Gender differences in examinee performance on the Step 2 Clinical Skills® data gathering (DG) and patient note (PN) components

Kimberly A. Swygert, Monica M. Cuddy, Marta van Zanten, Steven A. Haist, Ann C. Jobe

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Multiple studies examining the relationship between physician gender and performance on examinations have found consistent significant gender differences, but relatively little information is available related to any gender effect on interviewing and written communication skills. The United States Medical Licensing Examination (USMLE®) Step 2 Clinical Skills® (CS®) examination is a multi-station examination where examinees (physicians in training) interact with, and are rated by, standardized patients (SPs) portraying cases in an ambulatory setting. Data from a recent complete year (2009) were analyzed via a series of hierarchical linear models to examine the impact of examinee gender on performance on the data gathering (DG) and patient note (PN) components of this examination. Results from both components show that not only do women have higher scores on average, but women continue to perform significantly better than men when other examinee and case variables are taken into account. Generally, the effect sizes are moderate, reflecting an approximately 2% score advantage by encounter. The advantage for female examinees increased for encounters that did not require a physical examination (for the DG component only) and for encounters that involved a Women's Health issue (for both components). The gender of the SP did not have an impact on the examinee gender effect for DG, indicating a desirable lack of interaction between examinee and SP gender. The implications of the findings, especially with respect to the validity of the use of the examination outcomes, are discussed.

Original languageEnglish
Pages (from-to)557-571
Number of pages15
JournalAdvances in Health Sciences Education
Issue number4
StatePublished - Sep 2012

Bibliographical note

Funding Information:
M. van Zanten Foundation for Advancement of International Medical Education and Research (FAIMER), Philadelphia, PA 19104, USA


  • Assessment
  • Clinical skills
  • Gender
  • Hierarchical linear modeling (HLM)
  • Standardized patients

ASJC Scopus subject areas

  • Education


Dive into the research topics of 'Gender differences in examinee performance on the Step 2 Clinical Skills® data gathering (DG) and patient note (PN) components'. Together they form a unique fingerprint.

Cite this