| کلیدواژههای انگلیسی مقاله |
Medical student, Curriculum, Gender, IntroductionDiscrimination based on gender is the situation where individuals are treated negatively because of their gender and cannot benefit from some opportunities, resources and rights. In a worldwide content throughout their lives, women are subjected to more unequal treatment due to their gender than men. It is observed that women and men who do the same job are also disadvantaged.Gender roles reflect gendered stereotypes or gender differences determined by society ( 1,- 3,). This conception is related to cultural views, belief systems, images, and expectations concerning masculinity and femininity imposed by society. Women are expected to concern themselves with children and housework, to be devoted to their husband in a quiet, altruistic, patient, understanding, and affectionate manner, while men are expected to provide for their families, do work requiring physical strength, and to be stern, brave, and logical ( 1,). Traditionally, females encounter similar expectations in the professional sphere. Teaching, secretarial work, and nursing are regarded as suitable for women, while politics, leadership, and management are professions generally closed to them ( 1,, 3,, 4,). Physicians also behave in accordance with gender roles in their professional lives. For example, female patients are asked about their family more than male patients. This derives from physicians&,rsquo perception that family problems are of greater concern to women. Bias affects diagnostic processes, too.There is a masculine attitude that does not see coronary artery disease as a risk for the woman. While depression is a preliminary diagnosis for women, it is referred to as burnout syndrome for men. Research indicates that physicians are more likely to interpret men&,rsquo s symptoms as organic and women&,rsquo s as psychosocial and female patients are assigned more diagnoses of nonspecific symptoms and signs. Women are also prescribed more psychoactive drugs. Physicians exhibit gender-based behaviors not only in relations with patients but also as role models for colleagues, personnel, and students. Gender-aware physicians consider power representations and gender-based expectations and prejudices in such interactions ( 5,).The ability of physicians to maintain professionalism depends on their health advocacy and development of personal competence. The school and instructors play a role in the development of professional identity. One particularly important subject in professional identity development is gender awareness. This awareness is essential first for one&,rsquo s own experience and subsequently in the interests of patients and society. Research has shown that gender insensitivity in the physician&,rsquo s professional role and practice (i.e., a lack of gender awareness) can lead to outcomes such as gender discrimination and gender-based harassment in areas such as medical education, career opportunities, and specialty selection. For example, men constitute the majority of practitioners in surgical fields, while specialties in which women concentrate are traditionally regarded as less prestigious ( 5,- 8,). Gender-related issues have important implications for medical students&,rsquo learning. As the importance of gender awareness in medical education has increased, many medical schools have included education concerning gender in their curricula. Various theories investigate the relation between gender and education, and these appear as different research questions ( 2,, 4,). The purpose of this study was to reveal the place that the concept of gender occupies in medical education in Turkey by canvassing the opinions of final-year medical students regarding theories of gender roles and socialization, academic capitalism, and liberal feminism ( 3,). Our research questions within the framework of these theories were as follows, RQ 1, What are medical students&,rsquo gender-based perceptions during the education process? RQ 2, To what extent do members of teaching staff, health personnel and managers, and peers affect gender-based inequalities in medical education? RQ 3, Which specialties do medical students regard as appropriate for which gender, and why?RQ 4, What are medical students&,rsquo gender-related perspectives concerning the academic sphere? RQ 5, How do medical students regard gender differences in the official and hidden curricula (access, success, preference, deprivation, etc.)? Do medical students think there is any gender discrimination in the program content, method of application, or structuring of exams and tests?MethodsA cross-sectional survey was conducted in four different geographical regions the data was collected between September and November 2018. Study populationThis descriptive study was conducted in six medical faculties in four different geographical regions of Turkey. Regional representation was taken into consideration during the selection of medical faculties. The faculty sampling selection was determined by considering cultural and lifestyle options according to the regions in our country. It was chosen from four different regions. The students in the faculty were selected by calculating the 0.90 error margin and 80 power.The study population consisted of 1739 interns (known as final-year students in Turkey) in these faculties. A sample size of 315 was determined for the identification of difference at an alpha significance level of 0.05, 0.95 power, and 0.5 standard deviation. Internships in final year were taken as clusters and one of the clusters was chosen randomly, and a questionnaire was applied to them. The study population, sample, and collected data are shown in Table 1,. Faculty NamePopulationSampleCollected dataOndokuz Mayis