Purpose: We tested the significance of associations among students' demographics, communication styles, and feedback received during clerkships. Methods: US medical students who completed at least one required clinical clerkship were invited between April and July 2006 to complete an anonymous, online survey inquiring about demographics, communication styles (assertive-ness and reticence), feedback (positive and negative), and clerkship grades. The effects of self-identified race/ethnicity, gender, and generation (immigrant, first-or second-generation American) and their 2-way interactions on assertiveness, reticence, total positive and total negative feedback comments were tested using factorial analysis of covariance, controlling for age, clerkship grades, and mother's and father's education; pairwise comparisons used simple contrasts. Two-sided P values <.05 were considered significant. Results: Medical students from 105 schools responded (N = 2395; 55% women; 57% white). Men reported more assertiveness than women (P =.001). Reticence (P <.001) and total positive comments (P =.006) differed by race/ethnicity; in pairwise contrasts, black, East Asian, and Native American/ Alaskan students reported greater reticence than white students (P <.001), and white students reported receiving more positive comments than black, and South and East Asian students. Race/ethnicity-by-generation (P =.022) and gender-by-generation (P =.025) interaction effects were observed for total negative comments; white first-generation Americans reported receiving the fewest and male immigrants reported receiving the most negative comments. Conclusions: Demographic differences in students' communication styles and feedback they received highlight a need for cultural competency training to improve medical student-teacher interactions, analogous to training currently advocated to improve physician-patient interactions.
- Cultural competency