Sex differences in study progress at Medical

Transcrição

Sex differences in study progress at Medical University of
Vienna
Geschlechtsunterschiede im Studienfortgang an der Medizinischen
Universität Wien
1
2
3
• Lukas Mitterauer • Oskar Frischenschlager • Gerald Haidinger
Zusammenfassung:
Die Untersuchung zweier Jahrgänge an StudienanfängerInnen der Medizinischen Universität Wien ergab übereinstimmend vier Prädiktoren
für das Bestehen der ersten summativen integrativen Prüfung (SIP1) am Ende des ersten Studienjahres: männliches Geschlecht, deutsche
Muttersprache, gute Schulleistungen, hohe Lernkapazität. Vor allem das schlechtere Abschneiden weiblicher Studierender bedarf angesichts
der weltweit gegenläufigen Befunde einer Erklärung.
Die vorliegende Untersuchung des weiteren Studienverlaufs zeigt nun, dass ein beträchtlicher Teil jener weiblichen Studierenden, die
wegen Nichtbestehens der SIP1 nicht in das dritte Semester zugelassen wurden, mit einem Jahr Verlust wieder im Studium aufscheinen.
Der Anteil dieser Gruppe ist so groß, dass der anfängliche Geschlechtseffekt egalisiert wird, während die anderen drei Prädiktoren unverändert bestehen bleiben. Wir kommen zu dem Schluss, dass der Zeitverlust weiblicher Studierender nicht durch den Mangel an kognitiven
Fähigkeiten, sondern durch ein Zusammenspiel SIP-spezifischer Erfordernisse und geschlechtsspezifischen Lernverhaltens erklärt werden
können. Mehrere Teilprüfungen an Stelle der SIP könnten aus unserer Sicht die Benachteiligung weiblicher Studierender beheben.
Schlüsselwörter: Studienerfolg, Medizinstudium, Chancengleichheit, Geschlecht
Abstract:
The analysis of two freshmen’s cohorts at the Medical University of Vienna consistently yielded four predictors for passing the first summative integrative exam (SIP1) at the end of the first study year: male sex, German mother tongue, good school performance, and high
learning capacity. In particular the - against international trends - worse ratio of successful female students needs clarification.
In this analysis of their further study progress we are able to show that a considerable number of those female students who did not succeed
at first or second examination date and thus did not enter third semester immediately, show up in class schedules with at least one year’s
delay. While the other three predictors stay effective the large quantity of this group annihilates the initial sex-effect. We conclude that the
loss of time results not from a lack of cognitive abilities but from a combination of SIP-specific demands and sex-specific learning behaviour.
From our view, the splitting of the SIP into several small chapters could eliminate the disadvantage of female students.
Keywords: study success, medical studies, undergraduate, gender, equal opportunities
Introduction
Due to the fact that in Austria the access to university studies is
not limited by law, every year about 1600 beginners enrol medical
studies at the Medical University of Vienna. In 2002 a new curriculum with a highly selective summative integrative exam at the
end of the first study-year (SIP1) was implemented. Students who
pass this exam at the first or second date can progress into second
study year. Therefore passing this test is the first important success
criterion. Freshmen of this study-year were allowed to take this
exam four times but they had to succeed at the first or second date
to continue their studies without loss of time.
In two consecutive prospective studies of first-year students of
two study years we were able to prove that in comparison to their
male colleagues female students were discriminated by the above
mentioned decisive exam (see table 1). These analyses additionally
generated three predictors of succeeding the SIP1 at time, namely
German mother tongue, good school performance, and high
learning capacity [1], [2]. All other issues (socio-demographic
variables, family background, economic situation, living conditions, social integration and health, study-motivation, and the
ability to cope with stress) consistently showed no influence. The
reliability of these results was ensured by analysis of the data of
the entailing beginner’s cohort [3].
