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From the analysis, it appears that the majority of students drew images that demonstrated gender specific stereotypical features. Across all of the professions, 86% drew doctors as identifiably male, 94% drew nurses as female and 89% drew police officers as male. Statistics obtained from the List of Registered Medical Practitioners stated that in October 2016, 54.6% registrants were male (General Medical Council, 2016). The situation in nursing, according to an email received on the 3 November 2016 from the Nursing and Midwifery Council, indicated that only 11% of registered nurses are male and statistics suggest that 72% of police officers are male (The Home Office, 2015).

Of these statistics, the only drawings that realistically reflected reality was that of nursing being a predominantly female profession, which could be thought to be an illustration of the ‘kernel of truth’ concept whereby it is suggested that stereotypes can actually emerge from genuine group differences (McGarty et al., 2002). Perhaps the generally unisex design of police uniform for both men and women in the police force might be a contributing, and confounding factor for the drawings; although students who did draw identifiably female police officers they often made the gender apparent through overtly feminine hairstyles. In the absence of such identification, police officers with short hair were assumed to be male (Figure 4.1). It would appear that the

perception of doctors being male is the most common and most strikingly demonstrated gender stereotype in the images.

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Figure 4.1: Typical images of a nurse, doctor and police officer

The gender of the drawings of biomedical scientists is also noteworthy. I chose this profession for the students to draw as I thought they would be less likely to have had personal experience with a member of this profession or to have extensive knowledge of the professional role. Of those whose drawings identified a specific gender 70% indicated a male gender and 30% female. If my assumption was reliable the data might suggest that stereotypical views are not necessarily confined to those groups with whom individuals have had contact (Aiken, 2002; Stangor and Schaller, 1996). It is also possible that the drawings represented a stereotypical scientist with the ‘biomedical’ aspect being disregarded. It is possible that the data evidences this supposition as 17% of the biomedical scientists were portrayed with hair styles similar to that commonly associated with images of Einstein, and so by implication were identified as male.

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However, there is also data to support the contradictory view that stereotyping may involve a degree of knowledge about the group (Foster and Macleod Clark, 2015; Koenig and Eagly, 2014; Tajfel, 1981) and illustrative images, noted such as those including microscopes or test tubes of blood, might be indicative of the ‘biomedical’ aspect of the profession.

Figure 4.3: Pictures of biomedical scientists

It might seem appropriate to consider heuristic processing as a way of interpreting these findings, which would suggest that sufficiently accurate information is generated most of the time (Hogg and Vaughan, 2008; Hinton, 2000). However, the images drawn do not reflect, and appear to conflict with, the reality in some cases; this could be thought to be particularly relevant for all of the student nurses (notwithstanding their nursing field), who are very likely to have been

working alongside members of the medical profession on clinical placements during their preceding two years of study, and yet still predominantly drew male doctors.

4.4.3.2 Demonstration of hierarchy

It has been suggested that there are two strategies for remembering information about social groups; the prototype model which uses a combination of associations, and the exemplar model which involves recalling specific individuals (Hinton, 2000; Hilton and von Hippel, 1996; Stangor and Schaller, 1996). Of these two methods of processing it would seem that the students may be adopting the latter and are tending to recall specific individual(s). This point can be illustrated by the following drawing.

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Figure 4.4: Drawing of a doctor which could demonstrate the exemplar model of stereotyping

This image was not unique, others were similar, and they have been interpreted as conveying specific perceptions. In the drawing above there is a definite association with a particular medical speciality, possibly as an illustrative example of a small number of actual individuals. Additionally, there appears to be an expression of out-group bias, with the doctor being

portrayed as demonstrating superiority in a manner that can be interpreted as being antagonistic. Other examples of out-group bias were noted and such sentiments could be perceived as an illustration of prejudice, which has been noted to accentuate observed differences (Hilton and von Hippel, 1996; Tajfel, 1981).

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The theory that extreme individuals are more remarkable, and are therefore more commonly used as prompts, (Hilton and von Hippel, 1996; Stangor and Schaller, 1996; Tajfel and Forgas, 1981) might ameliorate any suggested level of actual prejudice.

