Medical student gender and issues of confidence

OBJECTIVE: To review the literature on gender differences and issues of self-confidence in medical students and to present original research on observers' perceptions of medical student confidence. METHODS: One hundred forty-one 3rd year medical students at Indiana University School of Medicine were videotaped during their objective structured clinical examination (OSCE). Trained coders rated how confident the student appeared and coded a variety of nonverbal behaviors at the beginning, middle, and end of the interaction. Analysis focused on gender differences in coders' ratings of perceived confidence. RESULTS: Female medical students were viewed as significantly less confident than male medical students (F(1,133)=4.45, p<0.05), especially at the beginning of the interaction. CONCLUSION: Past research indicates that despite performing equally to their male peers, female medical students consistently report decreased self-confidence and increased anxiety, particularly over issues related to their competence. In a standardized patient interaction examination situation, female medical students also appeared significantly less confident than male medical students to independent observers. PRACTICE IMPLICATIONS: Medical educators should focus on issues of female students' confidence, increasing faculty sensitivity, and publicly recognizing and discussing perceptions of confidence.