Table 1: Predictivity of students´ sex in the sample of the study years
2002/03 and their re-examination in the sample of 2003/04 (Finner´s
adjusted P values) [3].
The highly remarkable sex-effect, which stands in contradiction
to international findings [4] caused us to analyze the further studyprogress of the first (2002) cohort. In this paper we report the results of their "transition” characteristics.
1
University of Vienna, Centre for Quality Assurance, Vienna, Austria
2
Medical University of Vienna, Institute für Medical Psychology, Centre of Public Health, Vienna, Austria
3
Medical University of Vienna, Department of Epidemiology, Centre of Public Health, Vienna, Austria
©2007 Mitterauer et al.; licensee GMS Zeitschrift für Medizinische Ausbildung. This is an Open Access article: verbatim copying and redistribution of this article is permitted in all media for any purpose,
provided this notice is preserved with the article's original URL.
This article is freely available from http://www.egms.de/en/journals/mibe/2007-24/zma000405.shtml
Please cite as: Mitterauer L, Frischenschlager O, Haidinger G. Sex differences in study progress at Medical University of Vienna. GMS Z Med Ausbild. 2007;24(2):Doc111.
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Originalarbeit Humanmedizin
GMS Zeitschrift für Medizinische Ausbildung ISSN 1860-3572
Methods
In this study the four predictors (taken from data of the questionnaires of the 2002/03 cohort, see table 2) were merged with the
admission data of the following study years. We examined if students
SIP2 compared to a minus of 62.7% at SIP 1). We conclude that
like in SIP1, in SIP2 the same predictors are effective, in other
words, subjects who passed SIP1 have a high chance to succeed
SIP2.
Table 4: Hypothesis a - Differences between students who show up in
the 7th semester (Successful) and all others (Unsuccessful).
1. feature the previously found predictors of success [1], [2],
[3],
2. show study activity, and if so,
3. in which semester they are registered.
Considering the fact that passing the SIP2 is not conditional for
pursuing studies (SIP2 can be taken until the end of the third year)
the following constellations for the 2002/03 beginners are possible:
• Group 1: Students appear in 7th semester (SIP 1 passed in time)
• Group 2: Students appear in 5th semester (SIP 1 or SIP 2 not
passed in time)
• Group 3: Students appear in 3rd semester (SIP1 passed, but not
in time)
• Group 4: Students do not appear in the admission sheets of the
3rd, 5th or 7th semester (SIP 1 not yet passed or drop-out).
Hypotheses
1. Differences between students who show up in the 7th
semester (group 1) and all others (group 2, 3, 4).
2. Differences between those who passed SIP1 (groups 1, 2,
3) and the rest of the cohort (group 4).
Hypothesis b): When examining the groups of students who passed
SIP1 at any time (groups 1, 2, 3) three of the four predictors
mentioned above remain effective (see Table 5). The sex difference
is neutralized by the fact that female students show up again but
after a loss of at least one year (P=0.397). Of the freshmen 37.3%
continue according to study plan, 14.5% with one year’s loss, and
0.5% with a loss of two years. In the following year and even up
to three years later students of the examined cohort (2002/03) show
up in the admission sheets and thus must have passed SIP1 at a
later date.
Table 5: Hypothesis b - Differences between those who passed SIP1
(Successful) and the rest of the cohort (Unsuccessful).
To prove these hypotheses the statistical tests of successful and
unsuccessful groups comprise Chi-square and (in case of LAS) ttests, analyzed in SPSS 11.5 at the level of P=0.05 (adjusted for
multiple testing).
Results
The socio-demographic variables (age, sex) of the 2002 cohort are
given in table 3. Approximately two thirds of the first-year students
are females.
Table 3: Sociodemographic characteristics of the cohort 2002/03 [2].
To examine the annihilation of the sex effect we compared the 3rd
semester admission sheets of the three consecutive study years
(see table 6): 43.7 % of male students passed SIP1 in time but only
37.1% of females. 11.6% of male beginners but 15.5% of females
show up one year later. After a loss of two study years an equal
percentage of 0.5% of the cohort examined are admitted (see table
6).
