Emmons Sandra L, Adams Karen E, Nichols Mark, Cain Joanna
Department of Obstetrics and Gynecology L466, Oregon Health & Science University School of Medicine, 3181 SW Sam Jackson Park Road, Portland, OR 97201, USA.
Acad Med. 2004 Apr;79(4):326-32. doi: 10.1097/00001888-200404000-00008.
To investigate the perceptions of third-year medical students about how their acquisition of skills during their obstetrics and gynecology clerkship may be affected by their gender.
From January 1999 to December 2001, all third-year students at one school completing their obstetrics and gynecology rotation were given an anonymous questionnaire addressing whether gender had a positive, negative, or neutral effect on their learning experience. Students were also asked to enumerate procedures they had performed (e.g., deliveries and speculum examinations) and to rate their ability to counsel women on several clinical problems. To further investigate the perceptions of gender discrimination, a focus group of 12 fourth-year students was held.
A total of 263 questionnaires (95%) were returned. Of the respondents, 78% of the men felt their gender adversely affected their experience, and 67% of women felt gender had a positive affect. All but five of the remaining students were in the neutral group. Those students who reported a positive gender effect performed significantly more speculum examinations (15.5 versus 12.3), labor coaching (8.7 versus 6.2), and independent deliveries (3.4 versus 2.7) than did the negative gender-effect group. The positive gender-effect group felt more confident of counseling skills. The neutral group did not differ from the negative group. The overall numerical differences among groups were small, and all groups, on average, performed adequate numbers of skills to meet clerkship objectives.
There is a strong perception among medical students that gender influences experience on their obstetrics and gynecology clerkship, but the differences are actually small. Possible reasons for such strong feelings are addressed and related to the history of sexism in reproductive health care and to the ethics of patients' preferences.
调查三年级医学生对于其妇产科实习期间技能掌握情况受性别影响的看法。
1999年1月至2001年12月，某学校所有完成妇产科轮转的三年级学生均收到一份匿名问卷，询问性别对其学习经历产生了积极、消极还是中性影响。学生们还被要求列举他们所执行的操作（如接生和阴道窥器检查），并对他们就几个临床问题为女性提供咨询的能力进行评分。为进一步调查性别歧视的看法，召开了一次由12名四年级学生组成的焦点小组会议。
共收回263份问卷（95%）。在受访者中，78%的男性认为其性别对他们的经历产生了不利影响，67%的女性认为性别产生了积极影响。其余学生中除五人外均属于中性组。那些报告性别产生积极影响的学生进行的阴道窥器检查（15.5次对12.3次）、产程指导（8.7次对6.2次）和独立接生（3.4次对2.7次）明显多于性别产生消极影响的组。性别产生积极影响的组对咨询技能更有信心。中性组与消极组没有差异。各组之间的总体数值差异较小，并且平均而言，所有组都完成了足够数量的技能操作以达到实习目标。
医学生中普遍强烈认为性别会影响他们在妇产科实习的经历，但实际差异很小。针对这种强烈感受的可能原因进行了探讨，并与生殖健康护理中的性别歧视历史以及患者偏好的伦理问题相关联。
