88 Journal of Public Health Dentistry

DIFFERENCES IN SOCIAL PERCEPTIONS BETWEEN MALE AND FEMALE FIRST-YEAR DENTAL STUDENTS

Alexander C. Rosen, Ph.D.* Marvin Marcus, D.D.S., M.P.H.""

Introduction One of the many issues American dentistry faces is the preparation of

increasingly larger numbers of women for its professional ranks. Traditionally, American dentistry has been almost exclusively the domain of the male sex. Census data show that in 1970 there was a total (active and inactive) of three percent female dentists as compared with nine percent female physician^.^ ADA data illustrate that approximately 1.5 percent of the active members of the dental profession are women.' A partial reason for this underrepresentation of women in dentistry in the past was associated with American dentistry's "aura of masculinity."8 However, in recent years women have become interested in the profession and are being accepted into dental schools in increasing numbers. For example, in 1975, American dental schools graduated 156 female dentists - 3.1 percent of all dental graduates. In the same year, 707 females (12.3 percent) were enrolled as first-year dental students.'

The entry of large numbers of women into dental schools has not been without problems. Coornb~,~ in a survey of female dental students, reported that discrimination was not uncommon. Austin et a1.2 found that female students often perceived subtle discrimination from fellow students more than from the faculty. It is reasonable to assume that some members of the profession perceive the sizable increase of women dentists as inconsistent with the accepted concept of dentists and dentistry. On the other hand, there are those who actively advocate increasing the representation of women in dentistry because females possess unique qualities not generally attributed to the male.e The following quote illustrates this point of view:

Women usually show sympathy and gentleness. Such qualities aid in treating the ill, the injured, and the disabled. Women make good nurses because they have these qualities. Women can gain the confidence of children quickly. Children need to be treated with patience, gentleness, and understanding. Feminine and maternal instincts prepare women for treating children. Besides, women, if they become mothers, learn to display a depth of care not developed in men. As we go forward in the preventive programs, the government and the union-sponsored programs will demand more dental service for children. It behooves the dental profession to recruit more women in dentistry to help care for the oncoming children. Let the men of dentistry consider the aptitudes of women. Dentistry is an art as well as a science. It is generally conceded that women are as artistic, as creative and as faithful to details as men. Other advantages are that they have smaller hands and a gentler touch than men.I3 Both those who resist and those who advocate women joining the dental

profession characterize women as having emotional and attitudinal differences from men. However, this view is not consistent with the findings of McCreary

"Dept. of Psychiatry, University of California, Los Angeles, School of Medicine, Los Angeles, Cali- fornia 90024

'"School of Dentistry, University of California, Los Angeles, Los Angeles, California 90024

Vol. 37, No. %Spring, 1977 89

et al.9 in their study of the personality traits of first-year male and female dental students. They found females to be more similar to their male counterparts than to a standardized middle class University female population. Coombs found much the same to be true in a study of career choice among women dental student^.^

This report, which examines one aspect of the presence or absence of percep- tual differences between male and female first-year dental students, is part of a previous study that examined the attitudes of students during their first year of education in dentistry and their early preclinical experiences with patients and professional dentists."

Description of the Study At the onset of this study it was assumed that first-year male and female dental

students are sufficiently similar in their attitudes and in their perceptions of them- selves, dentists, and patients to make the gender of the applicant an unnecessary consideration in selection. Even with an aggressive affirmative action program, it is reasonable to assume that the male and female applicants are equally competent intellectually, since their selection is based on the same standards for academic record, the same dental aptitude test scores and other objective estimates of com- petence. In our effort to explore the attitudes of dental students, a 10-item Osgood Semantic Differential instrument was administered on three occasions to 109 first- year dental students at UCLA during their second quarter in attendance. The class consisted of 35 women and 74 men.

The semantic differential technic was used because it has demonstrated over the past 20 years repeated utility measuring attitudes, beliefs, and semantic meaning. 10~12 The current status of this respected instrument more than adequately justifies the expectation that it can measure differences between persons in their view of the relevant concepts being described. The authors have also used the same procedure and same 10 bipolar scales in an earlier study" in which changes in descriptions of patients and dentists by dental students were measured and differ- ences evaluated.

