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 that, due to this bias, the female standardized patient may be diagnosed with depression more often than the male.


METHODS
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.


CONCLUSIONS
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.
Lewis
Roya
R
University of California, Los Angeles Neuropsychiatric Institute and Hospital, Los Angeles, California, USA.
Lamdan
Ruth M
RM
Wald
David
D
Curtis
Michael
M
D000368:Aged; D001291:Attitude of Health Personnel; D015982:Bias; D002983:Clinical Competence; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D003937:Diagnosis, Differential; D005260:Female; D005852:Geriatric Psychiatry / Q000193:education* / Q000379:methods*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009483:Neuropsychological Tests; D010817:Physician-Patient Relations; D012720:Severity of Illness Index; D012737:Sex Factors; D013663:Teaching / Q000379:methods