Table 6: Appearance of the 2002/03 freshmen (who enroled until
October 1, 2002, N=1280) in registers of the third semester, by sex.
Hypothesis a): For students in the 7th semester (group 1) the same
predictors of study success are relevant (sex: female vs. male,
38.8% vs. 48.5%, P=0.022; German mother tongue: yes vs. no,
43.2% vs. 30.8%, P=0.013; good school performance: sum of
school marks, lower value is better, 7.7 vs. 9.4, P<0.001; and high
learning capacity: three items on LAS/hours, P<0.001, P=0.044,
P<0.001, see Table 4). Almost all students who passed SIP1 in
time (and therefore were allowed to continue studies without lack
of time) show up in 7th semester (diminished by only 11.1% by
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Table 2: List of items used in the original questionnaire (LAS=linear analogue scale) [1].
Discussion
Facing the fact that selection of students in Austria look place
during studies (and not before) we not only are interested in the
quantification of selection but also in its specificity. Previously
we were able to show that female students –- reliably – perform
worse in this selective exam and consequently we now are interested in their further study-advances. The results of this „students’
transition analysis“ yielded – in addition to our previous findings
(four predictors: male sex, school performance, German mother
tongue, high learning capacity [1], [2], [3]) – two new observations:
1. analogously to a master key the above mentioned predictors
“open” the door not only the third but also to higher
semesters.
2. female students who did not succeed SIP 1 in the first run,
show up in registers again after a stand-by time of one year
or even more.
This may stem from two causes: either they have adapted their
learning strategies to the demands of SIP or they succeeded after
an additional investment of learning efforts which would not have
been doable within time given. Within the group examined, there
may also be a small number of students who intermitted studies
because of pregnancy, granting of leaves or illness but their number
certainly is negligible. Furthermore, the opportunity for the nonsuccessful of taking elective courses in the mean time does not
compensate their loss of time.
We conclude that female students do not suffer a loss of time because of lacking cognitive competence, but because of an interaction of SIP-specific demands and a supposed sex-specific learningbehaviour.
From the present point of view we assume that a splitting of SIP
into several smaller exams would reduce the obvious disadvantage
of female students: data from the Medical University of Graz (yet
unpublished) where a similar curriculum is implemented but with
several small exams do not show this sex-effect. Furthermore, we
hope that the – currently undertaken – analysis of the influence of
sex-specific learning strategies on success at SIP1 will bring light
into matters.
Acknowledgements
The authors would like to acknowledge the financial contribution
of the ÖGHD (Austrian Society for didactics in higher education)
and of the Department of Further Education of the Austrian
Chamber of Physicians, who support our studies.
Corresponding author:
• Mag. Lukas Mitterauer, University of Vienna, Centre of Quality
Assurance, Maria Theresien Street 3/15a, A-1090 Vienna, Austria,
Phone: ++43-1-4277-18002, Fax: ++43-1-4277-9180
[email protected]
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References:
[1] Frischenschlager O, Haidinger G, Mitterauer L. Factors Associated with Academic
Success at Vienna Medical School: Prospective Survey. Croat Med J.
2005;46(1):58-65.
[2] Haidinger G, Frischenschlager O, Mitterauer L.: Prediction of success in the
first-year exam in the study of medicine - a prospective survey. Wien Klin
Wochenschr. 2005;117(23-24):827-832.
[3] Haidinger G, Frischenschlager O, Mitterauer L. Reliability of predictive factors
of study success in medicine. Wien Med Wochenschr. 2006;156(13-14):416-420.
[4] Ferguson E, James D, Madeley L. Factors associated with success in medical
school: systematic review of the literature. BMJ. 2002;324(7343):952-957.
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Sex differences in study progress at Medical

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