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Transcript Conclusions and feedback
Gender Competency
Training for Medical
Educators
28th of April 2003
SKILLS, GENDER COLLISIONS AND
RESISTANCE
Ann-Maree Nobelius
Faculty of Medicine, Nursing and Health Sciences
Monash University Australia
SKILLS, GENDER COLLISIONS
AND RESISTANCE
Gender Analysis
What difference does gender make to
this scenario?
Levels of Analysis
1. Individual
2. Environmental
social
cultural
communities
economic
3. Structural
institutional
legislative
4. Superstructural
international laws, policy and institutions
Individual Level
must convince the medical student or
newly graduated doctor that rural practice
is challenging and rewarding so perhaps
we must give the candidate role models
who have done it, hence the recruitment
of our rural GP tutors, both male and
female
Environmental Level
social- moral support and a social network to provide social
support…this leads into..
cultural- deconstruct the traditional rural doctor work model. The
standard that has been set is the ‘die with your boots on while the
wife takes care of the family’ model, but as Jo has frequently
pointed out what rural GP’s, both female and male need is a life
not a wife.
communities in need of GPs must collectively acknowledge their
part in making this new and valued resource welcome and provide
support to accommodate the needs of the GP eg if the GP is a
single mum…how can she be on call for overnight
emergencies…these practicalities must be acknowledged and
planned for
economic- is there an economic disadvantage to the GP for
choosing rural over urban practice and how can we need.
According to Medicare data female doctors on average make less
money than there male counterparts for a variety of reasons, is
this trend going to be exacerbated in rural practice?
Structural Level
institutional- are the institutions involved, such
as the regional health authority or bush nursing
hospital support a woman in their environment,
and in the case you will teach in week 9, based
on a true story, this was a source of conflict
legislative-Medicare rules, do they discriminate
against rural style of female style practice and
again is that going to be made worse by rural
practice
Superstructural Level
International laws and institutions- do
they acknowledge and support the need
to encourage more women into rural
practice?
So how does all of this relate to you
as tutors facilitating discussion with
medical students about potential
gender issues in their cases?
Reflective Questioning
what are the gender issues for the doctor as an individual?
what are the gender issues for the patient as an individual?
and so on with any other players presented in the case
and then move on to the environmental variables
what role does gender play in social issues in this scenario?
what role does gender play in cultural issues in this
scenario?
what role does gender play in economic issues in this
scenario?
What difference does gender make to
individual/social/cultural /environmental
economic….issues in this scenario
or
How would this scenario be different if the
patient were a woman/man?
How would this scenario be different if the
doctor were a woman/man?
…or in the more complex case of Mary’
patients:
How would this scenario be different if
the patient/doctor were a
woman/man/gay/lesbian/transgender/
male self-identified woman?
Everybody’s experience is different
Gender analysis allows us to investigate
difference
Gender Collisions
Process designed by Prof Elizabeth
Hultcrantz
Reworked by Monash 6th year students
to reflect their experience
Assist in acknowledging alternate
perspectives to our own
Case 1
Kon scrubbing in and Aletha observing
Female Solutions
Introduce yourself to the surgeon, make sure he knows who you
are
Express your enthusiasm, try not to be intimidated
Discuss career options with a woman
Talk to the surgeon if approachable
Wear nice clothes
Not to be disheartened by experience
Wear a name tag, make sure he knows your not a nurse
Ask Kon if he will take turns
Male Solutions
Dismissing surgery over one incident is over reaction
Comment that supervisor will focus on one student whether
because of gender, approachability, enthusiasm
She needs to be more assertive with this surgeon if that fails go to
another one
Negotiate with Kon and ask him to let Aletha do the scrubbing and
he can watch the anaesthetist
Case 2
Minh, Mario and the midwives
Female Solutions
Generalised sucking up: find common ground, male midwives or
older midwives
Do nights
Be physically at the unit more often
Mario could call Minh
Speak to supervisor
Male Solutions
Issues not gender, its assertiveness
Perspective: males have trouble too
Racial aspect: redneck
Clear view of where medical students stand vs. midwifery students
Talk with supervisors
Don’t inflame situation
Normal for her, he’s a ‘smoothe’ Italian Stallion
Case 3
Tim sitting in the waiting room
Female Solutions
Talk to GP, maybe question could be worded better
Nurses to warn patients as they arrive, may be happier if they are
not surprised
Word the question as he is a final year student Doctor
GP to explain to patient the importance of experience for the
student and the value of the patients contribution
Find a female GP discuss the problem and get advice
Male Solutions
Don’t over generalise
Talk to GP re explanations to patients about student experience
Talk to supervisor
Lie to patients about qualification of students
Is there something the student is doing to put the patient off
Involve the student in the history taking to develop rapport
Case 4
Mick being grilled by the consultant, Nancy being ignored
Female Solutions
Ask lots of questions
Keep turning up
Smile and be enthusiastic
Speak to the patients
Pre-reading/ask intelligent questions
Decide to diffuse the answering the questions
Mick to involve Nancy
Look consultants in the eye
Speak to clinical supervisor- get tutes from someone else
Male Solutions
Assess if it will be an on-going issue - this may be a once-off problem
Try to allow Nancy to answer questions
Get Nancy to state her case to the surgeon assert her enthusiasm
Perhaps allow both students to answer questions together
Speak to faculty or other students if the it seems to be an ongoing issue
Speak to registrar
RESISTENCE
you mustn’t over generalise,
everybody is an individual
its about power not gender
that’s changing, that’s the problem of
the older generation
Q&A
Participants
Ms Jo Wainer
Dr Kaye Birks
Dr Sudesh Arora
Conclusions and
feedback