Both gender and grading policies can have a big impact on the academic learning environment in medical school, according to a longitudinal cohort study of nearly 5,000 medical students from the matriculating classes of 2010 and 2011 at 28 medical schools in the United States and Canada.
The AMA-sponsored Learning Environment Study, which collected data and insights on the medical student experience throughout the four years of medical school, found that both men and women showed an overall decline in attitudes toward empathy from their first to second year of school. However, gender plays a significant role in determining students’ perceptions.
Relative to male students, females who participated in the study more strongly felt that there was no time for family, friends or outside interests. Women also tended to believe that their fellow students were less hesitant to assist each other and express opinions to faculty. Finally, males showed a stronger decline in the importance of empathy and females experienced a significantly stronger decline than males in the need to make a conscious effort to adopt the patient’s perspective. Both are important ingredients in empathic behavior.
“If female students feel that they cannot freely express their opinions as the findings suggest, then strategies should be implemented to overcome this barrier,” said AMA Vice President for Medical Education Outcomes Mark Quirk, EdD, who will be presenting the findings of this first phase of the study at an international medical education conference later this month. The study also recommended that medical schools consider gender when planning and making curricular and extracurricular changes.
Beyond gender, schools with pass/fail grading systems were markedly different from schools that offered letter grades. Students at pass/fail schools perceived less competition and experienced a more integrated curriculum. However, pass/fail students saw faculty and upper-level students as more disconnected and distant, potentially because less experienced don’t perceive as much of a need to improve their performance and seek out help.
“If the introduction of a pass/fail grading system detracts from these opportunities, then faculty and experienced students will need to be encouraged to reach out and create formal and informal policies to interact with these young learners,” the study said.
The study now is moving into its next phase: Examining the impact on learners of the transition from classroom to clinical settings.
