Gender Bias in Patient Care Learning Experiences: Reflective Writings of Third-Year Medical Students.

Abstract

Introduction: Medical students' accounts of gender bias in their patient care learning experiences remain limited. This study examines students' responses to gender bias and their consideration for how to prepare for gender bias in their futures.

Methods: We analyzed reflective writings of third-year clinical students. Within a phenomenology framework, conventional content analysis was used to inductively analyze all essays, using HyperResearch software. We coded in teams and reconciled disagreements, then combined codes in categories to identify themes.

Results: Sixty-seven students (39 females; 28 males) wrote about gender bias in patient encounters. We identified five themes: bias, context, students' responses to patients' bias, patient-centered approach, and preparation for future encounters. Observations of bias addressed gender and structural bias, sexism, and racism. Students reflected on how context framed their experiences. Students aimed for patient-centered care, while simultaneously feeling ambivalence regarding patients' expressed bias. Students described their need to prepare for future experiences of gender bias and their plans to use specific strategies to cope with this bias.

Discussion: Our study offers the voices of medical students regarding gender bias in their clinical learning, presenting an important perspective, given an often-hierarchical system of medical education. This examination, which includes recommendations for curricula and policies, informs education leaders of the need to incorporate preparation for dealing with gender bias and to help students personally as they face challenging encounters with patients and medical teams. Enlightened by critical theories, these findings should also motivate resident and faculty development and promote critical inquiry for institutional changes.