of confidence in different areas of performance [15,16]. ...
Background
This prospective study from end of medical school through internship investigates the course and possible change of self- reported self-efficacy in communication skills compared with observers’ ratings of such skills in consultations with simulated patients.
Methods
Sixty-two medical students (43 females) from four Norwegian universities performed a videotaped consultation with a simulated patient immediately before medical school graduation (T1) and after internship (internal medicine, surgery and family medicine, half a year each - T2). Before each consultation, the participants assessed their general self-efficacy in communication skills. Trained observers scored the videos and applied a well-validated instrument to rate the communication behaviour. Results from the two assessment methods were correlated at both time points and possible differences from T1 to T2 were explored.
Results
A close to zero correlation between self-efficacy and observed communication skills were found at T1. At T2, participants’ self-efficacy scores were inversely correlated with levels of observed skills, demonstrating a lack of concordance between young physicians’ own assessment of self-efficacy and observers’ assessment. When dividing the sample in three groups based on the observers’ scores (low <1/3-, medium 1/3 to 2/3-, high competence >2/3), the group of male physicians showed higher levels of self-efficacy than females in all the three performance groups at T1. At T2, those having a high performance score yielded a low self-efficacy, regardless of gender.
Conclusions
The lack of positive correlations between self-efficacy assessment and expert ratings points to limitations in the applicability of self-assessment measures of communication skills. Due to gender differences, groups of female and male physicians should be investigated separately. Those obtaining high-performance ratings from observers, through the period of internship, may become more conscious of how demanding clinical communication with patients may be. This insight may represent a potential for growth, but could in some physicians represent too much of a self-critical attitude. Active supervision of young physicians throughout internship is important in order to help physicians to be more aware of their strengths and weaknesses, in order to gain increased mastery in the art of doctoring.
... 7,17 Furthermore, leadership skills reflect aspects of personality and character that often vary according to age and sex. [18][19][20][21][22][23][24] Specifically, self-reported ratings show significant differences by sex; men often overreport and women often underreport their abilities. 25 To date, it is not known whether there are differences in leadership strengths and weaknesses by specialty or provider pathway. ...
The medical community has recognized the importance of leadership skills among its members. While numerous leadership assessment tools exist at present, few are specifically tailored to the unique health care environment. The study team designed a 24-item survey (Healthcare Evaluation & Assessment of Leadership [HEAL]) to measure leadership competency based on the core competencies and core principles of the Duke Healthcare Leadership Model. A novel digital platform was created for use on handheld devices to facilitate its distribution and completion. This pilot phase involved 126 health care professionals self-assessing their leadership abilities. The study aimed to determine both the content validity of the survey and the feasibility of its implementation and use. The digital platform for survey implementation was easy to complete, and there were no technical problems with survey use or data collection. With regard to reliability, initial survey results revealed that each core leadership tenet met or exceeded the reliability cutoff of 0.7. In self-assessment of leadership, women scored themselves higher than men in questions related to patient centeredness (P=0.016). When stratified by age, younger providers rated themselves lower with regard to emotional intelligence and integrity. There were no differences in self-assessment when stratified by medical specialty. While only a pilot study, initial data suggest that HEAL is a reliable and easy-to-administer survey for health care leadership assessment. Differences in responses by sex and age with respect to patient centeredness, integrity, and emotional intelligence raise questions about how providers view themselves amid complex medical teams. As the survey is refined and further administered, HEAL will be used not only as a self-assessment tool but also in “360” evaluation formats.
... Gude et al. reported that, compared with their male counterparts, female students had trouble identifying themselves as doctors, and therefore proposed that female students need to have female RMs [25]. The presence of gender differences in role modeling and professional development, perceptions of negative behavior or attributes, and value modification through interactions with RMs, need to be investigated in future studies, in addition to the lack of female RMs and the attributes of female students in medical education [26]. ...
Background
The use of role models (RMs) is a successful educational strategy. In formal training and other settings during undergraduate education, students have the opportunity to recognize numerous traits and behaviors of their RMs, such as teaching skills, professionalism in the clinical setting, and personal qualities. Encountering both positive and negative RMs allows medical students to learn a variety of professional norms and values. This learning process is likely influenced by a student’s developmental status, which itself is related to that student’s personal attributes and experiences. The purpose of this study was to examine graduating medical students’ perceptions of their RM encounters and their learning processes, and how these perceptions and processes are affected by their own personal attributes.
Methods
Sixth-year medical students were asked to complete questionnaires in 2013 and 2014 regarding encounters with positive or negative RMs, in terms of patient relationships, clinical expertise, teaching ability, and other factors, during clinical training and other situations. Associations between gender, age, admission status, and recognition of self-achievement and joy of learning in relation to RM encounters were then analyzed.
Results
Among 115 students (75 males, 40 females) who completed the questionnaires, 113 (98.3 %) and 85 (73.9 %) reported encountering positive and negative RMs, respectively. The majority of students reported encountering both positive and negative RMs in terms of relationships with patients, humanity, and teaching ability, and fewer negative RMs in terms of clinical expertise and contributions to the community. Older students, males, and those who had passed an entrance examination for bachelors reported encountering more negative RMs in terms of relationships with patients, humanity, and teaching ability than younger students, females, and general admission students. These results suggested an association between positive and negative RM encounters and recognition of self-achievement and joy of learning in formal clinical training.
Conclusions
Most medical students encountered both positive and negative RMs during undergraduate medical education. These findings suggest that encounters with not only positive, but also negative RMs might facilitate student learning. Therefore, personal development appears to affect student perception of RMs.
Electronic supplementary material
The online version of this article (doi:10.1186/s12909-016-0686-1) contains supplementary material, which is available to authorized users.