When the suggestion of prejudice is considered with reference to Allport (1954) there appears to be distinct tendency to stereotype doctors, as the images of gender are unsupported by the facts. The concern might be that such stereotyping is being used to rationalise or justify ways of behaving, and perhaps the social behaviour of whole professional groups (Pendry, 2012; Hogg and Vaughan, 2008; Stangor and Schaller, 1996). It has been suggested that such seemingly intransigent stereotyping may be an indicator of the power and hierarchy in the doctor-nurse relationship (Bell et al., 2014; Hilton and von Hippel, 1996) and the maintenance of professional distinctiveness (Veerapen and Purkis, 2014) but my findings would have to extend this beyond doctors and nurses to include professions such as pharmacy.

It does seem to be clear that some students’ drawings overlooked individual differences, although no motives can be definitely ascribed on the basis of images alone. However, if such categorisation is considered in terms of values, it could be suggested that the students are indicating a level of self-preservation, i.e. ‘they are not like us’, and they are choosing to demonstrate values that over-emphasise professional differences (Tajfel and Forgas, 1981). There is likelihood that such value-based judgements, if they are regarded as indicative of general behaviours, could lead to further differentiating perceptions of, and behaviour towards, other professional groups (Hamilton and Gifford, 1976).

It is perhaps an associated and unfortunate consequence of such potentially altered behaviour that the self-fulfilling prophesy may then become an influence; the behaviour of the individual with the stereotype will prompt reciprocal behaviour by the stereotyped individual (Croker et al., 2016; Hilton and von Hippel, 1996; Hamilton and Gifford, 1976), which may then reinforce negative perceptions in both parties.

Such derogation of out-groups will implicitly create the perception of enhanced in-group status, and therefore a positive effect on the individuals’ self-esteem (Mc Garty et al., 2002; Fein and Spencer, 1997; Stangor and Schaller, 1996; Tajfel and Forgas, 1981). I have suggested that the third-year students on the IPE module may already be experiencing anxieties (Section 4.1.2), and increased anxiety has been recognised as having a deleterious impact on information processing,

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possibly leading to increased stereotyping (Aiken, 2002; Hilton and von Hippel, 1996; Stangor and Schaller, 1996).

It has been proposed in literature that such derogation of out-groups is more likely to be apparent in behaviour by minority groups (Aiken, 2002) and that aspects of minority groups perceived as negative are liable to be overly emphasised (Hogg and Vaughan, 2008; Tajfel and Forgas, 1981). The data has been interpreted as demonstrating some evidence of this phenomenon, although not consistently. The mental health nurses tended to draw professions as being portrayed more negatively. Had drawings of the professions at the teaching session been requested, further insight could have been gained into this aspect. However, the children’s nurses (another minority group in the cohort) appeared to be more open-minded, drawing more male nurses, more female doctors and fewer nurses wearing caps.

4.4.3.3 Associated artefacts

It could be interpreted that there is further evidence to support the previous suppositions of stereotypical views about the medical profession demonstrated in the images. One interesting feature is the number of doctors that were drawn with stethoscopes (87% across all professions); common contemporary clinical practice entails many nurses using stethoscopes regularly, yet they were demonstrated as an artefact almost exclusively associated with the medical profession.

Figure 4.6: A typical drawing of a doctor wearing a stethoscope

The second element which may support this differentiation is the number of nurses who were drawn wearing fob watches and caps. In contemporary clinical practice, the fob-watch might be

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exclusively associated with nurses, in recognition of the element of their role to undertake patient observations (pulse and breathing rate). However, this exclusivity is not reflected in the

drawings as only 34% of the nurses were drawn wearing a fob watch.

In contrast, even if the adult nursing group are considered individually, over half of the cohort (52%) drew nurses wearing caps, despite this not having been part of a nurses’ uniform since the 1970’s, being identified as counter-indicated in infection control.It is probable that many of the students in the group were aged approximately twenty (excluding mature entry students), and these students would never have encountered nurses wearing caps in the United Kingdom (U.K.). It is not clear where such an apparently widespread aspect of stereotyping would have originated, as many contemporary portrayals of nurses, such as on the television, do not show nurses

wearing caps. The equivalent association between nurses’ uniforms and caps is not overt with doctors wearing white coats, which was demonstrated by only 6% across the whole cohort; this statistic does represent contemporary practice, as wearing white coats in clinical areas is also seen as counter-indicated in infection control. This anomaly is demonstrated in figure 4.7, which is thought be of note as they two pictures were drawn by the same student.

