‘Too male, too pale, too stale’: a qualitative exploration of student experiences of gender bias within medical education

Brown, Megan E. L.; Hunt, George E G; Hughes, Ffion; Finn, Gabrielle M.

doi:10.1136/bmjopen-2020-039092

Cited by 25 publications

(20 citation statements)

References 68 publications

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“…Organizational structures tend to perpetuate themselves; therefore, without conscious interventions in place, men are promoted more often than women [ 22 ]. The secondary effect on the medical student population is one which projects the subliminal message of who is accepted and most likely to succeed [ 23 ]. A dearth of females in positions of authority or influence can reduce the potential for scientific discovery, as females are more likely to develop new programs related to women’s health [ 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Physician gender as a source of implicit bias affecting clinical decision-making processes: a scoping review

Champagne‐Langabeer

Hedges

2021

BMC Med Educ

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Background The demographic profile of practicing physicians is changing as more female medical students are graduating and practicing in the field. While the education received may not differ by gender, studies have shown that physician practice outcomes vary by provider gender. Various factors could contribute to these differences, including culture and explicit biases which may lead to implicit bias. This study aims to identify the available evidence of gender-based implicit bias throughout the delivery process of medicine. Methods This scoping review evaluated published literature within the PubMed, Ovid MEDLINE, PsychINFO, Web of Science, and BioMed Central databases pertaining to physician’s gender as a factor in the delivery of medicine. Arksey and O’Malley’s six-stage methodology was used as a framework and reported using the updated Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Searches occurred between May 2020 and June 2020, and the timeframe was not limited. Included articles had gender as a factor in the delivery of medicine and implicit bias. Articles were excluded if they did not include the gender of the physician. After screening by reviewers and a medical librarian, study characteristics were charted and analyzed. Results The initial search resulted in 2420 records. After screening, 162 of the records were selected based on title and keyword relevance. After additional screening, 15 records were ultimately included in the review based on full-text evaluation. Records were organized into sub-topics post hoc focused on clinical qualities, diagnostics, treatment, and outcomes. Conclusion This scoping review found that gender-based implicit bias may be inadvertently acquired from culture and education. Although implicit bias is highly researched, much of the current literature focuses on the gender of the patient. This study found important gaps in the available literature regarding race and gender of the physician. Further studies could explore outcome differences between recent graduates and career physicians, for both female and male physicians.

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Section: Introductionmentioning

confidence: 99%

Physician gender as a source of implicit bias affecting clinical decision-making processes: a scoping review

Champagne‐Langabeer

Hedges

2021

BMC Med Educ

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“…Microaggressions are the commonplace verbal, behavioral, or environmental slights, whether intentional or unintentional, that communicate hostile, derogatory, or negative attitudes towards culturally minoritized groups (Sue et al, 2007). The prevalence and impact of microaggressions in health professions learning environments negatively impacts student psychosocial wellbeing inside and outside of the classroom, particularly in health professions learners who identify as women (Brown et al, 2020), disabled (Meeks et al, 2020) and/or racially marginalized (Chisholm et al, 2020). This research highlights the importance of revising health professions curriculum to formally include dialogue about diversity, equity, and inclusion (DEI).…”

Section: Introductionmentioning

confidence: 99%

IMPROVing communication about diversity, equity, and inclusion in health professions education

Muldoon

2022

The Anatomical Record

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There has never been a stronger call for authenticity in health professions education than this moment in time. The health inequities laid bare by the COVID-19 syndemic (a concept that describes the clustering of SARS-CoV-2 infection and disease by political, social, and economic factors) compels health professions educators to learn how to best engage in, sustain, and deepen conversations on diversity, equity, and inclusion (DEI) within our learning environments. Health professions curricula should address such concerns through explicit faculty training programs in dialogue models of communication. In this commentary, I propose that medical improv can help refocus health professions training to the humanistic values of empathy for others and respect for multiple viewpoints. Medical improv refers to teaching methods that adapt improvisation principles and exercises to enhance professional competencies in the health professions, such as communication. I describe a training series implemented at one institution to prepare faculty facilitators to engage in conversations about DEI in a discussion-based core course on the social determinants of health for first year medical students called "Humanity in Medicine." Key elements of dialogue training, including examinations of identity and positionality, caretaking and team-making, and conversations with a skeptic, are viewed through the lens of improv exercises as a pedagogy in communication. I report on facilitator and medical students' positive response to facilitator training and the Humanity in Medicine course. Potential next steps towards a formal evaluation of the method, and outcomes assessments of the use of improv in health professions training are discussed.

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“…[8][9][10][11] Prior research has demonstrated that there may be an underlying hidden curriculum in medical education that stymies the advancement of diversity in surgical subspecialties. 7,[12][13][14][15] Very little is known specifically about the diversity of current professors and society leaders of laryngology in the United States. Increasing the diversity of underrepresented physicians in laryngology is an important factor in improving healthcare delivery.…”

Section: Introductionmentioning

confidence: 99%

“…The glass ceiling is a multifactorial phenomenon that women and minorities routinely encounter that prevents higher levels of academic and professional advancement 8–11 . Prior research has demonstrated that there may be an underlying hidden curriculum in medical education that stymies the advancement of diversity in surgical subspecialties 7,12–15 …”

Section: Introductionmentioning

confidence: 99%

Diversity in Academic Laryngology: An Evaluation of Academic Advancement and Research Productivity

et al. 2021

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Background: Diversity within the medical profession with respect to sex and racial minorities has been shown to have a positive effect on health and healthcare. Characterization of a field is key to evaluating trends and the advancement of diversity in an otolaryngology subspecialty.Study Design: Observational study. Methods: A comprehensive list of all the academic laryngologists was compiled from the Accreditation Council for Graduate Medical Education accredited otolaryngology residency programs in 2020. The last 20 past presidents of the American Laryngological Association (ALA) and American Broncho-Esophogological Association (ABEA) were analyzed. Academic rank and years in practice were determined from departmental websites, with online search tools used as secondary resources. The h-index was utilized as a measure of research productivity. Regression analysis was performed to analyze these variables.Results: There are 184 academic laryngologists in the 124 programs. The majority of the population is Caucasian 76.6% (141/184), followed by Asian 16.3% (30/184), African American 4.34% (8/184), and then Hispanic 1% (2/184). There are 47 full professors with 83% Caucasian, 14.1% Asian, and 2.1% African American and 91.5% male and only 8.5% female. Past ALA presidents were 90% male and for the ABEA 75% male. H-index revealed a statistically significant difference between Caucasian and African American colleagues [P value (<.0005)].Conclusions: Minorities are disproportionately underrepresented in laryngology. Women are less likely to be in leadership roles in laryngology and become full professors. Laryngology lags behind other surgical specialties in the representation of minorities and women. Continued efforts should be made to increase diversity in the field of laryngology, especially in regard to underrepresented minorities.

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‘Too male, too pale, too stale’: a qualitative exploration of student experiences of gender bias within medical education

Cited by 25 publications

References 68 publications

Physician gender as a source of implicit bias affecting clinical decision-making processes: a scoping review

Physician gender as a source of implicit bias affecting clinical decision-making processes: a scoping review

IMPROVing communication about diversity, equity, and inclusion in health professions education

Diversity in Academic Laryngology: An Evaluation of Academic Advancement and Research Productivity

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