... Bedingt durch die familiale und schulische Sozialisation kommen männliche und weibliche Studierende mit unterschiedlich ausgeprägten Kommunikationsfertigkeiten und Einstellungen in das Medizinstudium, was durch die berufl iche Sozialisation kaum noch zu modifi zieren ist [ 45 ] . Medizinstudentinnen können besser als ihre Kommilitonen zuhören [ 46 ] und zeigen bessere Gesamtleistungen in ärztlicher Gesprächsführung schon am Beginn ihres Studiums [ 47 ] . Auch bereits im Beruf tätige Ärztinnen waren empathischer [ 48 ] und konnten leichter eine gute Zusammenarbeit mit Patienten in einem Gespräch herstellen [ 49 ] . ...
... Reporting on a study at the University of Alabama, Saleh (1998) concludes that there are significant gender differences in the level of tolerance of ambiguity. Clack (1999) discovers that the men feel better equipped with "tolerance of ambiguity and uncertainty" compared to the women who feel more confident in their "open-mindedness". It seems that both of the male and female subjects claim themselves with a high level of tolerance of ambiguity. ...
Stemming from the study on Intolerance of Ambiguity in psychological field, the study towards Tolerance of Ambiguity (TOA) has become a topic which more and more researchers take interest in. Great efforts have been made on the theoretical and practical development of this research focus from both the psychological field and the second / foreign language acquisition field. As the theoretical framework has been constructed so as to explore the connotation of TOA, a lot of empirical researches have been made either to find out the appropriate measurement instrument or to detect the correlation between TOA and other variables in both psychological and linguistic area. A thorough review of relevant researches about TOA will help us to be aware of the current tendencies as well as the potentials for further study in the future.
... It has been observed that there are gender differences in medical students' assessment of their personal skill levels. 11 The attitude of male students towards the point that 'communication skill develops the ability to choose a P drug' was more positive. More female students preferred OSPE over animal experimentation and this could be related to the greater empathy of females towards animals. ...
The study was planned to determine the attitude of undergraduate medical students towards the objective structured practical examination (OSPE) in pharmacology and to investigate any influence of sex, nationality and medium of instruction at school on these attitudes. The second year undergraduate medical students of the Manipal college of medical sciences, Pokhara, Nepal were asked to complete a questionnaire regarding the spotters and communication skills component of the practical examination. Students considered OSPE a good method of practical examination. The male students agreed more strongly that the spotters develops the ability to choose an appropriate drug while the female students were more in favour of OSPE over animal experimentation. The Sri Lankan students were less in favour of the introduction of stations testing skills as part of OSPE and also disagreed strongly with the point that communication skills should be conducted in a language other than English. Based on these observations, changes should be made in the teaching as well as evaluation methodologies to maximize learning.
... Men, on the other hand, appear to feel more confident in attributes associated with thègreat detective' style of patient interaction. Women value the psychological aspects of care more than men and tend to perform well in such skills (Clack & Head 1999:103). ...
This study was done to investigate how female students are performing in a programme which has traditionally been dominated by males and with stereotyped beliefs that male students perform better than their female counterparts. The study brought to the fore that female medical students are outperforming male students. The research also describes the student's profile and learner characteristics and study preferences. The authors are of the opinion that studies such as this will contribute towards eliminating the biases, stereotyping and prejudices against women in the traditionally male-dominated medical profession.South African Journal of Higher Education Vol.18(2) 2004: 233-249
... This supports earlier survey evidence that female doctors feel better equipped in psychosocial skills. 20 External factors also affected this: women were viewed as more approachable, and their patients demonstrated greater social conversation and likelihood of becoming tearful. ...
Objective:
Internationally, increasing numbers of women are practising medicine. Gender differences in doctors' working hours, specialty choices and communication styles are well documented, but studies often neglect contextual factors such as the role of socialised gender expectations on behaviours in the workplace and the medical profession. These may be important as recent studies have reported gender differences in doctors' activity rates that cannot be explained by specialty or contracted hours, suggesting other sources of variation. This study sought to explore the working lives of hospital doctors and how their work is negotiated according to gender and context.
Design:
Gender differences in the day-to-day work of hospital specialists (consultants) in the NHS were investigated using a qualitative approach, including observation and interview methods. Data were analysed inductively using qualitative observation and interview methods.
Setting:
Two NHS hospital trusts in England.
Participants:
Data were collected from 13 participants working in a variety of specialties and in a range of clinical and non-clinical settings.
Main outcome measures:
Various behaviours, attitudes and experiences were explored, such as doctor-patient communication, interactions with colleagues and workload.
Results:
Influences at both individual and situational levels, appear to affect differentially the work of male and female doctors. Female consultants described awareness of the impact of behaviours on relationships with colleagues, and their interactions appeared to be more carefully performed. Nurses and other colleagues tend to demonstrate less cooperation with female consultants. Gender differences also exist in patient communication, feelings of work-family conflict and barriers to career progression.
Conclusions:
These variations in hospital consultants' work may have implications for both the quantity and quality of care provided by male and female consultants. This is timely and of importance to the medical workforce as the gender composition approaches parity.
... It has been observed that there are gender differences in medical students' assessment of their personal skill levels. 11 The attitude of male students towards the point that 'communication skill develops the ability to choose a P drug' was more positive. More female students preferred OSPE over animal experimentation and this could be related to the greater empathy of females towards animals. ...
The study was planned to determine the attitude of undergraduate medical students towards the objective structured practical examination (OSPE) in pharmacology and to investigate any influence of sex, nationality and medium of instruction at school on these attitudes. The second year undergraduate medical students of the Manipal college of medical sciences, Pokhara, Nepal were asked to complete a questionnaire regarding the spotters and communication skills component of the practical examination. Students considered OSPE a good method of practical examination. The male students agreed more strongly that the spotters develops the ability to choose an appropriate drug while the female students were more in favour of OSPE over animal experimentation. The Sri Lankan students were less in favour of the introduction of stations testing skills as part of OSPE and also disagreed strongly with the point that communication skills should be conducted in a language other than English. Based on these observations, changes should be made in the teaching as well as evaluation methodologies to maximize learning.
