Objectives: To determine the importance of seven statements encouraging medical student participation in the health care team with respect to the effect they would have on a woman's decision to allow a medical student to participate in an intimate physical examination, and to explore factors associated with gender bias.
Methods: Questionnaires were administered to women attending outpatient clinics in obstetrics and gynaecology at Kingston General Hospital and to students at two local secondary schools.
Results: Responses from 683 clinic patients and 192 secondary school students were analyzed. The mean age (range) was 42 years (17- 85) and 16 years (15- 22) for the respective samples. More clinic patients rated each of the statements as important or very important than did students (P < 0.01, Fisher exact tests). The largest differences between the sample groups were seen for the statements pertaining to the potential for enhanced understanding (81.0% vs. 60.2%), quality of health care (87.4% vs. 69.8%), and affording medical students the opportunity to participate (92.7% vs. 77.0%); 72.8% (485/666) of clinic patients reported they would accept an intimate examination by a medical student of either gender, compared with 32.1% (61/190) of secondary school students, and 22.2% (148/666) of clinic patients indicated they would only accept a female student compared with 55.3% (105/190) of secondary school students. The proportion of students preferring female medical students was inversely related to the number of previous breast or pelvic examinations (P = 0.031, chi-square test for trend).
Conclusions: Educational statements designed to encourage women to allow students to participate in their medical care had less effect on the secondary school students than on the women in a clinic setting. Although secondary school students express a preference for female physicians, it appears that with increasing experience with intimate examinations other factors take precedence in determining choice of health care provider.