Ludgate Melissa B, Morse Emily E, Brown Hailey M, Min James Y, Chan Aubrey C
University of Iowa Health Care, Iowa City, IA, USA.
University of Kentucky Healthcare, Lexington, KY, USA.
Acad Psychiatry. 2025 Jan 7. doi: 10.1007/s40596-024-02110-6.
The authors aimed to determine if medical students' self-assessment of abilities and performance differed by gender during the psychiatry clerkship and if these differences were reflected objectively in test scores or clinical evaluations from educators.
Data from mid-clerkship self-assessments completed during the psychiatry core clerkship were reviewed from two classes of medical students. Students rated their performance on 14 items across five domains: knowledge/clinical reasoning, differential diagnosis, data presentation, studying skills, and teamwork as "below," "at," or "above expected level." Ratings were coded numerically, and statistical analysis was performed using Student's T-test. National Board of Medical Examiners (NBME) Subject Exam scores and clinical evaluations served as measures of actual performance.
Female students (n = 123) rated their performance significantly below male peers (n = 114) in medical knowledge (female - 0.05 vs male 0.13), clinical reasoning (- 0.02 vs 0.06), differential diagnosis (- 0.09 vs 0.00), balancing work and studying (- 0.02 vs 0.11), keeping up with clerkship assignments (0.03 vs 0.13), understanding role on the team (0.11 vs 0.23), interacting with other team members (0.15 vs 0.31), and functioning as part of the team (0.13 vs 0.25). Clinical evaluation scores and NBME Subject Exam scores showed no significant difference (evaluation scores 138.1 vs 136.0; NBME scores 163.8 vs 162.2) in performance between students.
Female medical students tend to underrate their performance compared to male peers in clinical knowledge, studying skills, and teamwork, despite equivalent academic and clinical performance. This study highlights gender disparities in self-assessment during medical training.
作者旨在确定在精神病学实习期间,医学生对自身能力和表现的自我评估是否因性别而异,以及这些差异是否在测试成绩或教育工作者的临床评估中得到客观反映。
回顾了两个班级医学生在精神病学核心实习期间完成的实习中期自我评估数据。学生们将他们在五个领域的14个项目上的表现评为“低于”、“达到”或“高于预期水平”,这五个领域分别是:知识/临床推理、鉴别诊断、数据展示、学习技巧和团队合作。评分进行了数字编码,并使用学生t检验进行统计分析。美国国家医学考试委员会(NBME)学科考试成绩和临床评估作为实际表现的衡量标准。
在医学知识(女生-0.05,男生0.13)、临床推理(-0.02对0.06)、鉴别诊断(-0.09对0.00)、平衡工作与学习(-0.02对0.11)、跟上实习任务(0.03对0.13)、理解团队角色(0.11对0.23)、与其他团队成员互动(0.15对0.31)以及作为团队一员发挥作用(0.13对0.25)方面,女生(n = 123)对自己表现的评分显著低于男同学(n = 114)。学生之间的临床评估分数和NBME学科考试成绩在表现上没有显著差异(评估分数138.1对136.0;NBME分数163.8对162.2)。
尽管学术和临床表现相当,但与男同学相比,女生医学生在临床知识、学习技巧和团队合作方面往往低估自己的表现。本研究突出了医学培训期间自我评估中的性别差异。