... There have been many studies that have examined the experiences of women doctors (Aasland and Wiers-Jenssen 2001;Clack and Head 1999;Kvaerner et al. 1999) and a number which have investigated place of qualification (Cohen 2006;Hagopian et al. 2003;Healy and Oikelome 2007;Hing and Lin 2009;Oikelome and Healy 2007;Parsi 2008;Rao et al. 1998Rao et al. , 2007 but less often are gender and place of qualification considered together. Studies which have investigated gender differences in the work experiences of UK doctors indicate that male and female doctors both express dissatisfaction with the balance between their career and family life (see Dumelow and Griffiths 1995). ...
This article draws on a large British Medical Association (BMA) survey which allows the comparison of doctors who qualified in the UK with International Medical Graduates (IMG) who qualified overseas. It does this with respect to inequality, morale and career aspiration. The paper argues that the human-capital protection of qualifications, profession and status is not sufficient to equal the experiences of migrant doctors with those of doctors who qualified in the UK. Moreover, the article provides a gendered analysis which demonstrates clear differences between women and men and shows that place of qualification intensifies the gendered experience of a medical career. Drawing on intersectional insights shows that women IMGs are the most disadvantaged despite the apparent protection of high human capital.
... 7 It may also have to do with gender differences in general. It has been for instance been shown how men and women attribute different qualities to themselves and how women feel less competent to deal with uncertainty (Clack, 1999). Further, Gwartney-Gibbs and Lach (1994) argue that female workers more often than their male counterparts tend to label conflicts taking place within their work as personal. ...
When unions worldwide confront a decline in density and power, pressure increases on shop stewards. They occupy a position desribed s demanding, which involves striking a balance between conciliation and tough negotiation, between ordinary work and union work, and feelings of isolation from members. If shop stewards already experien a demanding work situation, and parallel to this the overall union conditions become aggravated, a next step would be to find out in what ways their situation can be facilitated. This article is based on data desribing recent experiences of Swedish shop stewards, and it compares their situation to that desribed in the international research literature. It is found that the basic components of union work remain stable, in spite of rent labour relations changes and national differences. However, lees than half of the reported problems were related to direct contact with the employer. Shop stewards generaly experience a situation characterized by inherent conflict and wide-ranging tasks, resulting in high demands on their skills and in role overload. On the other hand, the results indicate differences with regard to the ulnion affilation, age, experience and gender. En the eyes of union members the shop stew ards largely emb ody the ui on organizati on. Therefore, they should reeive increased attention when dealing with the problems of unions. Measures to facilitate their work can include training, supportive networks and access to adequate information technology, and can further be targeted with regard to age/experience and gender.
... In a study in which problem-based and conventional curricula were compared, PBL-group students reported significantly more positive attitudes towards their curricula and towards their learning environment (Kaufman and Mann, 1996). However, there have been reports of gender differences in the perception of skills and personal attributes in recent medical and science graduates (Nabi and Bagley, 1998;Clack and Head, 1999). Similar gender differences have also been reported in medical undergraduates (Whittle and Eaton, 2001). ...
As self-directed learning becomes more important in the field of pharmacology, so, too, are "transferable skills." In this study, the attitudes of second year medical undergraduates towards transferable skills in pharmacology were assessed. Differences due to gender, nationality and medium of instruction at school were investigated. A survey was conducted with the help of a self-administered questionnaire asking the students to rate, first, the importance of the particular transferable skill, second, their own ability in these skills and, third, the effect of integrated teaching. Students were of the opinion that transferable skills were very important in pharmacology. Female students gave a higher rating to the importance of drug selection and communication skills than males. The Indian students rated their problem solving skills higher than the other defined demographic groups. Finally, students had a high level of confidence in their own skills. These results suggest that students are well equipped to succeed in the revised curriculum of Kathmandu University, Nepal, which will place a greater emphasis on self-directed learning in the future.
... La falta de asociación entre las preferencias IT y el rendimiento, en las mujeres, puede atribuirse a influencias culturales, que asocian ser mujer con una mayor capacidad de comunicarse 24 . Por ello, aun cuando la mujer tenga preferencias IT, es posible que sus habilidades interpersonales estén suficientemente desarrolladas como para desempeñarse en forma satisfactoria en el ámbito interpersonal. ...
Background: The degree of difficulty we experience while learning different concepts and skills depends, among other things, on our psychological features and learning style. This may be particularly true for medical students, whose formation involves the acquisition of multiple cognitive, affective and psychomotor skills. Aim: To assess whether the psychological features and learning styles of medical students are associated with their academic performance. Subjects and Methods: The psychological preferences and learning styles of 66 students of the 2001-graduating cohort were determined with the Myers Briggs Type Inventory (MBTI) and the Kolb Learning Style Inventory (LSI), respectively. The academic performance was assessed by the Calificación Médica Nacional (CMN), Chile and by the marks obtained during the Basic (1st to 3th), Preclinical (4th y 5th) and Clinical (6th y 7th) years of undergraduate training. Results: The psychological features, together with the sex of students were found to be associated with the performance in the Preclinical and Clinical years, and to the CMN. In men, the interest and ability to communicate with people and the concern for harmony, and in women the tendency to function in a systematic and orderly way are the features associated to high academic performance. No associations were found between learning styles and academic performance. Conclusions: The finding that the psychological preferences of medical students are relevant to their academic performance opens a new perspective to analyze the medical education and to design programs aimed at improving learning (Rev Méd Chile 2004; 132: 1127-36)
... Later a postal questionnaire was sent to five cohorts of doctors who had previously qualified from Kings, asking them if they thought they had acquired the defined attributes of doctors that the medical school wished to produce. The results revealed significant gender differences (Clark & Head, 1999). Cruess et al. (2006) in Canada developed a Professionalism Mini-Evaluation Exercise (P-MEX) using the mini-Clinical Examination Exercise (mini-CEX) format. ...
