Comparing gender awareness in Dutch and Swedish first-year medical students - results from a questionaire

BMC Medical Education

Katarina Hamberg³  Toine Lagro-Janssen⁴  Eva E Johansson³  Petra Verdonk¹  Jenny Andersson² 

[1] VU University Medical Center, Department of Medical Humanities, EMGO Institute for Health and Care Research, van der Boechorsstraat 7, 1081 BT Amsterdam, the Netherlands;Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, 901 85 Umeå, Sweden and National Graduate School of Gender Studies, Umeå University, 901 87 Umeå, Sweden;Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, 901 85 Umeå, Sweden;Department of Primary and Community Care, Centre for Family Medicine, Geriatric and Public Health, Unit Women's Studies, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands

关键词: stereotypical thinking;    attitudes;    gender;    gender implementation;    medical students;    Medical curricula;   

Others  :  1153838
DOI  :  10.1186/1472-6920-12-3

 received in 2011-08-03, accepted in 2012-01-12,  发布年份 2012

【 摘 要 】

Background

To ascertain good and appropriate healthcare for both women and men implementation of gender perspectives in medical education is needed. For a successful implementation, knowledge about students' attitudes and beliefs about men, women, and gender is crucial. The aim of this study was to compare attitudes to gender and gender stereotyping among Dutch and Swedish male and female medical students.

Methods

In this cross-sectional study, we measured the attitudes and assumptions about gender among 1096 first year medical students (616 Dutch and 480 Swedish) with the validated Nijmegen Gender Awareness in Medicine Scale (N-GAMS). The response rate was 94% in the Netherlands and 93% in Sweden. Univariate analysis of variance (ANOVA) was used to compare the scores between Dutch and Swedish male and female students. Linear regressions were used to analyze the importance of the background variables.

Results

There were significant differences in attitudes to gender between Dutch and Swedish students. The Swedish students expressed less stereotypical thinking about patients and doctors and the Dutch were more sensitive to gender differences. The students' sex mattered for gender stereotyping, with male students in both countries agreeing more with stereotypical statements. Students' age, father's birth country and mother's education level had some impact on the outcome.

Conclusions

There are differences between cultures as well as between men and women in gender awareness that need to be considered when implementing gender in medical education.

This study suggests that to arouse the students' interest in gender issues and make them aware of the significance of gender in medical work, the examples used in discussions need to be relevant and challenging in the context of the specific country. Due to different levels of knowledge and different attitudes within the student population it is important to create a climate for dialogue where students feel permitted to disclose their ideas and attitudes in order to become aware of what these are as well as their possible consequences on interaction and decision-making in medical work.

【 授权许可】

   
2012 Andersson et al; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Doyal L: What makes women sick: gender and the political economy of health. London: Macmillan; 1995.
• [2]Sen G, Östlin P, George A: Unequal, unfair, ineffective and inefficient, gender inequity in health: why it exists and how we can change it. Final report to the WHO Commission on Social Determinants of Health 2007. [Available from: http://www.who.int/social_determinants/resources/csdh_media/wgekn_final_report_07.pdf webcite]
• [3]Hall J, Roter D: Do patients talk differently to male and female physicians? A meta-analytic review. Patient Educ Couns 2002, 48:217-224.
• [4]Danielsson U, Bengs C, Lehti A, Hammarström A, Johansson E: Struck by lightning or slowly suffocating - gendered trajectories into depression. BMC Fam Pract 2009, 10:56. BioMed Central Full Text
• [5]Hamberg K, Risberg G, Johansson E, Westman G: Gender bias in physicians' management of neck pain: a study of the answers in a Swedish national examination. J Womens Health Gend Based Med 2002, 11:653-666.
• [6]Chiaramonte G, Friend R: Medical students' and residents' gender bias in the diagnosis, treatment, and interpretation of coronary heart disease symptoms. Health Psychol 2006, 25:255-266.
• [7]Colameco S, Becker L, Simpson M: Sex bias in the assessment of patient complaints. J Fam Pract 1983, 16:1117-1121.
• [8]Daly C, Clemens F, Lopez Sendon J, Tavazzi L, Boersma E, Danchin N, et al.: Gender differences in the management and clinical outcome of stable angina. Circulation 2006, 113:490-498.
• [9]Hamberg K: Gender bias in medicine. Womens Health 2008, 4:237-243.
• [10]The National Board of Health and Welfare: A gender perspective on Swedish health care. (Swedish title: Jämställd vård? Könsperspektiv på hälso- och sjukvården). Stockholm; 2004.
• [11]Verdonk P, Benschop YWM, De Haes H, Lagro-Janssen TLM: Medical students' gender awareness. Sex Roles 2008, 8:222-234.
• [12]Verdonk P, Benschop Y, de Haes H, Lagro-Janssen T: From gender bias to gender awareness in medical education. Adv Health Sci Educ Theory Pract 2009, 14:135-152.
• [13]Phillips S: Evaluating women's health and gender. Am J Obstet Gynecol 2002, 187:22-24.
• [14]Hamberg K: Gender perspective mostly lacking at Umeå Medical School. The faculty play a key role when implementing suggestion for improvement. (Swedish title: Få och spridda genusinslag i Umeås läkarprogram. Lärarna nyckelgrupp för att sjösätta förslagen till förbättringar). Lakartidningen 2003, 100:4084-4085. 4088-4090
• [15]Wainer J: Gender and the medical curriculum: a rural case study. Women Health 2003, 37:67-87.
• [16]Hamberg K, Johansson E: Medical students' attitudes to gender issues in the role and career of physicians: a qualitative study conducted in Sweden. Med Teach 2006, 28:635-641.
• [17]Johansson E, Hamberg K: From calling to a scheduled vocation: Swedish male and female students' reflections on being a doctor. Med Teach 2007, 29:1-8.
• [18]Verdonk P, de Rijk A, Klinge I, de Vries A: Sickness absence as an interactive process: gendered experiences of young, highly educated women with mental health problems. Patient Educ Couns 2008, 73:300-306.
• [19]Visser J: The first part-time economy in the world: a model to be followed? Journal of European Social Policy 2002, 12:23-42.
• [20]Evertsson M, England P, Mooi-Reci I, Hermsen J, de Bruijn J, Cotter D: Is Gender Inequality Greater at Lower or Higher Educational Levels? Common Patterns in the Netherlands, Sweden, and the United States. Social Politics: International studies in gender, state and society 2009, 16:210-241.
• [21]Statistics Sweden: Women and men in Sweden, Facts and figures 2008. 2008. Örebro
• [22]Connell RW: Gender. Cambridge: Polity; 2002.
• [23]Nordenmark M: Does gender ideology explain differences between countries regarding the involvement of women and of men in paid and unpaid work? International Journal of Social Welfare 2004, 13:233-243.
• [24]Ridgeway C, Correll S: Unpacking the gender system: A theoretical perspective on gender beliefs and social relations. Gender & Society 2004, 18:510-531.
• [25]Glick P, Fiske S, Mladinic A, Saiz J, Abrams D, Masser B, et al.: Beyond prejudice as simple antipathy: Hostile and benevolent sexism across cultures. Journal of Personality and Social Psychology 2000, 79:763-775.
• [26]Lagerberg R, Randecker E: Sweden - Up North, Down to earth. Stockholm: Swedish Institute; 2010.
• [27]Spence J, Buckner C: Instrumental and expressive traits, trait stereotypes, and sexist attitudes: What do they signify? Psychology of Women Quarterly 2000, 24:44-62.