Self-assessment differences between genders in a low-stakes objective structured clinical examination (OSCE)

Methods

Results

Thirty-three (15 males, 18 females) third-year students were included in the analysis. Participants scored themselves lower than their peers [F (1, 31) = 21.04, p < 0.001, \( \eta_{P}^{2} \) = 0.404]. Furthermore, females marked themselves lower than males [F (1, 31) = 9.24, p = 0.005, \( \eta_{P}^{2} \) = 0.230]. The linear model did not show any significant differences in SA-GRS and PA-GRS between stations [F (1, 31) = 0.24, p = 0.887, \( \eta_{P}^{2} \) = 0.001] and did not show any combined interactions between gender, station type, and SA and PA [F (1, 31) = 0.24, p = 0.887, \( \eta_{P}^{2} \) = 0.001].

As outlined in Fig. 1, females had significantly lower SA-GRS scores compared to PA-GRS scores (3.88 vs. 4.67; p < 0.001, d = 1.18), whereas no significant difference was found between SA-GRS and PA-GRS scores for male examinees (4.64 vs 4.80; p = 0.228, d = 0.32). No significant difference existed between male and female students in the achieved checklist (60.32 vs. 56.27; p = 0.828) and GRS scores (4.80 vs. 4.67; p = 0.452).

Discussion

Our study demonstrates that underestimation among females is observable even in a low-stakes setting. Notably, despite the disparity in self-assessment between genders, their overall achievement in the mock OSCE did not differ, corroborating the data in the current literature [6]. Our findings—in conjunction with previous research –are noteworthy for several reasons. Firstly, the presence of female underestimation in a low-stakes setting suggests the potential existence of systemic phenomena within medical school that affect mediators such as self-confidence and anxiety among female students. Colbert-Getz et al. [7] found that high anxiety in a high-stakes OSCE contributed to underestimation in performance among female medical students. Even within this low-stakes setting, anxiety may persist due to the pressure from being assessed by fellow medical students [8] or the perceived novelty of the stations. Secondly, these results suggest that similar performance outcomes between male and female students may not necessarily equate to similar perceptions of performance due to variations in anxiety, confidence, and/or self-efficacy [5–7]. Thirdly, socialization within the medical profession may affect male and female trainees differently, potentially contributing to the observed difference in self assessment [9]. Prior research suggests that female medical professionals are more likely to have personal values that are incongruent with institutional values of academic medicine compared to their male counterparts, leading to a reduction in self-confidence and self-efficacy [10]. Whether differences in self-assessment are inherent or acquired upon entry into medical school would be an interesting area of future research.

Curricula should thus move towards recognizing and addressing differences in performance perceptions between genders and promote a more equitable learning experience. A combination of vicarious and personal learning experiences that facilitate the identification of knowledge gaps could help students more accurately appraise their own performance [7].