Introduction: Patan Academy of Health Sciences (PAHS) is a new medical school that specialises in specifically training doctors for service in the rural areas of Nepal. The trainee doctors' values are consistent with sustainable improvements in the health of poor and marginalized people. This new faculty is engaged in a collaborative exercise to define professional attributes that are required of new graduates and to design a simple assessment tool to measure themselves. Background: Professionalism is an increasingly important topic in medical education today and a number of studies have described ways of defining and measuring professional attributes in Western medical graduates. No such studies can be found in any Asian medical schools. Methods: An initial faculty-wide consultation meeting in 2007 produced a list of 29 attributes for PAHS graduates. In 2008, the newly formed Medical Education Unit was given the task of refining them into a workable list that could be realistically assessed. This produced a list of 12 attributes together with their operational definitions. Results: The definitions of required attributes together with the presence or absence of their corresponding behaviour would be indicated in a simple table that could be used in a wide variety of educational settings. Discussion: The final assessment document requires only a 'meets expectations' or 'below expectations' tick from the tutor across 11 attributes. The efficacy and practical value of this tool will only be determined with use, and further research to determine how effective it is.
... Studies have shown that demonstration of empathy by dentists has been correlated with decreased dental fear (21,22), improved treatment success and cooperation in paediatric patients (23,24), thus leading to increased patient satisfaction (21,25). Investigators have reported greater female representation in paediatric dentistry, for example, in Israel (26,27). This could be because of the traditional belief that treating a child patient requires tenderness, empathy, caring and other related qualities that woman are more likely to possess than men. ...
Introduction:
Whilst the corporate world seems to have embraced the concept of emotional intelligence (EI) as a predictor of worker success, its role in the dental profession needs to be explored; this study provides an Indian context. Hence, the EI of postgraduate (PG) students of Paedodontics and Preventive Dentistry was assessed.
Aims:
To measure EI amongst Paedodontics PG students in India, to assess any gender differences in EI and associated dimensions amongst them.
Materials and methods:
A total of 300 PG students from various dental institutions across India participating in their specialty national conference at I.T.S. Centre for Dental Studies and Research, Muradnagar, were included. EI was measured by the inventory developed by Singh (2004), based on Goleman's model (1998).
Results:
Overall, 240 questionnaires (80% response rate) were completed by 142 male and 98 female PG students and analysed. Results showed that 19% and 58% of the respondents had very high and high EI scores, respectively. None of the students had poor or very poor scores. Results indicated that both males and females had high EI scores of 230.4 (± 10.38) and 222.6 (± 12.04), respectively. However, males had higher scores for dimensions of self-awareness (P<0.01), social awareness (P<0.01) and social skills (P<0.001) than their female counterparts.
Conclusions:
Both male and female paedodontic postgraduate students in India had high EI scores. This study provides valuable baseline information on EI in an Indian context.
... 5 More recently, Clack studied gender differences in medical graduates' self-assessments of personal attributes and found that women generally felt more confident than men in possessing nine of the 16 "ideal" attributes listed. 38 These studies indicate that our understanding of students' attitudes, some of which may reflect aspects of "professionalism," can benefit from self-report questionnaires. However, these studies are comparing groups and trends, not assessing the qualities of individuals. ...
An abstract is unavailable. This article is available as HTML full text and PDF.
... Stepulevage (2001) presented evidence of girls 'constructed incompetence' in secondary school Computing and Technology classrooms which they adopted in order to fit with gendered expectations of their peer group. Similarly in their study of medical students, Clack's and Head's empirical investigation of perceived attributes found that these were split between women and men along gendered lines: men felt better equipped with 'a spirit of curiosity' and 'leadership potential' compared with women who reported that they felt more confident in their 'ability to listen', 'work in a team' and to 'inspire confidence in others' (Clack and Head 1999). ...
This paper draws its evidence from the report Meta-analysis of gender and science research: Country group report UK and Ireland countries (Bennett et al 2010) which used the Gender and Science Database (GSD, www.genderandscience.org) to compile an extensive literature review of the research already undertaken on women’s and men’s careers in science. The paper begins by outlining the nature of horizontal and vertical segregation in the Science Engineering and Technology (SET) sectors in the UK. It then describes Sue Berryman’s model of a ‘pipeline’ to explain women’s career progression in science occupations and academic disciplines (Berryman 1983). The model has provided a focus for different explanations of the barriers and issues faced by women, combining research on gendered stereotypes and labour market practices and processes. The policy responses which the model has prompted are outlined. The final section of the paper discusses the ways in which the model has been expanded through critique and the development of new research areas, such as in the fields of diversity, globalisation and multiple gendered subjectivities which offer promising ways of moving beyond a view of women’s careers in science as single, narrowing and prescribed trajectories.
... In one study, female physicians were found to have more apprehension, less self-assurance, and worried more than their male counterparts. 36 Physician gender is associated with different personality characteristics, 41,42 either innate or learned, and several studies have pointed towards a gender impact on decisionmaking. [43][44][45][46] Gender is generally associated with risktaking behaviour 47 which may explain the finding that missed diagnosis of an acute coronary syndrome in the ED is more likely to happen with a male physician than a female. ...
... Bedingt durch die familiale und schulische Sozialisation kommen männliche und weibliche Studierende mit unterschiedlich ausgeprägten Kommunikationsfertigkeiten und Einstellungen in das Medizinstudium, was durch die berufl iche Sozialisation kaum noch zu modifi zieren ist [ 45 ] . Medizinstudentinnen können besser als ihre Kommilitonen zuhören [ 46 ] und zeigen bessere Gesamtleistungen in ärztlicher Gesprächsführung schon am Beginn ihres Studiums [ 47 ] . Auch bereits im Beruf tätige Ärztinnen waren empathischer [ 48 ] und konnten leichter eine gute Zusammenarbeit mit Patienten in einem Gespräch herstellen [ 49 ] . ...