University Medical Faculty 2514646Sel&,ccedil uk University Medical Faculty 1663035Erciyes University Medical Faculty 3005459Akdeniz University Medical Faculty 2504562Ege University Medical Faculty 33160221Gazi Medical Faculty 44180104Total 1739315527Table 1. Population, sample and collected data numbers Development of the questionnaireThe questionnaire was structured with the participation of all researchers. A conceptual framework was created, and research questions were structured in light of the above-mentioned theories. An item pool was generated and consensus regarding the items of the instrument was established. The questionnaire contained 14 questions and propositions concerning the five research questions based on the theories of gender roles and socialization, academic capitalism, and liberal capitalism. Nine questions were about the socio-demographic features of the participants. One was about the exposure to sexist expressions and behavior during medical education and the other four questions contained propositions concerning the five research questions based on the theories. Scope validity was checked by sending the questionnaire to 5 experts in the survey area prepared.The preliminary instrument was given to a group of volunteer students (n=10) who evaluated the items in terms of meaningfulness, readability, comprehensibility, sentence length, and clarity of expression. The collected data were entered into a standard database by researchers in the relevant faculties. Data quality control was performed, and the final data were collected and analyzed.Data analysisStatistical analysis was performed on PASW Statistics software for Windows (SPSS, Inc., IBM), version 18.0. Mean values and standard deviation were calculated for continuous variables, while descriptive analyses (number and percentage) were given for nominal variables. The chi square test was used for comparative analysis.Ethical Considerations, This study was approved by the Ethics Committee of the X University Faculty of Medicine (Decision Number 11-6.1/10). There were no conflicts of interest in this study.ResultsThe students&,rsquo socio-demographic characteristics are presented in Table 1,. We found that 60.5% of female students and 39.5% of male students thought that insufficient importance was attached to the concept of gender equality during medical education, (2 = 11.603, p = 0.003). In response to the question &,ldquo How has your gender affected your working and educational life during clinical training?&,rdquo , no difference was found between female and male students (2 = 3.439, p = 0.179). In addition, 54.3% (n = 286) of interns reported that their gender had no effect on their working and educational lives during their internship, 26.2% (n = 138) said it had an adverse impact, and 18.6% (n = 98) reported a positive effect. Additionally, 47.6% of students who stated that their gender had no effect on their educational lives during clinical training reported a negative impact during their internship. The change between the clinical and internship periods was statistically significant (2 = 111.208, p &,lt 0.0001). The proportion of female students believing that their gender had a negative impact on their working and educational life during their internship (71.7%) was higher than that of male students (28.3%) (2 = 40.997, p &,lt 0.001).A significant difference between gendered behaviors was found only in the context of health personnel (=214,884, p&,lt 0.001), with 40.1% of female students and 27.7% of male students reporting experiencing gendered behavior by health personnel (Table 2,). YesNoundecided N (%)N (%)N (%)I have encountered gendered discourse and behaviors by my peers during my medical education (n=526).216 (41.1)253 (48.1)57 (10.8)I have encountered gendered discourse and behaviors by members of teaching staff during my medical education (n=527).215 (40.8)233 (44.2)79 (15.0)I have encountered gendered discourse and behaviors by health personnel during my medical education (n=527).179 (34.0)259 (49.1)89 (16.9)I have encountered gendered discourse in various situations (presentations, discussions, at the patient bedside, etc.) during my medical education (n=526).132 (25.1)322 (61.2)72 (13.7)I have encountered gendered discourse and behavior by deans and assistant deans during my medical education (n=527). 38 (7.2)417 (79.1)72 (13.7)Table 2. Exposure to sexist expressions and behavior during interns&,rsquo medical education Thirty percent (158) of students stated that a female physician graduating from a medical school can select whatever specialty she wishes. The great majority of students (410 students 77.79%) described internal medical sciences as the most suitable specialty for a female physician (Table 3,).Conceptions Supporting quotationPhysical featureFor example, fields such as cardiovascular surgery and plastic surgery require a male body. Women already predominate in dermatology and pediatric diseases due to their lower rates of mental and physiological burnout. So they should not enter this field, too. |
| نویسندگان مقاله |
OZLEM MIDIK |
Ondokuz Mayıs University, Faculty of Medicine, Medical Education Department, Samsun, Turkey
AYŞEN M ELEK AYTUĞ KOŞAN |
Onsekiz Mart University, Faculty
of Medicine Medical Education Department, Çanakkale, Turkey
OZLEM COSKUN |
Gazi University, Faculty of Medicine, Medical Education Department,
Ankara, Turkey
ZEYNEP BAYKAN |
Erciyes University, Faculty of Medicine, Medical Education Department, Kayseri, Turkey
ÖZLEM SÜREL 85784 KARABILGIN ÖZTÜRKÇÜ |
Ege University, Faculty
of Medicine, Medical Education Department, İzmir, Turkey
YEŞIM ŞENOL |
Akdeniz University, Faculty of Medicine, Medical Education Department, Antalya, Turkey
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