On the first administration the 10 bipolar semantic differential adjective scales were used by male (n = 74) and female (n = 35) first-year dental students to describe themselves, what they considered to be the ideal dentist, and what they considered to be the ideal patient. The second session was one in which the students were presented with a videotape of an interaction between a doctor and a patient; they were asked to describe their observations of each individual. The third admin- istration of the 10-item instrument was one in which the students were asked to describe the three persons they observed on videotape, namely, a doctor, a patient, and a dental assistant. There were 160 descriptions or individual bipolar compari- sons that could be made between males and females. T-scores were computed as indicated between males and females on each bipolar scale (total of 10 for each rating), and for each of the three occasions and each of the totals of eight persons described (Table I).

Findings The mean scores for all participants who used the Osgood instrument are given

in Table I. Of the 160 scales, only seven two-tailed t-tests between the mean scale

90 Journal of Public Health Dentistry

TABLE I MEAN SCORE OF BIPOLAR RATINGS ON TEN SEMANTIC

3.5 FEMALE, 74 MALE DIFFERENTIAL SCALES FOR 100 DENTAL STUDENTS -

~ ~ ~~ ~~

Dentist Ideal Dentist Dentist

Bipolar Scales'" Rating Tape No. 1 Tape No. 2 M F M F M F

Positive/Negative 1.45 1.31 1.70 1.78 1.86 1.66 Self-Centered/Interested

in Others 1.54 1.41 2.80 2.66 2.46 2.57 Free/Constrained 5.10 5.44 5.19 5.53 6.2A 6.46 Active/Passive 1.84 1.69 2.00 1.59" 2.25 2.06 Predictable/Unpredictable 1.93 1.66 2.52 2.06" 4.04 4.00 Refreshed/Weary 1.41 1.19 1.93 1.65 1.95 1.91 Anxious/Calm 6.54 6.66 5.62 5.63 6.22 6.34 Authoritarian/Permissive 3.09 3.38 2.46 2.50 2.95 3.2.3 Pleasant/Unpleasant 1.38 1.19 2.09 1.84 1.74 1.69 Relaxing/S timulating 2.74 2.93 3.18 3.06 2.80 2.97 Trusting/Distrusting 1.81 1.66 2.73 2.56 2.46 2.11

Patient Ideal Patient Patient

Rating Tape No. 1 Tape No. 2 M F M F M F

Positive/Negative 1.79 1.59 3.67 3.87 2.34 2.03 Self-Centered/Interested

in Others 3.09 3.00 4.23 4.50 3.12 2.85 Free/Constrained 4.65 4.74 2.58 2.87 4.51 4.79 Active/Passive 4.82 4.56 5.56 5.75 4.74 4.06' Predictable/Unpredictable 1.81 1.87 2.84 2.97 3.19 2.89 Refreshed/Wear y 1.90 2.03 4.07 3.97 2.82 2.35 Anxious/Calm 6.34 6.16 2.46 2.50 5.20 5.60 Authoritarian/Permissive 5.57 5.81 5.82 5.93 5.78 5.91 Pleasant/Unpleasant 1.46 1.56 2.51 2.48 2.01 1.74 Relaxing/S timulating 3.00 2.81 3.50 3.64 3.06 3.14 Trusting/Distrusting 1.47 1.50 2.61 2.61 2.03 1.51

'Significant difference at the .05 level A score of one on a seven point scale places value closest to the left hand descriptive adjective, i.e. positive. A score of seven places value closest to the right hand descriptive adjective, i.e. nega- tive.

a *

Vol. 37, No. 2-Spring, 1977 91

Dental Dental Self Assistant Assistant

Rating Tape No. 1 Tape No. 2 M F M F M F

Positive/Negative 2.49 2.50 - 3.74 3.34 Self-Centered/Interested

in Others 2.54 2.19 - 3.92 3.77 Free/Constrained 4.13 4.00 - 2.01 3.03 Active/Passive 2.84 3.00 - 3.67 3.46 Predictable/Unpredictable 2.84 3.09 - 2.75 2.31 Refreshed/Wear y 2.74 3.44" - 4.08 3.54 Anxious/Calm 4.73 4.34 - 4.85 5.29 Authoritarian/Permissive 3.64 3.97 - 4.99 4.65 Pleasant/Unpleasant 2.38 2.37 - 3.70 3.17O

3.52 3.60 Trusting/Distrusting 2.67 3.00 - 3.51 2.91'

scores between men's and women's ratings of self, of dentists, of patients, and of dental assistants are significant at the five percent level or better (approximately 4.4 percent of the mean ratings). At this level of significance one would expect to find a statistically significant difference in four or five of the comparisons occurring by chance (Table I). In this instance seven of the comparisons were statistically significant - not a dramatic difference between the male and female groups with respect to the individual rating scales.

