A gender biased hidden curriculum of clinical vignettes in undergraduate medical training.

Abstract

ObjectivesMedical education relies extensively on clinical vignettes, yet little attention has been given to what hidden curriculum they might convey. Our research aimed to identify whether the clinical vignettes used in pre-graduate medical education transmit gender stereotypes or gender biases. MethodsWe conducted a mixed quantitative and qualitative analysis of gender-related characteristics currently existing in clinical vignettes used for pre-graduate teaching and evaluation at the Geneva Faculty of Medicine. Results2359 vignettes were identified, of which 955 met inclusion criteria. Patients’ professions and family caregiver roles showed a strongly gendered distribution, as did the healthcare professions where male physicians and female nurses were the norm. Qualitative results identified widespread stereotyped gender roles and gender expression. ConclusionOur study reveals that the clinical vignettes used in education and evaluation materials in pre-graduate medical education in Geneva convey a gender-biased hidden curriculum, which could negatively impact patient care and undermine equal opportunity for men and women. Practice implicationsActive revision of the content and the form of clinical vignettes used in undergraduate medical education is needed using a gender lens. Based on rare gender neutral or gender transformative examples from our study, we propose guidelines for writing non-gender-biased vignettes.