In order to determine if first year medical students of a Medical Psychology and Medical Sociology course have adopted basic physician patient communication skills, we developed an appropriate Objective Structured Clinical Examination (OSCE). The parcours took place in a pretest condition (n=182) and in the following semester under test condition, now relevant for passing the course (n=181). Reliability of the OSCE reached a medium degree (α=0.55/0.50). Results of written examinations and OSCE scores were weakly correlated. The correlation between task competence and patient-centeredness was higher in the pretest than under test condition. Female students mostly achieved higher scores than male students. Nearly all of the students (92%/97%) were in favor of continuing this examination. Physician-patient communication is a process of high complexity, but it can be tested by OSCE. Relevance for passing the course seems to enhance the learning behaviour.
© Georg Thieme Verlag KG Stuttgart · New York.
... This study confirms previous work by ourselves and others , showing that females tend to perform slightly better on the course [8,9] , and particularly within skills assess- ments. [20,21]This may relate to differences in personal attributes between men and women.222324 Previous studies at Nottingham have shown that minority ethnicity is a predictor of 'struggling' and poor perform- ance [8,9], whereas fee status is not; in this self-selected cohort, in which the strugglers and worst-performing students had been excluded from the analysis, ethnicity was no longer a predictive factor, although Home/EU students were more likely to perform well, particularly in the clinical course. ...
It has been suggested that studying non-science subjects at A-level should be compulsory for medical students. Our admissions criteria specify only Biology, Chemistry and one or more additional subjects. This study aimed to determine whether studying a non-science subject for A-level is an independent predictor of achievement on the undergraduate medical course.
The subjects of this retrospective cohort study were 164 students from one entry-year group (October 2000), who progressed normally on the 5-year undergraduate medical course at Nottingham. Pre-admission academic and socio-demographic data and undergraduate course marks were obtained. T-test and hierarchical multiple linear regression analyses were undertaken to identify independent predictors of five course outcomes at different stages throughout the course.
There was no evidence that the choice of science or non-science as the third or fourth A-level subject had any influence on course performance. Demographic variables (age group, sex, and fee status) had some predictive value but ethnicity did not. Pre-clinical course performance was the strongest predictor in the clinical phases (pre-clinical Themes A&B (knowledge) predicted Clinical Knowledge, p < 0.001, and pre-clinical Themes C&D (skills) predicted Clinical Skills, p = or< 0.01).
This study of one year group at Nottingham Medical School provided no evidence that the admissions policy on A-level requirements should specify the choice of third or fourth subject.
... colleagues (13% versus 27%) to rate themselves highly on leadership ability (p = .01). 12 The reason for the difference in the attitudes of male and female faculty about leadership is unclear. Women generally have greater family responsibilities, few female role models in positions of leadership, and different leadership styles. ...
To assess attitudes of female faculty about career progress, resources for career development, and values related to academic success and recognition.
In 1997, the authors surveyed all faculty at Virginia Commonwealth University School of Medicine and its associated Veterans Affairs Medical Center.
Of 918 faculty, 567 (62%) responded to the survey; 33% of the respondents were women. Compared with men, women faculty were less likely to be tenured or at the level of professor, spent more time in clinical activities, had less time for scholarly activity, and reported slower career progress. Women were more likely to report that promotion and tenure criteria had not been reviewed with them. Significant differences were found between female physicians and non-physician faculty; female physicians reported the least time for scholarly activities and poorest understanding of promotion and tenure criteria. When the authors asked faculty how they valued certain indicators of career success, women were less likely to value leadership than were men. Female physicians were less likely to value scholarship and national recognition as indicators of their career success.
This survey found important differences in career progress of male and female faculty, with women reporting less time for career development. In addition, there were differences in values related to career success and recognition, which were most pronounced for female physicians. These differences may have an important impact on promotion for women in general and particularly for female physicians.
Differential attainment exists in all professions and is a manifestation of systemic factors creating an unequal environment where individual careers and aspirations may be thwarted. Although this inequality which affects some groups of students unfairly, has been recognised over the last 2 decades, it remains a significant issue. This scoping review explores the causes and contributors in relation to undergraduate medical education. Using thematic analysis, the authors present the case for tackling the disparity in education and training. There are evidence-based solutions for individuals, organisations and at a societal level. The recommendations from this review will be discussed and debated in the series of workshops, as part of the ‘Bridging the Gap’ series from the Alliance for Tackling Inequalities in Health, chaired by the British Association of Physicians of Indian origin. The output of the consensus-building workshops and thematic synthesis with the accompanying qualitative research will be presented in the final report due in 2021.
Background:
Understanding the work habits, attitudes, and experiences of women physicians is critical for optimal patient care. In a gendered work environment, obstacles faced hinder women physicians from contributing to their full ability. This study investigated how women physicians' work habits are viewed, in the context of women's attitudes and experiences.
Methods:
An analysis of the medical literature (1990-2017) was undertaken. Published studies were located using search engines, article references, consultation with experts, and relevant Mesh terms. Of 1185 listings, 354 studies were evaluated and 44 articles, selected by three reviewers, were analyzed in detail.
Results:
Four themes emerged-practice styles, productivity, prevailing attitudes, and the workplace environment. Comparing women physicians to male colleagues as a standard for evaluating performance, for example, undervalues distinctive characteristics women bring to medical practice. Productivity models that focus on work hours, procedures, and publications do not encompass the full scope of patient care.
Conclusions:
Solutions offered mainly have been designed to help women physicians fit into existing workplace environments, but traditionally available "adapt or exit" options in response to challenges faced appear insufficient. A gender equity perspective helps to explain findings and suggests ways to reshape the health care workplace to better understand, utilize, and retain women physicians.
