Gender Bias in Medical Images Affects Students’ Implicit but not Explicit Gender Attitudes

Abstract

Medical education curricula have the potential to impact the gender attitudes of future healthcare providers. This study investigated whether gender-biased imagery from anatomy textbooks had an effect on the implicit and explicit gender attitudes of students. We used an online experimental design in which students (N = 456; 55% female) studying anatomy were randomly assigned to a visual priming task using either gender-neutral or gender-biased images. The impact of this priming task on implicit attitudes was assessed using the Implicit Association Test (IAT) and the impact on explicit attitudes was measured using the Gender Bias in Medical Education Scale. Viewing biased images was significantly positively associated with implicit gender bias as indicated by higher IAT scores in the treatment compared to the control condition (mean IAT difference = 43 milliseconds; Cohen's d = .33). In contrast, there was no significant effect of gender-biased images on explicit gender attitudes.

Colonization, cadavers, and color: Considering decolonization of anatomy curricula

“…These omissions may provide one route through which bias presents within healthcare. Similar findings have been demonstrated in other studies (Louie & Wilkes, 2018;Parker et al, 2017;Parker et al, 2018), with analysis including other protected characteristics such as gender, further supporting the perpetuation of inequity and discrimination.…”

“…Within anatomy education, teaching and learning relies upon bodies (cadavers and life models), physical representations of the body (e.g., plastic models), technological software, and diagrammatic representations (e.g., textbooks and anatomy atlases). Anecdotally, diagrammatic, technological, and physical representations are frequently devoid of diversity in terms of the populations they represent (Louie & Wilkes, 2018 ; Parker et al, 2018 ). Not many attempts have been made to systematically review and collate these representations.…”

Older women are frailer, but less often die than men: a prospective study of older hospitalized people

“…Moreover, frailty is associated with several negative outcomes in hospitalized older people, including increased length of stay, mortality, institutionalization [13,14]. In addition, it has been reported that older women tend to be excluded from certain acute therapeutic interventions more than men, and such selective exclusion may be revealed looking at differential mortality [15].…”

Improving Equity, Diversity, and Inclusion in Plastic, Reconstructive, and Aesthetic Surgery in Canada: A Call to Action

“…31 As educators, we are responsible for ensuring inclusive trainee education. Skin tone diversity lacks in this area, as medical literature images are predominantly of male gender 32 and white skin tones. 33 In 2019, Massie et al a study of images in multiple prominent medical journals (eg, New England Journal of Medicine , Annals of Plastic Surgery , Aesthetic Surgery Journal , Journal of Craniofacial Surgery , Journal of Hand Surgery , Journal of Plastic, Reconstructive, and Aesthetic Surgery , and Plastic and Reconstructive Surgery ) revealed an overrepresentation of white skin tones in the plastic surgery literature, which is not representative of the global or regional populations.…”

“…35 A lack of representation excludes patient experiences and outcomes and is associated with negative stereotyping when diverse images are used, contributing to the systemic racism ingrained in our healthcare system. 32,36 It can also have important clinical implications. For example melanomas in non-White populations are more strongly linked to misdiagnosis and worsened health outcomes.…”