Gender and achievement in clinical medical students: a path analysis

Background and purpose Men and women interact differently with the learning environment. Women's standards and goals are responsive to social and envi ronmental influences. Men seem relatively indifferent but check their perfo rmance against strongly internalized standards. The purpose of this study w as to discover how these interactions determined achievement. Methods A longitudinal study examined students on their first clinical firm s. Students' view of the learning environment was measured as their attribu tion style. Perceived self-efficacy, anxiety and fear of negative evaluatio n were also measured at the start of the course and again 3 months later. P ath analysis was used to connect these measures to achievement assessed in tests of knowledge and skills after a further 3 months. Results Men and women showed significant differences. In both, a perception that bad events in the learning environment were persistent and pervasive appeared to be causal of high achievement in tests of knowledge. In men thi s was dominantly mediated through fear of negative evaluation and anxiety. In women the path appeared to be direct and associated with a sense of redu ced self-efficacy. Men also showed two additional and opposing paths to ach ievement when good events were pervasive and persistent. For some, achievem ent was improved. Others experienced a reduction in anxiety and performed p oorly. Conclusions Achievement in men demands arousal. This is greatest in environ ments that provide frequent opportunities for comparison of their performan ce with their internal standards. Achievement in women seemed consequential on a re-evaluation of their sense of efficacy in adverse environments. Per sisting with attempts to manage learning in a socially unresponsive environ ment can cause unproductive anxiety and poor performance.