Investigating gender bias in pharmacy practice: a study nested in a pharmacy training exercise

Investigating gender bias in pharmacy practice: a study nested in a pharmacy training exercise | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Investigating gender bias in pharmacy practice: a study nested in a pharmacy training exercise Enriqueta Vallejo-Yagüe, Lisa Paul, Byron Oppliger, Sven Streit, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8334982/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Evidence on gender bias in the healthcare system is growing, and pharmacists have an important role in Swiss primary care. Yet, research on gender bias among pharmacists remains extremely sparse and highly relevant. Methods This study investigates gender bias in assessment, treatment and recommendations by pharmacy students within training consultations of a mild depression case and an acute lower back pain case, comparing those facing a male vs female simulated patient. The study was conducted at Swiss Master’s in Pharmacy programs, during 2023 and 2024. Results The study included 190 students in the mild depression case and 219 in the acute lower back pain case. Assessment and management were similar for female and male simulated patients, with only minor exceptions. In the mild depression case, women were more likely to be referred to a medical doctor (observed for direct referrals but not for referrals conditional to red flags or not improvement), and recommended to exercise and reduce stress; while men were more frequently recommended sleep-hygiene measures. In the acute lower back pain case, men were more frequently erroneously assessed as having a herniated disc (5.1% vs 0%); and women were more frequently recommended alternative medicine practices. Conclusions The study shows general absence of gender bias among pharmacy students handing these cases, besides overestimation of pain in men and variability in life-style recommendations. While the evaluation-like setting may hinder intuitive and bias behaviours and encourage intentional analytical thinking, results may also suggest that using structured guidance for consultation may aid equity in treatment and reduce gender bias. This is supported by the observed general consistency in assessment and pharmacological treatment, for which there is structured guidance within the educational curriculum; conversely to the higher variability in non-pharmacological recommendations, which are less strictly covered. Further research in experienced pharmacists remains of interest. Clinical Pharmacology Gender Studies #pharmacy #gender #genderbias Full Text Additional Declarations The authors declare no competing interests. Supplementary Files SupplementaryMaterialInvestigatinggenderbiasinpharmacypractice251201.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8334982","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":558748146,"identity":"aea9d30e-3eff-483b-8f08-786544be2aa6","order_by":0,"name":"Enriqueta Vallejo-Yagüe","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABFUlEQVRIie3OMUvDQBTA8ScHzXJy6zuE+hWeCNUhxK9y4eCmDk7FSSJCJt0LrR/CRTpeOWiX4BzRod0rZNQpXhoRhTSugvlDjkeSH+8Aurr+aPZrWp0DgyABiP0D2E7qz4o84fZ3At+JHxXAXgsRB7dr+5qGlyLhR4WiMBByM1itZyGISdJI5HRJ87vUIFp+jIoMk5PhCcWZAXyxjYRyA24/dQi2pzxxjJ6HA4xTB1TdsKGzmpR4aHv6TVHJ6CmrSLmTEG6JRbJs4bdYRjmviN1J0G+ZTx+1vHdscapIM3ljRhhnmmPeTMTYsGIzikR/eXWdFxeRFoF7kO+zqC/GzWQbrw5Wz/rHy3byWdT6Z1dXV9e/7APquFoQtHbP2AAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0002-5911-2037","institution":"Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland","correspondingAuthor":true,"prefix":"","firstName":"Enriqueta","middleName":"","lastName":"Vallejo-Yagüe","suffix":""},{"id":558748147,"identity":"29627b4a-bc32-4633-a417-b503d6344bda","order_by":1,"name":"Lisa Paul","email":"","orcid":"","institution":"Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Institute of Pharmaceutical Sciences, ETH Zurich, Zurich, Switzerland","correspondingAuthor":false,"prefix":"","firstName":"Lisa","middleName":"","lastName":"Paul","suffix":""},{"id":558748148,"identity":"67e5c5b5-38ae-453e-8e37-5566f78f57a8","order_by":2,"name":"Byron Oppliger","email":"","orcid":"","institution":"Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland","correspondingAuthor":false,"prefix":"","firstName":"Byron","middleName":"","lastName":"Oppliger","suffix":""},{"id":558748149,"identity":"0e091886-6c96-4f92-a78c-b1bb87939880","order_by":3,"name":"Sven Streit","email":"","orcid":"https://orcid.org/0000-0002-3813-4616","institution":"Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland","correspondingAuthor":false,"prefix":"","firstName":"Sven","middleName":"","lastName":"Streit","suffix":""},{"id":558748150,"identity":"abd91af8-5443-43ae-830b-d4f476bce435","order_by":4,"name":"Daniela Petralli-Nietlispach","email":"","orcid":"","institution":"Institute of Pharmaceutical Sciences, ETH Zurich, Zurich, Switzerland","correspondingAuthor":false,"prefix":"","firstName":"Daniela","middleName":"","lastName":"Petralli-Nietlispach","suffix":""},{"id":558748152,"identity":"5e0f11f8-f35e-46ee-ad89-3810326a83f4","order_by":5,"name":"Verena Renggli","email":"","orcid":"","institution":"Pharmaceutical Care Research Group, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland","correspondingAuthor":false,"prefix":"","firstName":"Verena","middleName":"","lastName":"Renggli","suffix":""},{"id":558748154,"identity":"46ab7253-5505-4d5f-b9eb-2ad305f389b9","order_by":6,"name":"Karen A. 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exercise\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"#pharmacy, #gender, #genderbias","lastPublishedDoi":"10.21203/rs.3.rs-8334982/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8334982/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eEvidence on gender bias in the healthcare system is growing, and pharmacists have an important role in Swiss primary care. Yet, research on gender bias among pharmacists remains extremely sparse and highly relevant.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis study investigates gender bias in assessment, treatment and recommendations by pharmacy students within training consultations of a mild depression case and an acute lower back pain case, comparing those facing a male vs female simulated patient. The study was conducted at Swiss Master\u0026rsquo;s in Pharmacy programs, during 2023 and 2024.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe study included 190 students in the mild depression case and 219 in the acute lower back pain case. Assessment and management were similar for female and male simulated patients, with only minor exceptions. In the mild depression case, women were more likely to be referred to a medical doctor (observed for direct referrals but not for referrals conditional to red flags or not improvement), and recommended to exercise and reduce stress; while men were more frequently recommended sleep-hygiene measures. In the acute lower back pain case, men were more frequently erroneously assessed as having a herniated disc (5.1% vs 0%); and women were more frequently recommended alternative medicine practices.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe study shows general absence of gender bias among pharmacy students handing these cases, besides overestimation of pain in men and variability in life-style recommendations. While the evaluation-like setting may hinder intuitive and bias behaviours and encourage intentional analytical thinking, results may also suggest that using structured guidance for consultation may aid equity in treatment and reduce gender bias. This is supported by the observed general consistency in assessment and pharmacological treatment, for which there is structured guidance within the educational curriculum; conversely to the higher variability in non-pharmacological recommendations, which are less strictly covered. 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