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探索医学教育中的性别视角:对以色列一年级医学生反思的潜在语义分析

Exploring Gender Perspectives in Medical Education: Latent Semantic Analysis of Israeli First-Year Medical Students' Reflections.

作者信息

Khamisy-Farah Rola, Farah Raymond, Jabaly-Habib Haneen, Nakhleh Francis Yara, Bragazzi Nicola Luigi

机构信息

Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.

Clalit Health Services, Akko, Israel.

出版信息

JMIR Med Educ. 2025 Aug 29;11:e78371. doi: 10.2196/78371.

Abstract

BACKGROUND

Gender is increasingly recognized as a crucial determinant of health and health care delivery. Integrating gender-sensitive content into medical education is essential for cultivating socially responsive, culturally competent, and clinically effective physicians of the future. However, limited research has examined how medical students conceptualize gender in clinical contexts, particularly through their own reflective narratives.

OBJECTIVE

This study explores the thematic landscape of gender-related perceptions among first-year medical students in Israel following a mandatory course in gender medicine. Using latent semantic analysis (LSA), we examined how students reflected on gendered dimensions of health care and how these reflections varied by gender and ethnicity.

METHODS

First-year medical students enrolled in the four-year path of medicine in Israel participated in a compulsory gender medicine course and were invited to submit anonymous written reflections. A total of 83 students (n=52, 63%, females; n=31, 37%, males; n=68, 82%, Jewish; and n=15, 18%, Arab) submitted responses, which were preprocessed and analyzed using LSA. The texts were lemmatized and vectorized to construct a term-document matrix, followed by singular value decomposition for dimensionality reduction. Ten latent topics were extracted, and thematic labels were assigned through an inductive, consensus-based coding procedure. Subgroup analyses were conducted by gender and ethnicity.

RESULTS

LSA identified 10 distinct topics, accounting for 56.6% of the total variance in the overall sample. The most dominant theme was Gendered Patient-Doctor Interactions (eigenvalue=121.188; 28.1% variance; 527 terms; 75 documents), followed, in terms of variance, by Gender-Specific Diseases and Health Concerns (5.7%) and Cultural and Religious Influences on Health Care (4.3%). Reflections from female students introduced 3 unique themes: Gendered Help-Seeking and Familial Roles (2.8%), Gender and Health Education (2.5%), and Gendered Communication and Advocacy (2.2%). Male students uniquely discussed Perceived Gender Bias in Clinical and Research Settings (3.8%) and the Legal and Ethical Dimensions of Reproductive Health Care (3.3%). Among Jewish students, additional themes included Population-Level Framing of Gendered Conditions (3.7%) and Gendered Youth Expectations (2.1%). Arabic students contributed culturally specific themes, such as Modesty and Cultural Norms (8.6%), Paternal Authority and Structural Discrimination (6.3%), and Reproductive Vulnerability (3.6%).

CONCLUSIONS

Thematic patterns in student reflections suggest that gender medicine curricula are effective in fostering critical engagement with diverse gendered realities in clinical care. The emergence of culturally grounded and gender-specific themes underscores the importance of tailoring educational interventions to reflect student diversity.

摘要

背景

性别日益被视为健康及医疗服务的关键决定因素。将性别敏感内容融入医学教育对于培养未来具有社会责任感、文化胜任力且临床高效的医生至关重要。然而,仅有有限的研究考察了医学生在临床情境中如何概念化性别,特别是通过他们自己的反思性叙述。

目的

本研究探讨以色列一年级医学生在修读性别医学必修课程后,与性别相关认知的主题格局。我们使用潜在语义分析(LSA),研究学生如何反思医疗保健中的性别维度,以及这些反思如何因性别和种族而异。

方法

在以色列参加四年制医学课程的一年级医学生参加了一门必修的性别医学课程,并被邀请提交匿名书面反思。共有83名学生(n = 52,63%为女性;n = 31,37%为男性;n = 68,82%为犹太学生;n = 15,18%为阿拉伯学生)提交了回复,这些回复经过预处理并使用LSA进行分析。文本进行了词形还原和向量化以构建词项 - 文档矩阵,随后进行奇异值分解以降维。提取了10个潜在主题,并通过基于归纳和共识的编码程序分配主题标签。按性别和种族进行亚组分析。

结果

LSA识别出10个不同主题,占总体样本总方差的56.6%。最主要的主题是性别化的医患互动(特征值 = 121.188;方差28.1%;527个词项;75份文档),其次按方差依次为特定性别的疾病与健康问题(5.7%)以及文化和宗教对医疗保健的影响(4.3%)。女生的反思引入了3个独特主题:性别化的求助与家庭角色(2.8%)、性别与健康教育(2.5%)以及性别化的沟通与倡导(2.2%)。男生独特地讨论了临床和研究环境中感知到的性别偏见(3.8%)以及生殖健康保健的法律和伦理维度(3.3%)。在犹太学生中,其他主题包括性别化状况的人群层面框架(3.7%)和性别化的青年期望(2.1%)。阿拉伯学生贡献了文化特定主题,如谦逊与文化规范(8.6%)、父权权威与结构性歧视(6.3%)以及生殖脆弱性(3.6%)。

结论

学生反思中的主题模式表明,性别医学课程在促进对临床护理中多元性别现实的批判性参与方面是有效的。基于文化且特定性别的主题的出现强调了调整教育干预以反映学生多样性的重要性。

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