Internal medicine residents' perceived ability to direct patient care: impact of gender and experience.

Full Abstract

BACKGROUND: Physicians are expected to effect patient care by giving orders to members of a healthcare team. Because women are socialized to be less directive than men, the assertive behavior required of new physicians may be experienced differently by male and female residents. We sought to explore the effects of gender and year of training on residents' experiences and perceived ability to direct patient care. METHODS: This was a mixed-methods, cross-sectional, descriptive study employing a quantitative written survey and qualitative interviews among internal medicine residents at an academic health center. Measurements included questionnaires and interviews about stress, assertiveness, and personal factors that influence their effectiveness in directing patient care. Analyses examined differences by gender and year of training. RESULTS: One hundred residents were invited to participate; 65 returned questionnaires, and 16 of these residents were interviewed. Compared with male residents, female residents selected less assertive behaviors for clinical scenarios (p = 0.047) and were more likely to perceive gender as inhibiting their ability to influence patient care (p < 0.01). Stress associated with being assertive varied more with experience than gender. Interviews corroborated these findings and supported the complexity of gender norms for behavior for female residents in a directive leadership position. CONCLUSIONS: When compared with male peers, female residents reported more gender issues in residency and chose less assertive behaviors in clinical scenarios. Experience mitigated some gender differences. Our findings suggest that discussion of the existing research on prescriptive gender norms for behavior and leadership may be warranted in resident orientation.

Author information

Author/s: Bartels, Christie (C); Goetz, Sarah (S); Ward, Earlise (E); Carnes, Molly (M);

Affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.

Grants: KL2 RR025012-01 (Agency:NCRR NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Journal of women's health (2002) (J Womens Health (Larchmt)), published in United States. (Language: eng)

Reference: 2008-Dec; vol 17 (issue 10) : pp 1615-21

Dates: Created 2008/12/03; Completed 2009/03/09; Revised 2009/10/05;

PMID: 19049356, status: MEDLINE (last retrieval date: 10/6/2009, IMS Date: 06 Oct 2009 00:00:00)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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