Power and Control in Medicine and Nursing – Could Intrinsic Gender Beliefs Impact Interprofessional Education in Pre-Professional Programs?

Abstract

ABSTRACT Examination of the power dynamics at work in perpetuating health care hierarchy-related interprofessional collaboration barriers is needed to rationally develop strategies for teaching collaborative skills to health care providers. A mixed-methods study employing critical realist grounded theory examined the implicit beliefs, assumptions and power hierarchies related to gendered perceptions of the professions of nursing and medicine by students of those professions. Two focus groups of nursing students (n = 6 and n = 8) and one focus group of medical students (n = 6) and an online survey of both medical and nursing students utilizing the Interpersonal Hierarchy Expectation Scale (Mast, 2005a) (N = 73) provided the data. Focus group data revealed that both nursing and medical students had strongly gender-essentialized beliefs about the social categories of medicine and nursing with nursing as feminine and medicine as masculine. Students ascribed expectations of work performance based on gender with female physicians expected to be more successful in family-oriented roles (pediatrics) and male nurses expected to be more successful in ‘non-nurturing’ roles (surgery). Survey data revealed that both nursing and medical students had the same level of hierarchy expectations. Gendered stereotypes of nurses as communal and physicians as agentic can contribute to the maintenance of components of the health care hierarchy that lead to sub-optimal interprofessional collaborative practice. Understanding students’ essentialist beliefs about the social categories of nursing and medicine can inform effective interprofessional education curriculum development.