Departments of Medicine and Community Health Science, University of Calgary's Cumming School of Medicine, Calgary, Alberta, Canada.
Department of Surgery, University of Calgary's Cumming School of Medicine, Calgary, Alberta, Canada.
Med Educ. 2022 Sep;56(9):949-957. doi: 10.1111/medu.14854. Epub 2022 Jun 17.
Critical review of institutional policies is necessary to identify and eliminate structural discrimination in medical schools. Dress code policies are well known to facilitate discrimination in other settings.
In this critical policy analysis, the authors used qualitative inquiry guided by feminist critical policy analysis (FCPA) and critical race feminism (CRF) frameworks to understand how Canadian undergraduate medical school dress code policies may contribute to discrimination and a hostile culture for marginalised groups. Dress code policies were obtained from 14 of 17 Canadian medical schools in September 2021. Deductive content analysis of dress codes was performed independently and in parallel by all four members of a racially diverse study team using Edwards and Marshalls' established framework for applying FCPA and CRF to dress code policy statements. Inductive content analysis was used to classify statements that fell outside this framework. Using a historical and contemporary legal understanding of how dress code policies have been used to discriminate against marginalised groups, the authors analysed how recommendations or restrictions may contribute to discrimination of marginalised medical students.
Fourteen dress code policies were analysed. Overall, there were five feminine-coded restrictions for every one masculine-coded restriction (n = 77/213 and n = 16/213, respectively). Some policies prohibited feminine-coded items (e.g. perfumes and bracelets) while specifically allowing masculine-coded items (e.g. cologne and watches). A discourse of 'professionalism' based on patient preferences prioritised Eurocentric patriarchal norms for appearance, potentially penalising racially and culturally diverse students. Most policies did not include a policy for appeals or accommodations.
Canadian undergraduate medical school dress code policies overregulate women and gender, racially and culturally diverse students by explicitly and implicitly enforcing white patriarchal social norms. Administrators should apply best practices to these policies to avoid discrimination and a hostile culture to marginalised groups.
审查医疗机构政策对于识别和消除医学院校中的结构性歧视至关重要。着装规范政策在其他环境中也被认为是造成歧视的原因。
在这项批判性政策分析中，作者使用了定性研究方法，以女性主义批判性政策分析（FCPA）和批判性种族女权主义（CRF）框架为指导，了解加拿大本科医学学校的着装规范政策如何可能导致边缘化群体受到歧视和产生敌对文化。作者于 2021 年 9 月从 17 所加拿大医学院中的 14 所获取了着装规范政策。一个由不同种族成员组成的研究团队对 14 所医学院的着装规范政策进行了独立平行的演绎内容分析，使用了爱德华兹和马歇尔（Edwards and Marshalls）为将 FCPA 和 CRF 应用于着装规范政策声明而建立的框架。对于不属于该框架的声明，使用了归纳内容分析进行分类。作者根据历史和当代对如何使用着装规范政策来歧视边缘化群体的法律理解，分析了建议或限制如何导致边缘化医学生受到歧视。
分析了 14 项着装规范政策。总体而言，每一项针对女性的着装限制都对应五倍针对男性的着装限制（分别为 77/213 和 16/213）。一些政策禁止女性化的物品（如香水和手镯），而特别允许男性化的物品（如古龙水和手表）。基于患者偏好的“专业性”话语优先考虑了以欧洲中心主义父权制规范为基础的外貌要求，这可能会使种族和文化多样化的学生受到惩罚。大多数政策没有包括申诉或适应的政策。
加拿大本科医学学校的着装规范政策过度监管女性和性别、种族和文化多样化的学生，明确和含蓄地执行白人父权制社会规范。管理者应将最佳实践应用于这些政策，以避免歧视和对边缘化群体产生敌对文化。
