Race, ethnicity, and gender representation in clinical case vignettes: a 20-year comparison between two institutions
Abstract Background The medical case vignette has long been used in medical student education and frequently includes demographic variables such as race, ethnicity and gender. However, inclusion of demographic variables without context may reinforce assumptions and biases. Yet, the absence of race,...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-07-01
|
| Series: | BMC Medical Education |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12909-022-03665-4 |
| _version_ | 1818162943561302016 |
|---|---|
| author | Courtney R. Lee Kurt O. Gilliland Gary L. Beck Dallaghan Sue Tolleson-Rinehart |
| author_facet | Courtney R. Lee Kurt O. Gilliland Gary L. Beck Dallaghan Sue Tolleson-Rinehart |
| author_sort | Courtney R. Lee |
| collection | DOAJ |
| description | Abstract Background The medical case vignette has long been used in medical student education and frequently includes demographic variables such as race, ethnicity and gender. However, inclusion of demographic variables without context may reinforce assumptions and biases. Yet, the absence of race, sexual orientation, and social determinants of health may reinforce a hidden curriculum that reflects cultural blindness. This replication study compared proportions of race, ethnicity, and gender with University of Minnesota (UMN) findings. This study sought to determine if there has been progress in the representation of demographic characteristics in case vignettes. Methods: University of North Carolina (UNC) case vignettes from 2015–2016 were analyzed and compared to UMN case vignettes from 1996–1998. Data included mentions of race, ethnicity, gender and social determinants of health. Results: In the 278 UNC vignettes, white race was noted in 19.7% of cases, black race was in 7.9% cases, and 76.6% of cases were unspecified. In the 983 UMN vignettes, white race was recorded in 2.85% cases, and black race in 0.41% cases. The institutions were significantly different in the proportion of their cases depicting race (0.20; 95% CI (0.15, 0.25)). Males were represented in the majority of vignettes. Discussion: Comparing case vignettes results from two medical schools suggests that reporting explicit demographic diversity was not significantly different. The findings illustrate that sex was the demographic characteristic consistently described, where males were over-represented. Based on these findings, greater cultural diversity as it intersects with social determinants of health is needed in medical student education. |
| first_indexed | 2024-12-11T16:41:42Z |
| format | Article |
| id | doaj.art-d3fedbd264de4c58a78e47f97e545cdb |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-12-11T16:41:42Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-d3fedbd264de4c58a78e47f97e545cdb2022-12-22T00:58:18ZengBMCBMC Medical Education1472-69202022-07-012211710.1186/s12909-022-03665-4Race, ethnicity, and gender representation in clinical case vignettes: a 20-year comparison between two institutionsCourtney R. Lee0Kurt O. Gilliland1Gary L. Beck Dallaghan2Sue Tolleson-Rinehart3University of Pennsylvania Perelman School of MedicineUNC School of MedicineUNC School of MedicineUNC School of MedicineAbstract Background The medical case vignette has long been used in medical student education and frequently includes demographic variables such as race, ethnicity and gender. However, inclusion of demographic variables without context may reinforce assumptions and biases. Yet, the absence of race, sexual orientation, and social determinants of health may reinforce a hidden curriculum that reflects cultural blindness. This replication study compared proportions of race, ethnicity, and gender with University of Minnesota (UMN) findings. This study sought to determine if there has been progress in the representation of demographic characteristics in case vignettes. Methods: University of North Carolina (UNC) case vignettes from 2015–2016 were analyzed and compared to UMN case vignettes from 1996–1998. Data included mentions of race, ethnicity, gender and social determinants of health. Results: In the 278 UNC vignettes, white race was noted in 19.7% of cases, black race was in 7.9% cases, and 76.6% of cases were unspecified. In the 983 UMN vignettes, white race was recorded in 2.85% cases, and black race in 0.41% cases. The institutions were significantly different in the proportion of their cases depicting race (0.20; 95% CI (0.15, 0.25)). Males were represented in the majority of vignettes. Discussion: Comparing case vignettes results from two medical schools suggests that reporting explicit demographic diversity was not significantly different. The findings illustrate that sex was the demographic characteristic consistently described, where males were over-represented. Based on these findings, greater cultural diversity as it intersects with social determinants of health is needed in medical student education.https://doi.org/10.1186/s12909-022-03665-4Cultural awarenessSocial determinants of healthMedical studentClinical case discussionsRaceGender |
| spellingShingle | Courtney R. Lee Kurt O. Gilliland Gary L. Beck Dallaghan Sue Tolleson-Rinehart Race, ethnicity, and gender representation in clinical case vignettes: a 20-year comparison between two institutions BMC Medical Education Cultural awareness Social determinants of health Medical student Clinical case discussions Race Gender |
| title | Race, ethnicity, and gender representation in clinical case vignettes: a 20-year comparison between two institutions |
| title_full | Race, ethnicity, and gender representation in clinical case vignettes: a 20-year comparison between two institutions |
| title_fullStr | Race, ethnicity, and gender representation in clinical case vignettes: a 20-year comparison between two institutions |
| title_full_unstemmed | Race, ethnicity, and gender representation in clinical case vignettes: a 20-year comparison between two institutions |
| title_short | Race, ethnicity, and gender representation in clinical case vignettes: a 20-year comparison between two institutions |
| title_sort | race ethnicity and gender representation in clinical case vignettes a 20 year comparison between two institutions |
| topic | Cultural awareness Social determinants of health Medical student Clinical case discussions Race Gender |
| url | https://doi.org/10.1186/s12909-022-03665-4 |
| work_keys_str_mv | AT courtneyrlee raceethnicityandgenderrepresentationinclinicalcasevignettesa20yearcomparisonbetweentwoinstitutions AT kurtogilliland raceethnicityandgenderrepresentationinclinicalcasevignettesa20yearcomparisonbetweentwoinstitutions AT garylbeckdallaghan raceethnicityandgenderrepresentationinclinicalcasevignettesa20yearcomparisonbetweentwoinstitutions AT suetollesonrinehart raceethnicityandgenderrepresentationinclinicalcasevignettesa20yearcomparisonbetweentwoinstitutions |