It is interesting to note, however, that two of the significant comparisons were for the trusting/distrusting scale in the second videotape. For the patient and the assistant, the females rated the individuals as more trusting than did the males. The active/passive scale also had two significant comparisons. In the first videotape, the females rated the dentist as more active and similarly in the second they rated the patient as more active than their male counterparts. In both of these scales the females tended to perceive the individual in a more favorable light. The other significant comparison occurred only once and no trend was evident. The overall assessment is that there were no dramatic differences in the perception of these male and female first-year dental students using the individual rating scales.

Using the statistics developed by Osgood for the Semantic Differential, the D- score, one can examine the degree of similarity (or the degree of difference) between the males and females in the first-year dental school class (Table 11). If one views both systematically, the self-descriptive scores have a D-score of 1.041 which should suggest a relatively high similarity between male and female students. Their perceptions of the ideal dentist and patient are even more closely related. Similarly, the male and female students rated dentists, patients, and dental assistants whom they observed in clinical situations on videotape in very similar fashions. Also no significant differences were found between male and female dental students in the way in which they looked at ideal ratings or their own self concept.

When dealing with male and female students separately, Table I11 compares descriptions of the ideal dentist, the ideal patient and self descriptions. The male

Relaxing/S timulating 3.57 3.66 -

'Significant difference at the .05 level.

92

FEMALE Session No. 1 Ideal Ideal M=68 F=32 Self Dentist Patient Self -

Ideal Dentist Ideal

Session No. 2 M=69 F=32 Dentist Patient Assistant Dentist - - - Patient 7.787 - -

Assistant - - -

Session No. 3 M=74 F=35 Dentist Patient Assistant Dentist - - - Patient 4.069 - - Assistant 5.464 3.700 -

- -

4.535 - -

Patient 4.272 4.330 -

Journal of Public Health Dentistry

MALE Session No. 1 Ideal Ideal M=68 F=32 Self Dentist Patient Self Ideal Dentist 3.558 - - Ideal Patient 6.601 4.273 -

Session No. 2 M=69 F=32 Dentist Patient Assistant Dentist - - - Patient 7.191 - Assistant

Session No. 3 M=74 F=35 Dentist Patient Assistant Dentist - - - Patient 4.785 - -

6.473 - - Assistant

- - -

-

- - -

TABLE I1 MEAN D-SCORES BETWEEN MALE AND FEMALE STUDENTS’ RATINGS USING 10-ITEM SEMANTIC DIFFERENTIAL SCALE

Session No. 1

Self Description = t1.041 Ideal Dentist = +0.701 Ideal Patient = t0.538

Session No. 2

Male Students = 68 Female Students = 32

Male Students = 69 Female Students = 32 Dentist Tape No. 1 = +0.838 Patient Tape No. 1 = +0.577

Session No. 3 Male Students = 74 Female Students = 35

Dentist Tape No. 2 = +1.020 Patient Tape No. 2 = +1.263

Dental Assistant Tape No. 2 = +1.285

TABLE I11

STUDENTS PERCEPTIONS OF DENTISTS, PATIENTS, D-SCORE DIFFERENCES BETWEEN MALE AND FEMALE

DENTAL ASSISTANTS AND SELF-DESCRIPTION

Vol. 37, No. 2-Spring, 1977 93

and female students described the ideal dentist and the ideal patient in a more similar fashion than their self-descriptions, which apparently showed some greater discrepancy, although marginally significant. It is generally true that the magni- tude of the correlations, or the D-score differences, are approximately the same for both the male and female students. Male students, however, see themselves as having a greater difference between their self-description and that of the ideal patient than do the female students. This difference is great enough in Osgood’s criteria to suggest that female students are somewhat more likely to see an identity between themselves and the ideal patient.

In rating Session Two, the correlations between the observed doctor and the observed patient in the D-score values were approximately the same for male and female students, as they were in rating Session Three. However, once again the female students can perceive the dental assistant as being closer to the dentist than do the male students.

