Gender Bias in the Diagnosis of a Geriatric Standardized Patient: A Potential Confounding Variable

Background: Gender bias has been reported in the diagnosis and treatment of patients with a variety of illnesses. In the context of our 10-station fourth year Objective Structured Clinical Evaluation, we queried whether this could influence diagnosis in a geriatric case. Case writers hypothesized th...

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Bibliographic Details
Published in:Academic psychiatry 2006-09, Vol.30 (5), p.392-396
Main Authors: Lewis, Roya, Lamdan, Ruth M, Wald, David, Curtis, Michael
Format: Article
Language:English
Subjects:
Aged
Attitude of Health Personnel
Bias
Clinical Competence
Clinical Diagnosis
Clinical Experience
Cognition Disorders - diagnosis
Cognition Disorders - epidemiology
Cognitive Ability
Data Analysis
Depression (Psychology)
Depressive Disorder, Major - diagnosis
Depressive Disorder, Major - epidemiology
Depressive Disorder, Major - therapy
Diagnosis, Differential
Female
Females
Gender Bias
Gender Differences
Geriatric Psychiatry - education
Geriatric Psychiatry - methods
Geriatrics
Graduate Medical Education
Humans
Identification
Internship and Residency
Male
Medical Services
Medical Students
Mental Disorders
Neuropsychological Tests
Older Adults
Patients
Physician-Patient Relations
Predictor Variables
Psychological Patterns
Severity of Illness Index
Sex Factors
Teaching - methods
Widowed
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Summary:Background: Gender bias has been reported in the diagnosis and treatment of patients with a variety of illnesses. In the context of our 10-station fourth year Objective Structured Clinical Evaluation, we queried whether this could influence diagnosis in a geriatric case. Case writers hypothesized that, due to this bias, the female standardized patient may be diagnosed with depression more often than the male. Method: A male or female geriatric standardized patient protrayed a dysphoric widow with mild cognitive impairment. Students examined the patient and documented the clinical encounter and their differential diagnosis. Results: Major depression was diagnosed in 93/107 female standardized patient encounters compared with 58/78 male exams, with the female students contributing most to this difference. Discussion: The potential for gender bias in medical care and in education remains a concern. We need to be mindful of this when designing clinical skills assessments.
ISSN:1042-9670
1545-7230
DOI:10.1176/appi.ap.30.5.392