ArticleBMC medical education2026
Gender-based discrimination shapes psychological safety and professional identity in clinical settings: a qualitative study of nursing, midwifery, and medical students.
Article in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGender-based discrimination remains a persistent structural challenge in health professions education and may shape students' access to learning opportunities, sense of belonging, and professional identity formation. Psychological safety is essential for participation in clinical learning; however, little is known about how gendered experiences are perceived to influence psychological safety, professional identity, and resilience among nursing, midwifery, and medical students.
methodsThis qualitative study explored how nursing, midwifery, and medical students experience gender-based discrimination in educational and clinical learning settings and how they perceive these experiences as relating to psychological safety, professional identity development, and resilience. Guided by critical social theory, the study adopted an IPA-informed interpretative qualitative design. Seven FGDs were conducted with nursing, midwifery, and medical students (n = 56). Data were analysed using an iterative, interpretative process supported by MAXQDA. Reporting followed the COREQ guidelines.
resultsAnalysis generated three interrelated themes with nine sub-themes. Theme 1, Gendered Professional Identity: Professional Role, Competence, and Status, comprised gender-based labelling of professional roles, gender-coded task allocation framed through "sensitivity versus physical strength," and glass-ceiling perceptions in career pathways. Theme 2, Inequity in Clinical Learning Opportunities and Psychological Safety, included restricted access to learning, gendered recognition and discrimination, and psychological safety and withdrawal. Theme 3, Resilience Through the Lens of Gender, encompassed competence-based identity construction, supportive academic and institutional ecosystems, and collective voice through professional solidarity and advocacy.
conclusionsThe findings suggest that gender-responsive and psychologically safe clinical learning environments may be important across nursing, midwifery, and medical education. Educators, supervisors, and clinical staff should consider addressing gendered role labelling, inequitable task allocation, and hidden curricula as potential structural barriers to learning and participation. Transparent and auditable learning objectives, gender-responsive supervision, monitoring of task and feedback allocation, and accessible reporting pathways may help reduce perceived inequities and support students' willingness to speak up. The findings also indicate that moving beyond an exclusive reliance on individual resilience may better support equitable professional identity development, sustainable workforce preparation, and safe patient care. However, these interpretations should be understood within the specific educational, clinical, and sociocultural context of the study.
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