Evidence of gender bias in True-False-Abstain medical examinations

Shona Kelly,Reg Dennick

doi:10.1186/1472-6920-9-32

Abstract

BackgroundThere is evidence that males and females differ in their attainment on a variety of assessments in general and in medical education. It has been suggested that the True-False-Abstain (TFA) format with negative marking is biased against females.MethodsEight years worth of examination data from the first two years of an undergraduate medical curriculum was analysed. 359 courses were evaluated for statistically significant differences between the genders using ANOVA. Logistic regression was used to test if subject area, calendar year or exam format predicted that males or females do better (termed male advantage or female advantage).ResultsStatistically significant differences between the genders were found in 111 (31%) of assessments with females doing better than males in 85 and males better in 26. Female advantage was associated with a particular year (2001), the Personal and Professional Development strand of the curriculum, in course assessment and short answer questions. Male advantage was associated with the anatomy and physiology strand of the curriculum and examinations containing TFA formats, where the largest gender difference was noted. Males were 16.7 times more likely than females to do better on an assessment if it had any questions using the TFA format.ConclusionAlthough a range of statistically significant gender differences was found, they were concentrated in TFA and short answer formats. The largest effect was for TFA formats where males were much more likely to do better than females. The gender bias of TFA assessments in medical education is yet another reason why caution should be exercised in their use.

Highlights

There is evidence that males and females differ in their attainment on a variety of assessments in general and in medical education
Assessment is a key component of teaching and its effective use in medical education can assist in meeting curriculum goals and maintaining standards acceptable to the profession and to the public [1]
BMC Medical Education 2009, 9:32 http://www.biomedcentral.com/1472-6920/9/32 has added to the dispute on gender differences between male and female minds with a recent debate at Harvard garnering press and online coverage [1]

Summary

Introduction

There is evidence that males and females differ in their attainment on a variety of assessments in general and in medical education. It is acknowledged that assessment should be fair and defensible, reliable and valid and that it should promote the deep learning of appropriate domains of knowledge, skills and attitudes. In addition it should accommodate individual differences and, by using a wide range of formats, should not disadvantage any particular group of learners. BMC Medical Education 2009, 9:32 http://www.biomedcentral.com/1472-6920/9/32 has added to the dispute on gender differences between male and female minds with a recent debate at Harvard garnering press and online coverage [1]. Some have suggested that females do better on in-class assessments as opposed to unseen exams [2] but a test of this at the University of Sussex found that females did better than males in both formats over a wide range of coursework [3]

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Results

Discussion

Conclusion