Medical student gender and issues of confidence.

OBJECTIVE To review the literature on gender differences and issues of self-confidence in medical students and to present original research on observers' perceptions of medical student confidence. METHODS One hundred forty-one 3rd year medical students at Indiana University School of Medicine were videotaped during their objective structured clinical examination (OSCE). Trained coders rated how confident the student appeared and coded a variety of nonverbal behaviors at the beginning, middle, and end of the interaction. Analysis focused on gender differences in coders' ratings of perceived confidence. RESULTS Female medical students were viewed as significantly less confident than male medical students (F(1,133)=4.45, p<0.05), especially at the beginning of the interaction. CONCLUSION Past research indicates that despite performing equally to their male peers, female medical students consistently report decreased self-confidence and increased anxiety, particularly over issues related to their competence. In a standardized patient interaction examination situation, female medical students also appeared significantly less confident than male medical students to independent observers. PRACTICE IMPLICATIONS Medical educators should focus on issues of female students' confidence, increasing faculty sensitivity, and publicly recognizing and discussing perceptions of confidence.