Background:
Uncertainty tolerance (UT) is thought to be a characteristic of individuals that influences various outcomes related to health, healthcare, and healthcare education. We undertook a systematic literature review to evaluate the state of the evidence on UT and its relationship to these outcomes.
Methods:
We conducted electronic and bibliographic searches to identify relevant studies examining associations between UT and health, healthcare, or healthcare education outcomes. We used standardized tools to assess methodological quality and analyzed the major findings of existing studies, which we organized and classified by theme.
Results:
Searches yielded 542 potentially relevant articles, of which 67 met inclusion criteria. Existing studies were heterogeneous in focus, setting, and measurement approach, were largely cross-sectional in design, and overall methodological quality was low. UT was associated with various trainee-centered, provider-centered, and patient-centered outcomes which were cognitive, emotional, and behavioral in nature. UT was most consistently associated with emotional well-being.
Conclusions:
Uncertainty tolerance is associated with several important trainee-, provider-, and patient-centered outcomes in healthcare and healthcare education. However, low methodological quality, study design limitations, and heterogeneity in the measurement of UT limit strong inferences about its effects, and addressing these problems is a critical need for future research.
There is no empirical evidence for a specific physician personality, but we lack large and representative comparison studies. Prospective studies show that the neuroticism trait is a risk factor for stress, depression, and reduced well-being in physicians as well as in the general population. The conscientiousness trait may be both beneficial (reduce drinking and increase performance) and detrimental (for stress and burnout) in physicians. Reality weakness is a pathological trait that has shown predictive validity in Norwegian physicians with respect to severe depression, suicidal ideation, and lack of help-seeking. Despite being relatively stable after young adulthood, traits may develop and change over the whole life span, suggesting that traits causing dysfunction can also change with treatment. Psychotherapy is effective in the treatment of personality disorders.
Transitions from school to university are major life events impacting previously established routines. This has potential for elevating stress that entails coping. Employing focus groups, this unique study endeavoured to understand the struggles, strengths, challenges and the first year experience of the "first of the first" cohort of medical students at a newly developed medical school. Three main themes identified were: (i) unique experience of being the first cohort; (ii) first year experience and (iii) perceptions of personal growth. Supportive peers, faculty and novel teaching approaches could potentially off-set stressful aspects of transition like altered routines; absence of seniors; past exam resources and weakening friendships. Both content (course structure; curriculum; teaching methodology) and context of teaching (supportive faculty; adequate social support; resourced environment) have policy implications for educators. Appropriate scaffolding (type and extent of support) will promote student wellbeing and minimize attrition. © Common Ground, Renu Narchal, Leanne S. Cowin, Ian Wilson, David Harding.
Objectives. To determine the extent to which recent pharmacy graduates perceived themselves as caregivers, and to identify differences between respondents' possessing caring attributes and their belief that these were desirable in a pharmacist. Methods. A cross-sectional study was conducted using a self-administered, online survey instrument asking 402 PharmD graduates to indicate to what extent they felt they had obtained 16 personal attributes appropriate to their responsibilities to patients. Outcome measures included the degree to which graduates believed they possessed the attributes and the desirability of possessing these attributes. Results. Most of the 95 respondents agreed they possessed the attributes under study and many agreed that these attributes were desirable. There were statistically significant differences between genders, mostly associated with the "dealing with uncertainty" and "leadership" domains. Conclusion. Pharmacy curricula appear effective, at least partly, in instilling confidence in graduates to provide direct patient care.
Purpose: The author interprets the state of the art of assessing professional behavior. She defines the concept of professionalism, reviews the psychometric properties of key approaches to assessing professionalism, conveys major findings that these approaches produced, and discusses recommendations to improve the assessment of professionalism. Method: The author reviewed professionalism literature from the last 30 years that had been identified through database searches; included in conference proceedings, bibliographies, and reference lists; and suggested by experts. The cited literature largely came from peer-reviewed journals, represented themes or novel approaches, reported qualitative or quantitative data about measurement instruments, or described pragmatic or theoretical approaches to assessing professionalism. Results: A circumscribed concept of professionalism is available to serve as a foundation for next steps in assessing professional behavior. The current array of assessment tools is rich. However, their measurement properties should be strengthened. Accordingly, future research should explore rigorous qualitative techniques; refine quantitative assessments of competence, for example, through OSCEs; and evaluate separate elements of professionalism. It should test the hypothesis that assessment tools will be better if they define professionalism as behaviors expressive of value conflicts, investigate the resolution of these conflicts, and recognize the contextual nature of professional behaviors. Whether measurement tools should be tailored to the stage of a medical career and how the environment can support or sabotage the assessment of professional behavior are central issues. Final thought: Without solid assessment tools, questions about the efficacy of approaches to educating learners about professional behavior will not be effectively answered.
To investigate the effect of physician gender on consultation length in UK hospital outpatient clinics and compare this, through meta-analysis, with previous studies outside the UK.
Observational data on clinic times were analysed and findings were combined in a meta-analysis with existing studies investigating the effect of physician gender on consultation length.
UK hospital practice.
A total of 174 observations of outpatient consultations with 10 hospital specialists (consultants) from different specialties in two UK hospital trusts.
Clinic times were recorded and analysis of consultation length was undertaken with physician gender as a covariate. Data were then synthesised through meta-analysis with 10 existing studies in this field.
No statistically significant difference was found in the length of consultations for male and female doctors in these UK hospital settings. When pooled with existing studies, consultations with women doctors were found to be approximately two minutes longer than with men (p = 0.01).
Findings from this analysis of clinic consultations in the UK National Health Service do not support previous studies, which were undertaken predominantly in North America and primary care settings. Overall, meta-analysis suggests doctors' gender may influence consultation length. Gender differences in communication should be considered in training clinicians and in overall clinical practice.
© The Royal Society of Medicine.
