#KeyLIMEPodcast 226: When Feminist Theory Meets the Lancet

For her review, Lara selected a manuscript from a special February edition of the Lancet, which focused on feminist and gender issues. Her selection examined how feminist theory can be used to address modern challenges in the world of #meded and how it holds the potential to move clinicians and educators from theory to action.  The authors conducted a scoping review that identified the four main ways feminist theory has been applied to medical education and medical education research – but to find out what these are, you’ll have to listen to the episode.

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KeyLIME Session 226

Listen to the podcast.

Reference

Sharma M. Applying feminist theory to medical education. Lancet. 2019 Feb 9;393(10171):570-578

Reviewer

Lara Varpio (@LaraVarpio)

Background

This manuscript is from the February 9th, 2019 edition of the Lancet that highlighted feminist and gender issues in both medicine and medical education. While that edition of the journal has several important manuscripts, I selected this one because it focuses on medical education and on feminist theory.

Purpose

Instead of reporting on a study, this manuscript focuses on how feminist theory has been applied to medical education, and how rigorous application of feminist theory can help address some of medical education’s modern challenges.

Key Points on the Methods

This paper writes up a scoping review, which is an appropriate choice for this research. Remember the question is to explore how feminist theory has been applied to the field of medical education. A common purpose of a scoping review is to summarize a range of research on a particular topic – so that’s fine.

The author used search terms of medical education, feminist and gender issues to make sure to find as much relevant lit as possible. She did not include any grey literature, justifying that choice by stating she was interested in reviewing literature that provides insight into what is considered legitimate or worthy by the field. There is a also a brief description of some of the other inclusion and exclusion criteria, including excluding any work that was theoretical or that dealt with medical practice and not medical education (which makes sense – she wants to see how feminist theory has been applied in med ed so if there is no theory in the paper or no education, it makes sense to exclude that work) The author approached two experts in medical education and feminist theory, asking them for literature that should be included in the review. Now, normally, consulting with experts is the final – and optional – step of a scoping review, but I think it is reasonable to have them weigh in early to help find literature. I think that was a clever approach used by the author

To my surprise, this search practice ended up finding 80 manuscripts for inclusion in the review. That is way more than I expected.

Key Outcomes

Before reporting the findings of her review, the author clarifies her key terms. She notes that there is no single definition of feminism, that it is a concept with multiple interpretations and historical roots. She turns to Bell Hook’s simple definition as her grounding: “that feminism is a movement to end sexism, sexist exploitation, and oppression.” She also explains that there is no single unifying definition of a feminist theory. Table one offers a brief outline of 11 different feminist theories

The author found that feminist theory has been used in medical education in four main ways. First, is what the author called the what . This is about understanding gender issues in medical curricula through a feminist lens. Here, the “what” is the content of our curricula, where the author highlights systems that have failed to adequately consider women’s health issues and contexts, that frequently patronize women and their experiences, and that place little value on women’s lived experiences and areas of expertise. Second, is who. Here, the author notes that feminist theory has been used in medical education to analyze the lived experiences of medical training. This is a body of literature where the lived experiences of medical trainees has outlined the issues of classism, racism, homophobia, and sexism they have faced in their medical training. Third is how. Here the author summarizes how feminist theory has informed pedagogy. Feminist pedagogical approaches encourage us to recognize our assumptions and to examine the hidden curriculum of medical education systems. This body of work looks at the ideology that is perpetuated by our pedagogy, noting that current discourses and systems in education neglect social contexts and do not advocate for broader curricular shift to make room for different cultures. Finally, feminist theory has informed medical education research – this is what the author calls the why. Feminist theory has shaped the research questions asked, the theoretical frameworks through which those questions are asked, the methodologies used, and the the ways in which findings are translated into practice.

Key Conclusions

The author explains that medical education lays the foundation for medical practice. She argues that it is therefore essential for us to understand how in our teaching of future practitioners, we are socializing them into ways of thinking and working. Feminist theories are essential for not only changing what content we cover in our curricula, and who is brought into the medical profession, but also feminist theory requires us to see how our pedagogy has patriarchal underpinnings and why our research addressing some questions and includes some voices, but not others.

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