Differences in ambulatory teaching and learning by gender match of preceptors and students

Background and Objectives: Important differences exist in traditional medic al education by gender of the teachers and learners. Much less is known abo ut how gender influences educational experiences in community-based ambulat ory settings. In this study, we explored how community-based teaching and l earning varies by gender of the students and preceptors. Methods: This pros pective study used both paper- and computer-based documentation systems to collect information on student-patient-preceptor encounters. a consecutive sample of third-year medical students contributed data on one full clinical day each week as they rotated through a required 8-week family medicine cl erkship. The main measures of interest included patient age and gender, hea lth care visit type (acute, acute exacerbation of chronic, chronic, and hea lth maintenance), method of learning in history taking and physical examina tions (observing preceptor, being observed by preceptor, performing unobser ved, or working jointly with preceptor), content of physical examinations, amount of preceptor feedback, preceptor teaching content, and gender of the students and their preceptors. Results: Ninety-three students contributed data on 5,017 patient encounters. The distribution of encounters by student -preceptor dyad included: 1,926 (38%) female students with male preceptors, 1,716 (34%) male students with male preceptors, 841 (17%) female students with female preceptors, and 534 (11%) male students with female preceptors. We found that female preceptors conduct more complete physical exams with students than do male preceptors (28% versus 23%). Female students with mal e preceptors devoted more encounters to observation only than any other dya d (20% versus 12%), and female preceptors are more likely than male precept ors to allow students to perform unobserved (70% versus 59%). Patient gende r played little if any role in how students and their preceptors worked tog ether. Conclusions: Differences of potential importance were found in teach ing and learning by gender of the student-preceptor dyad. This factor can a nd should be considered when determining how students can best meet educati onal objectives in community-based ambulatory settings.