Ethical issues concerning dichotomies which may occur in educational counselling in one kind of vocational training - medical education - are discussed. In many respects, this kind of learner-centred mentoring, so useful in other disciplines at tertiary and post-tertiary levels, is problematic when there is a parallel imperative to protect the common good. It is reassuring that these problems have also been recognised in other disciplines.
A new compound, K2Cr8O16 with the hollandite-type structure was synthesized under high temperature-pressure conditions ranging from 1100° to 1250° C and from 55 to 65 kbars. Its crystal structure was classified as C32h - C2/m with the lattice parameters a=13.820, b=2.941, c=9.772 A and β=135°. Ferromagnetism was observed in this compound whose Curie temperature was 225 K and magnetic moment was approaximately 18 μB.
Purpose: To assess attitudes of female faculty about career progress, resources for career development, and values related to academic success and recognition.
Method: In 1997, the authors surveyed all faculty at Virginia Commonwealth University School of Medicine and its associated Veterans Affairs Medical Center.
Results: Of 918 faculty, 567 (62%) responded to the survey; 33% of the respondents were women. Compared with men, women faculty were less likely to be tenured or at the level of professor, spent more time in clinical activities, had less time for scholarly activity, and reported slower career progress. Women were more likely to report that promotion and tenure criteria had not been reviewed with them. Significant differences were found between female physicians and non-physician faculty; female physicians reported the least time for scholarly activities and poorest understanding of promotion and tenure criteria. When the authors asked faculty how they valued certain indicators of career success, women were less likely to value leadership than were men. Female physicians were less likely to value scholarship and national recognition as indicators of their career success.
Conclusion: This survey found important differences in career progress of male and female faculty, with women reporting less time for career development. In addition, there were differences in values related to career success and recognition, which were most pronounced for female physicians. These differences may have an important impact on promotion for women in general and particularly for female physicians.
ContextChanges to the style of medical teaching will place a greater responsibility on individual medical students to manage their own learning, highlighting the need for students to develop good so-called ‘transferable’ skills at an early stage in their undergraduate career.Objectives
To assess the attitudes of first year undergraduates towards transferable skills, and investigate the gender difference in these attitudes. To assess the contribution of their first year course to skills development.SubjectsFirst year students, enrolled on a traditional-style course.MethodA questionnaire asking the students to consider: (a) the importance of named transferable skills for medicine; (b) their own ability in these areas; and (c) the influence of their first year course.ResultsAll students, irrespective of gender, regarded transferable skills as very important to medicine, rating organizational skills and self-learning skills as most important. Overall, students have a high level of confidence in their own skills. Male students rated their overall level of skills more highly than women. In particular they rated their information handling, managing self-learning and technical skills more highly. Students feel that their first year course has enhanced their skills in most areas.Conclusions
Our results suggest that students will feel equipped to succeed in a learning system which places the onus on them to take responsibility for their own learning. They clearly believe that they have the necessary skills for independent learning. The study highlights the need to enhance students’ self-evaluation skills.
Although the number of women entering medical school has been steadily rising in the U.S.A., female medical students continue to report instances of sexual harassment and gender discrimination. The full spectrum of such experiences and their effect on the professional identity formation of female students over time remains largely unknown. To investigate these experiences, we interviewed 12 third year female medical students at a private New England medical school over several points during the 2006-2007 academic year. Using theoretical frameworks of gender performance and the centrality of student-patient and student-supervisor relationships, we were better able to understand how female medical students interpret the role of 'woman doctor' and the effect of negative and positive gendered interactions on the evolution of their professional identity. We found that participants quickly learned how to confront and respond to inappropriate behavior from male patients and found interactions with female patients and supervisors particularly rewarding. However, they did not feel equipped to respond to the unprofessional behavior of male supervisors, resulting in feelings of guilt and resignation over time that such events would be a part of their professional identity. The rapid acculturation to unprofessional behavior and resignation described by participants has implications for not only professional identity formation of female students but specialty choices and issues of future physician workforce.
An alumni study of graduates from the medical school in Uppsala, was performed to give input into an ongoing reform process.
This study aimed to investigate how medical interns view their undergraduate medical education and the extent to which they felt that the curriculum prepared them for their current positions.
A web-based questionnaire was sent out via mail in 2005 to all past graduates who had qualified in Uppsala in 2003.
Replies were obtained from 69 of 102 students (68%). The most apparent suggested change of the education was increased integration of preclinical and clinical teaching. Correlations were found between student satisfaction with the medical school and perceived teacher attitude, encouragement to reflect, and the graduates' perception of having sufficient practical abilities. Significant gender differences were found regarding perceived clinical ability and concerning feedback and encouragement from the teachers.
Our results suggest more direct feedback from the teachers and more integration between basic sciences and clinical education. Female and male students may have different needs. A key question is therefore to encourage teachers to learn about gender since female and male students should equally experience respectful encounters with teachers and doctors acting as role models.
The development of palliative care as a recognizable specialty has been supported by an acknowledgment of palliative medicine as a discrete discipline within the medical profession. While the knowledge and skills required for training in palliative medicine are well defined, there are elements of the medical care of people at the end of life that are more difficult to outline. Nursing practitioners and academics in particular have made important contributions in defining caring as an entity, and published work in the field of nursing, bio-ethics and philosophy has encouraged an understanding of what caring is and how it is practised. However, it has rarely been addressed specifically in the medical literature. Undergraduate and postgraduate curricula outline some of the attitudes required to practise palliative medicine but the way in which doctors learn to care and indeed should care has not been clearly detailed. This paper reviews some of the literature pertinent to this aspect of palliative care, with particular reference to some of the elements that may influence how and why doctors learn to care in the way that they do in their practice of medicine.
The data presented discuss the motivations and personality of the female medical school student from the University of California, San Francisco campus. Inductive analyses of conscious reasons for entering medical school reveal the importance of encouragement from others, long-standing interest, self-development motives, and altruism. In contrast to studies reported on male subjects, economic and prestige factors as well as the unreachable aspect of other occupations are seldom mentioned by women.
