Gender bias in the diagnosis of a geriatric standardized patient: a potential confounding variable

Gender bias has been reported in the diagnosis and treatment of patients with a variety of illnesses. In the context of our 10-station fourth year Objective Structured Clinical Evaluation, we queried whether this could influence diagnosis in a geriatric case. Case writers hypothesized that, due to this bias, the female standardized patient may be diagnosed with depression more often than the male.

A male or female geriatric standardized patient protrayed a dysphoric widow with mild cognitive impairment. Students examined the patient and documented the clinical encounter and their differential diagnosis.

Major depression was diagnosed in 93/107 female standardized patient encounters compared with 58/78 male exams, with the female students contributing most to this difference.

The potential for gender bias in medical care and in education remains a concern. We need to be mindful of this when designing clinical skills assessments.