Summary and Conclusions Male and female first-year dental students generally possess the same attitudes

and the same perceptions about themselves, dentists they observe, and about their ideals for dentists and patients. The null-hypothesis, that is, assuming no difference between the two groups on the basis of these data, is accepted. In general, one must assume that those women who choose dentistry as a career are not significantly different from their men counterparts, although indirect evidence shows a possible exception of a more compassionate identification with the patient by female students.

The findings suggest that it would not be appropriate or accurate to either admit or exclude male or female students based on what may well be “sexist” assumptions regarding women’s perceptions of themselves as dentists or their perception of their relationships to patients. The findings should be generalized very cautiously beyond the UCLA School of Dentistry. However, at the time this study was conducted, this dental school had both the largest number of female students and the highest percentage of female students in the United States. The study is limited to perceptual differences of freshmen and does not attempt to deal with issues such as productivity or longevity ,of professional involvement. These issues may have some bearing on the formation of attitudes toward women enter- ing the profession, but additional longitudinal studies following the careers of the current cohort of female dental students will be necessary to allay criticisms of women in dentistry.

REFERENCES

1. American Dental Association, Council on Dental Education, Division of Educational Measure- ments, and the American Association of Dental Schools. Annual Reports; Dental Education

2. Austin, G., Maher, M., and LoMonaco, C. Women in dentistry and medicine: attitudinal survey of educational experience. J. Dent. Educ,, 37:ll-7, Nov. 1973.

3. Coombs, J. Sex discrimination in dental schools as a function of institutional characteristics. 103rd Annual Meeting of Am. Pub. Health Assoc. and Related Organizations, Programs and Abstracts, 1975, No. 238A, p. 103.

1975-76. 9 p.

94 Journal of Public Health Dentistry

4. Coombs, J. A. Factors associated with career choice among women dental students. J. Dent.

5. Decennial Census Data for Selected Health Occupations: United States 1970. DHEW Pub. No.

6. Levine, P. Distaff dentists. J. Dent. Educ., 34352-7, Dec. 1970. 7. Linn, E. Professional activities of women dentists. Am. Dent. A. J., 81:1383-7, Dec. 1970. 8. Linn, E. Women dental students-women in a man’s world. Milbank Mem. Fund Quar., 4953-76

(Part 2), July 1971. 9. McCreary, C., Gershen, J., and Spolsky, V. Personality comparison between male and female

dental students. J. Dent. Res., Program and Abstracts of Papers, 55:B277 (Special Issue B) Feb. 1976.

10. Osgood, C. E., Suci, G . J., and Tannenbaum, P. H. The measurement of meaning. Champaign, University of Illinois Press, 1957.

11. Rosen, A., Marcus, M. Changes in models of behavior by first year dental students. J. Dent. Educ. (in press)

12. Snider, J., and Osgood, C. E. Semantic differential technique. A source book. Chicago, Aldine, 1969.

Educ., 40:724-31, Nov. 1976.

(HRA) 76-1231 National Center for Health Statistics, Sept. 1975, p. 3.

_...

13. Xhonga, F. and Vernetti, J. Women power-an unused source for dentistry. South. Calif. Dent. A. J., 3947-50, June 1971.

DIRECTOR CHILDREN’S DENTAL PROGRAM

The Department of Northern Saskatchewan requires a Director to head a comprehensive children’s Dental Health Program in Northern Saskatchewan. The program, which includes treatment, prevention and education is aimed at the native population of 25,OOO and incorporates a team of three dentists, six dental nurses, specially trained local dental assistants, and association with the university. The successful candidate, on occasion, will be required to travel by aircraft to com- munities throughout the forested lake regions from a base clinic at La Ronge, a growing community of 2,000 accessible by paved road and scheduled flights.

Applicants will have university graduation from an accredited school of dentistry preferably with specialization in public health dentistry, and additional training in children’s dentistry; the ability to design and organize community dental programs; social cultural sensitivity; concern with development and the capability for administrative duties. SALARY: $27,912-$34,836 (Director of Dental Health) COMPETITION NUMBER: 613040-6-581

The salary for this position is under review, with an effective date of October 1, 1976, for any adjustment.

Forward your application forms and/or resumes to the Public Service Com- mission, 1820 Albert Street, Regina, S4P 2S8, quoting position, department, and competition number.