title: Does the gender of the standardised patient influence candidate performance in an objective structured clinical examination?
abstract: BACKGROUND
  The objective structured clinical examination (OSCE) requires the use of standardised patients (SPs). Recruitment of SPs can be challenging and factors assumed to be neutral may vary between SPs. On stations that are considered gender-neutral, either male or female SPs may be used. This may lead to an increase in measurement error. Prior studies on SP gender have often confounded gender with case.
  
  
  OBJECTIVE
  The objective of this study was to assess whether a variation in SP gender on the same case resulted in a systematic difference in student scores.
  
  
  METHODS
  At the University of Ottawa, 140 Year 3 medical students participated in a 10-station OSCE. Two physical examination stations were selected for study because they were perceived to be 'gender-neutral'. One station involved the physical examination of the back and the other of the lymphatic system. On each of the study stations, male and female SPs were randomly allocated.
  
  
  RESULTS
  There was no difference in mean scores on the back examination station for students with female (6.96/10.00) versus male (7.04/10.00) SPs (P = 0.713). However, scores on the lymphatic system examination station showed a significant difference, favouring students with female (8.30/10.00) versus male (7.41/10.00) SPs (P < 0.001). Results were not dependent on student gender.
  
  
  CONCLUSIONS
  The gender of the SP may significantly affect student performance in an undergraduate OSCE in a manner that appears to be unrelated to student gender. It would be prudent to use the same SP gender for the same case, even on seemingly gender-neutral stations.
authors.affiliation: Department of Medicine, University of Ottawa, Ottawa Hospital, Ottawa, Ontario, Canada. shumphrey@ottawahospital.on.ca
authors.forename: Susan
authors.initials: S
authors.lastname: Humphrey-Murto
authors.forename: Claire
authors.initials: C
authors.lastname: Touchie
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Wood
authors.forename: Sydney
authors.initials: S
authors.lastname: Smee
mesh_terms: D002170:Canada; D002983:Clinical Competence / Q000592:standards*; D004504:Education, Medical, Undergraduate / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D016544:Patient Simulation; D010808:Physical Examination; D012737:Sex Factors; D013223:Statistics as Topic; D013337:Students, Medical / Q000523:psychology