背景:医学案例插图长期以来一直用于医学生教育,并且经常包括人口统计学变量,例如种族,种族和性别。然而,在没有背景的情况下纳入人口统计学变量可能会强化假设和偏见。然而,没有种族,性取向,健康的社会决定因素可能会加强反映文化盲目性的隐藏课程。这项复制研究比较了种族的比例,种族,和性别与明尼苏达大学(UMN)的调查结果。这项研究旨在确定案例小插曲中人口统计学特征的表示是否取得了进展。
方法:分析了北卡罗来纳大学(UNC)2015-2016年的病例插图,并与1996-1998年的UMN病例插图进行了比较。数据包括提及种族,种族,健康的性别和社会决定因素。
结果:在278UNC小插曲中,在19.7%的病例中发现了白人种族,黑人占7.9%,76.6%的病例不明。在983UMN小插曲中,白种人占2.85%,黑人种族占0.41%。这些机构在描述种族的病例比例上存在显着差异(0.20;95%CI(0.15,0.25))。男性在大多数小插曲中都有代表。
结论:比较两个医学院的病例对照结果提示,报告明确的人口统计学差异没有显著差异。研究结果表明,性别是一贯描述的人口统计学特征,男性人数过多。基于这些发现,在医学生教育中,需要更大的文化多样性,因为它与健康的社会决定因素相交。
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.
CONCLUSIONS: 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.