Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan.
Department of Medical Education, University of Kelaniya, Kelaniya, Sri Lanka.
Adv Health Sci Educ Theory Pract. 2020 May;25(2):299-319. doi: 10.1007/s10459-019-09919-z. Epub 2019 Sep 20.
Medicine is a gendered discipline, in which women, both as patients and practitioners, have often held subordinate positions. The reproduction of dominant gender biases in the medical setting can negatively impact the professional development of medical students and the wellbeing of patients. In this analysis of medical students' narratives of professionalism dilemmas, we explore students' experiences of gender bias in hospital settings. Seventy-one students participated in 12 group interviews, where they discussed witnessing or participating in various activities that they thought were professionalism lapses. Within the dataset, 21 narratives had a distinctly gendered component broadly pertaining to patient dignity and safety dilemmas, informed consent issues, and female student abuse. Interestingly, perpetrators of such acts were commonly female healthcare professionals and educators. Although students recognized such acts as professionalism lapses and often expressed concern for patient wellbeing, students did not intervene or report such acts due to hierarchical cultural contexts, and at times even reproduced the discriminatory behavior they were criticizing. This raises concerns about medical students' professionalism development and the extent to which gender bias is ingrained within particular medical systems. The normalization of disrespectful and abusive treatment of female patients poses immediate and future consequences to the wellbeing and safety of women. Furthermore, the same socio-cultural values that sustain these acts may account for perpetrators often being women themselves as they strive to overcome their subordinate position within medicine.
医学是一门具有性别倾向的学科，女性无论是作为患者还是从业者，往往处于从属地位。医疗环境中主导性别偏见的再现可能会对医学生的专业发展和患者的健康产生负面影响。在对医学生专业困境叙述的分析中，我们探讨了学生在医院环境中经历的性别偏见。71 名学生参加了 12 次小组访谈，讨论了他们目睹或参与的各种被认为是专业失误的活动。在数据集内，有 21 个叙述具有明显的性别因素，主要涉及患者尊严和安全困境、知情同意问题以及女学生受虐待。有趣的是，此类行为的肇事者通常是女性医疗保健专业人员和教育工作者。尽管学生认为这些行为是专业失误，并经常对患者的健康表示关注，但由于等级文化背景，学生没有干预或报告这些行为，有时甚至复制了他们所批评的歧视行为。这引发了对医学生专业发展以及特定医疗系统中性别偏见根深蒂固程度的担忧。不尊重和虐待女性患者的行为普遍化，对女性的健康和安全构成了当前和未来的后果。此外，维持这些行为的相同社会文化价值观可能是肇事者通常也是女性，因为她们努力在医学领域中克服从属地位。