Figure 4.7: Drawing by the same adult nursing student showing a nurse in a cap but a doctor without a white coat.

Artefacts that appeared to be commonly associated with police officers include hand cuffs, the most common item and included on 42% of the drawings, and handguns, identified by 25%. This demonstrates an interesting enigma. In the U.K., police-officers do commonly carry handcuffs, and these are often visible, attached to their uniform belt. The reality would suggest

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the depiction of handcuffs on the students’ images as accurate reflection (Koening and Eagly, 2014). However, police officers in the U.K. do not commonly overtly carry handguns.

Figure 4.8: A typical drawing of a police officer with handcuffs and hand gun

I suggest that there are two possible explanations for this finding. The first is that the illustration of handguns is a manifestation of a cultural model. The students in the cohort are from a variety of nationalities, ethnicities and cultural backgrounds and it could be thought to be highly likely that police officers in countries other than the UK, such as Ireland and South Africa, do carry handguns, therefore their illustration mirrors reality. The caveat of this connection being suppositional should be added, as no data on students’ cultural background was collected. The threat that may be identified by such manifestation of cultural models is the suggested link with an individual’s behaviour (Tajfel, 1981).

A second explanation that can be suggested is the influence of media, in particularly television and films, principally those originating in countries such as the United States of America. In such media, police officers are frequently portrayed as carrying and using handguns. It has been suggested that the media has an influence on stereotypes (Section 4.1.4), although Hilton and Von Hippel (1996) suggested any effect was subtle, Stangor and Schaller (1996)

contemporaneously proposed it could be significant.

The final artefact of note included on the students’ drawings was that of spectacles. Less than 1% of the drawings of nurses and police officers included them wearing spectacles, but 12% of doctors and 44% of the biomedical scientists included them. This would seem to demonstrate an element of collective thinking and perhaps there is a supposed association between spectacle

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wearing and intelligence. When this association is extended it could be suggested that doctors and biomedical scientists may be thought of as more intelligent than police officers and nurses. If collaboration in health and social care is considered it might be supposed that doctors being stereotyped as more intelligent than nurses is indicative of professional cultures and hierarchy and that spectacles were indicative of group differentiation, and the epistemic function of stereotypes (Veerapen and Purkis, 2014; McGarty et al., 2002; Stangor and Schaller, 1996; Tajfel and Forgas, 1981). There is perhaps an inevitable link between these perceptions and perceived dominance of one profession over another (Greene, 2013; Freidson, 2007).

Figure 4.9: Drawings of a doctor and a biomedical scientist wearing spectacles

4.4.3.4 Demeanour

The final notable feature of the drawings that will be discussed is that of the demeanour

demonstrated on the drawn figures. While the majority of images had neutral facial expressions, there was a tendency for nurses to be drawn positively and police officers negatively.

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Figure 4.10: Typical drawing showing the difference in facial expressions between nurses and police officers

The disparate facial expressions could be interpreted as non-conscious categorisation illustrating differences between groups (Hogg and Vaughan ,2008), which perhaps has a level of subjective importance to individuals, as described in Tajfel’s accentuation principle (Tajfel, cited in Hogg and Vaughan, 2008); it could perhaps be the difference in how the attributes of the two job roles are viewed (Eagly and Chaiken, 1993), nurses as caring and helpful, police officers as law enforcers. The stern-looking police officers seem to be more congruent with the view that stereotypical views tend to be negative in contrast to the friendly looking nurses (Aiken, 2002) although Allport’s (1954) view that stereotypes demonstrate a tendency to justify like or dislike appears apposite. It does seem reasonable that the differing assigning of facial expressions could be linked to behaviours towards the two professional groups (Pendry, 2012; Cuddy et al., 2007; Stangor and Schaller, 1996; Hamilton and Gifford, 1976).