Gender-based discrimination shapes psychological safety and professional identity in clinical settings: a qualitative study of nursing, midwifery, and medical students.
4 affiliations
- 1Department of Nursing, Koç University School of Nursing, Koç University Health Sciences Campus, Topkapı, Istanbul, 34010, Türkiye. [email protected].
- 2Department of Nursing, Koç University School of Nursing, Koç University Health Sciences Campus, Topkapı, Istanbul, 34010, Türkiye.
- 3Department of Midwifery, Faculty of Health Science, Istanbul University-Cerrahpasa, Istanbul, Türkiye.
- 4Graduate School of Health Sciences, Koç University, Istanbul, Türkiye.
Abstract
Background
Gender-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.Methods
This 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.Results
Analysis 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.Conclusions
The 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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BibTeX
@article{sengul2026genderbased,
title = {{Gender-based discrimination shapes psychological safety and professional identity in clinical settings: a qualitative study of nursing, midwifery, and medical students.}},
author = {Tuba Sengul and Seda Sarıköse and Betül Uncu and Ezgi Hasret Kozan Cikirikci and Dilek Yilmaz Akyaz and Nurten Kaya},
journal = {BMC medical education},
year = {2026},
month = jul,
doi = {10.1186/s12909-026-09965-3},
url = {https://europepmc.org/article/MED/42897604},
note = {CC BY},
}
RIS
TY - JOUR
TI - Gender-based discrimination shapes psychological safety and professional identity in clinical settings: a qualitative study of nursing, midwifery, and medical students.
AU - Tuba Sengul
AU - Seda Sarıköse
AU - Betül Uncu
AU - Ezgi Hasret Kozan Cikirikci
AU - Dilek Yilmaz Akyaz
AU - Nurten Kaya
PY - 2026
DA - 2026/07/01
JO - BMC medical education
DO - 10.1186/s12909-026-09965-3
UR - https://europepmc.org/article/MED/42897604
AB - Background Gender-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.Methods This 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.Results Analysis 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.Conclusions The 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.
SN - 1472-6920
ER -