Sex differences in specialty choices, specialty beliefs, and personality characteristics of female and male medical students were analyzed. Subjects included 95 female and 166 male medical students from the University of Colorado School of Medicine and the University of California, San Diego, School of Medicine. Results from a personality measure, the Adjective Check List, and from measures of students' beliefs as to status, similarity-to-self, and social desirability of various specialties revealed significant differences between men and women on specialty choice, ratings of status and social attractiveness of the specialties, and personality characteristics. It appears that for female medical students specialty choices and general personality characteristics have changed to less traditional and stereotypic positions in the past few years.
In spite of the increasing number of women medical students, in many specialties the number of women actually working as doctors still lags behind the number of men working in the same profession. To define factors contributing to this discrepancy 646 medical students at the Vrije Universiteit in Amsterdam were surveyed. A questionnaire was used to obtain information about the difference between women and men medical students concerning their outlook on a future career as combined with domestic responsibilities. The questionnaire covered the items motives and career preference, barriers to reaching the profession of first choice, career planning and the combination of domestic responsibilities and a medical career. The results of this survey indicate that there are still important differences between women and men students in career perspectives. These differences need attention from medical students as well as teaching staff.
The aim of this study was to examine the factors influencing medical students' communication skills. The sample comprised all first-year clinical students. Thirty-two received teaching in communication skills during the year; the remaining 56 did not. Students' career preferences, attitudes towards communication skills and confidence in their ability to communicate with patients were assessed by questionnaire at the beginning and end of the year. At the end of the year each student was videotaped interviewing a simulated patient. Students' communication skills were assessed on the basis of this interview by raters using a standardized rating scale, and by patient questionnaires. While there was some evidence that brief communication skills training improved skills, sex of student was a more significant predictor of level of skill. Students who perceived communication skills as less relevant to medicine and those who were more confident about their own communication skills were more likely to prefer a career in hospital medicine. Students' judgements of their ability to communicate effectively were poor. In the main there was no relationship between confidence and level of skill: where they were related, the association was negative. The benefits from communication skills training might be enhanced by involving hospital doctors in the teaching, and providing students with detailed video feedback on their skills at the outset.
A questionnaire was given to 254 medical students matriculated in 1992/93 concerning their motivation for wanting to become a doctor, attitudes towards which qualities a doctor should have and their potential choice of medical specialty. The analysis focuses on whether answers are relation-orientated (i.e. directed towards relations to others) or autonomy-orientated (i.e. directed towards rationality and independence). The results show that motivations for becoming a doctor are both relation- and autonomy-orientated. Most students expect the doctor to both be able to relate to the patient and be professionally competent. No gender differences could be demonstrated concerning motivations for becoming a doctor or which qualities a good doctor should possess. Significant gender differences were displayed concerning choice of specialty, most women aiming towards relation-orientated specialties and most men aiming towards autonomy-orientated specialties. It is concluded that the growing proportion of women doctors could change the medical profession towards becoming more patient- and relation-orientated, however their choice of relation-orientated and lower prestige specialties could result in less overall influence than one might otherwise expect.
To obtain information from a group of young physicians and compare men and women on their evaluations of selected areas of the medical school curriculum, their perceptions of issues related to medical practice and professional life, and their specialty choices, professional activities, and research productivity.
In 1992, a questionnaire was mailed to 1,076 physicians who had graduated from Jefferson Medical College between 1982 and 1986. The responses of men and women were compared using multivariate and univariate analyses of variance, t-tests, chi-square, and median test.
Completed questionnaires were returned by 667 graduates (530 men and 137 women). The curriculum areas of interpersonal skills, disease prevention, medical ethics, and economics of health care were rated by both men and women as being the most important in medical training. Conversely, research methodology and statistics received the lowest ratings. Women, in general, valued psychosocial aspects of medical care higher than did men. Among the areas of perceived problems related to practice, lack of leisure time received the highest ratings (as being the greatest problem) and interpersonal interactions received the lowest ratings (as being the least problem) from both men and women. The men were more concerned than the women about the areas of patient chart and documentation, malpractice litigation, physician oversupply, peer review, and interaction with patients. These differences remained when specialties and numbers of hours worked per week were held constant. Generally, the physicians reported satisfaction with their professional lives, but the men tended to be more satisfied than the women about their decisions to become physicians and in their perceptions of medicine as a rewarding career. The proportion of men employed full-time (99.4%) was significantly higher than that for women (84%). Women were more likely to practice general pediatrics, while men were more likely to practice surgery and surgical subspecialties. Full-time--employed women worked fewer hours per week (57) than men (63), and men reported more research productivity than women.
The implications of the findings of numerous gender differences are discussed regarding the issues of physician workforce, types of care rendered by men and women, and possible changes in the national health care system.
In response to the General Medical Council's 1991 Consultative Document proposing changes to medical curricula, the King's College School of Medicine and Dentistry, London, established a steering group to plan a new curriculum. As part of this process a postal survey was undertaken of five cohorts of King's graduates to ascertain how well the medical course they had undertaken had equipped them for practice. The questionnaire explored the level of factual content, the adequacy of their skills training, and the development of personal attributes during the course. A total of 371 graduates replied, a response rate of 78%. Over 70% indicated that their education had satisfactorily equipped them for their medical practice. Significant differences were found, however, between those now practising in primary care and those in hospital medicine regarding the importance attached to different subjects within the curriculum, and also with respect to the personal attributes the graduates felt they had acquired. Both groups identified deficiencies in virtually all aspects of their skills training: clinical, analytical, communication, management and technical.
This feedback from some of the ‘consumers’ of medical education is now being used to assist the planning of the new King's curriculum.
Improve teaching of practical skills
- Clack GB
Six Minutes for the Patient: Interactions in General Practice Consultation
- Balintm
Aequanimitas 3rd edn
- Oslerw
Empathy' enters the profession of medicine
- Morees