The Effect of Gender Interactions on Students' Physical Examination Ratings in Objective Structured Clinical Examination Stations

Purpose Previous studies have reached a variety of conclusions regarding the effect of gender on performance in objective structured clinical examinations (OSCEs). Most measured the effect on students' overall OSCE score. The authors of this study evaluated the effect of gender on the scores of specific physical examination OSCE stations, both "gender-sensitive" and "gender-neutral." Method In 2008, the authors collected scores for 138 second-year medical students at the University of Calgary who underwent a seven-station OSCE. Two stations-precordial and respiratory exams-were considered gender-sensitive. Multiple linear regression was used to explore the effect of students', standardized patients' (SPs'), and raters' genders on the students' scores. Results All 138 students (69 female) completed the OSCE and were included in the analyses. The mean scores (SD) for the two stations involving examination of the chest were higher for female than for male students (83.2% [15.5] versus 78.3% [15.8], respectively, d = 0.3, P = .009). There was a significant interaction between student and SP gender (P = .02). In the stratified analysis, female students were rated significantly higher than male students at stations with female SPs (85.4% [15.5] versus 76.6% [16.5], d = 0.6, P = .004) but not at stations with male SPs (80.2% [15.0] versus 80.0% [15.0], P = 1.0). Conclusion These results suggest student and SP genders interact to affect OSCE scores at stations that require examination of the chest. Further investigations are warranted to ensure that the OSCE is an equal experience for all students.