Abstract
BackgroundGender is an important social determinant, that influences healthcare. The lack of awareness on how gender influences health might lead to gender bias and can contribute to substandard patient care. Our objectives were to assess gender sensitivity and the presence of gender stereotypes among swiss medical students.MethodsA validated scale (N-GAMS – Nijmegen Gender Awareness in Medicine Scale), with 3 subscores assessing gender sensitivity (GS) and gender stereotypes toward patients (GRIP) and doctors (GRID) (ranging from 1 to 5), was translated into French and was distributed to all medical students registered at the University of Lausanne, Switzerland in April–May 2017. Reliability of the three subscales was assessed calculating the alpha Cronbach coefficient. Mean subscales were calculated for male and female students and compared using two sample t-tests. A linear model was built with each subscale as a dependent variable and students’ sex and age as covariables.ResultsIn total, 396 students answered the N-GAMS questionnaire, their mean age was 22 years old, 62.6% of them were women. GS and GRID sub-scores were not significantly different between female and male students (GS 3.62 for women, 3.70 for men, p = 0.27, GRID 2.10 for women, 2.13 for men, p = 0.76). A statistically significant difference was found in the GRIP subscale, with a mean score of 1.83 for women and 2.07 for men (p < 0.001), which suggests a more gender stereotyped opinion toward patients among male students. A trend was observed with age, gender sensibility increased (p < 0.001) and stereotypes decreased (GRIP p = 0.04, GRID p = 0.02) with students getting older.ConclusionMedical students’ gender sensitivity seems to improve throughout the medical curriculum, and women students have less stereotypes towards patients than men do. The implementation of a gender-sensitive teaching in the medical curriculum could improve students’ knowledge, limit gender bias and improve patients’ care.
Highlights
Gender is an important social determinant, that influences healthcare
To measure student’s gender sensitivity we used the Nijmegen Gender Awareness in Medicine Scale (N-GAMS) scale, which has been developed in 2008 and validated by the Dutch team of Radboud University Nijmegen Medical Centre [7]. This scale is based on two attitudinal aspects of gender-awareness: gender sensitivity (GS) and gender role ideology which is assessed towards patients (GRIP) or doctors (GRID)
An improvement of general gender awareness could be achieved by implementing gender focused courses at a clinical level, for nursing staff, senior clinicians or attended specialists, who are usually responsible for medical students in the first years of clinical learning
Summary
Gender is an important social determinant, that influences healthcare. The lack of awareness on how gender influences health might lead to gender bias and can contribute to substandard patient care. Gender is considered as a social determinant of health, at the same level as ethnicity and education. Social inequalities between men and women influence health at different levels from structural to individual health. Rrustemi et al BMC Medical Education (2020) 20:156 stereotype, which is defined as the clinically unjustified difference of treatment between female and male patients; and gender blindness, which is defined by the inability to recognize differences when they are clinically pertinent [6, 7]. A common example of stereotypes is found in cardiovascular disease, where coronary heart disease is often underdiagnosed in women due to a different, biased management [8, 9]. Gender stereotypes are acquired in society through socialization of both men and women and are rooted in gendered roles, identities and representations. The common example is again in the treatments of cardiovascular diseases [10]
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