A shortage of primary care physicians exists in the US, and medical schools are investigating fac... more A shortage of primary care physicians exists in the US, and medical schools are investigating factors that influence specialty choice. To better understand the factors associated with medical students choosing primary care specialties, a longitudinal annual survey from 2013 to 2019 was administered to students at the University of Iowa Carver College of Medicine, starting pre-matriculation. A logistic regression model examined factors of interest. Matching into a primary care specialty (family medicine, internal medicine, pediatrics) for residency was the primary outcome. Our study compared factors students reported in annual surveys: demographics, mentorship, debt, and lifestyle. Factors significantly associated with primary care specialty included pre-medical and medical school research, a family member in primary care, student age and gender. 28% of men chose primary care, and 47% of women. Although there was no gender difference in rates of medical education debt (N = 286,χ2(1) = 0.28, p = 0.60), men were more likely to report being influenced by debt (N = 278, χ2 (1) = 10.88, p = 0.001), and students who reported debt-influenced specialty choice were one-third as likely to enter primary care (N = 189, 95% CI [0.11–1.06], p = 0.06). For men, potential salary was negatively associated with entering primary care (p = 0.03). Women were more likely to have a mentor in primary care (N = 374, χ2(1) = 13.87, p < 0.001), but this was not associated with an increased likelihood of entering primary care for men or women. Having a family member who practices primary care was associated with a 2.87 times likelihood of entering primary care (N = 303, 95% CI [1.14–7.19], p = 0.03). The decision to enter primary care is influenced by many factors; a key gender differentiator is that men’s specialty choice is more negatively influenced by financial concerns.
The impact of testosterone on decision-making is a growing literature, with several reports of ec... more The impact of testosterone on decision-making is a growing literature, with several reports of economically relevant outcomes. Similar to Wibral et al. (2012), we investigate the effects of exogenous testosterone administration on deception in a double-blind placebo controlled study. Participants (N = 242) were asked to roll a die in private and were paid according to their reported roll, which creates the opportunity to lie about the outcome to increase earnings. We find evidence for self-serving lying in both treatment and control groups and a statistically insignificant negative effect (d = −0.17, 95% CI[−0.42, 0.08]) indicating more honest behavior (i.e., lower reports) following testosterone administration. Although insignificant, the direction was the same as in the Wibral et al. study, and the meta-analytic effect of the two studies demonstrates lower reporting (i.e., more honesty) following testosterone (vs. placebo) administration, significant at the 0.05 level (d = −0.27, 95% CI[−0.49, −0.06]). We discuss how our results and methodology compare with Wibral et al. and identify potential causes for differences in findings. Finally, we consider several plausible connections between testosterone and lying that may be further investigated using alternative methodologies. Lying plays an important role in interpersonal relationships and many types of economic transactions, as it can create strategic advantages from informational asymmetries. Investigations of the determinants of lying have recently attracted widespread attention, and include research of the roles played by other-regarding preferences 1 , social and cultural norms 2,3 , the size and nature of incentives 4–6 , the likelihood and costs of detection 7 , performance in an antecedent competition 8 , the opportunity for self-justification or self-signalling 9–11 , and the role of individual differences, and gender in particular 12,13. Deception is a part of the behavioral repertoire of many animal species 14–16. The understanding of the biological foundations of deceptive behavior or lying in humans, however, is limited. Functional Magnetic Resonance Imaging (fMRI) studies suggest that deception is associated with increased activation in brain regions involved in socio-cognitive processes, such as the right tempero-parietal junction, precuneus and anterior frontal gyrus, and executive functions, such as the anterior cingulate cortex and amygdala 17–20. In addition, two studies reported that intranasal administration of the neuropeptide oxytocin promotes group-serving dishonesty 21 and decreases the ability to detect lies told by members of the opposite sex 22. However, it should be noted that several methodo-logical reviews have recently challenged the validity of the intranasal oxytocin literature, casting uncertainty over these findings 23–25. The male sex steroid hormone testosterone plays a central role in physical development, and has been shown to have considerable psychological effects, such as on mood in hypogonadal men 26,27 and cognition 28–31. There are also several reports documenting the hormone's impact on decision making in a variety of economically important contexts, such as financial risk taking 32 , asset trading 33–35 , and economic games assessing trust, reciprocity, and cooperation 36–38. Published: xx xx xxxx OPEN
The study of effort provision in a controlled setting is a key research area in experimental econ... more The study of effort provision in a controlled setting is a key research area in experimental economics. There are two major methodological paradigms in this literature: stated effort and real effort. In the stated-effort paradigm the researcher uses an " effort function " that maps choices to outcomes. In the real-effort paradigm, participants work on a task, and outcomes depend on their performance. The advantage of the stated-effort design is the control the researcher has over the cost of effort, which is particularly useful when testing theory. The advantage of the real-effort design is that it may be a better match to the field environment, particularly with respect to psychological aspects that affect behavior. An open question in the literature is the degree to which the results obtained by the two paradigms differ, and if they do, why. We present a review of methods used and discuss the results obtained from using these different approaches, and issues to consider when choosing and implementing a task.
A shortage of primary care physicians exists in the US, and medical schools are investigating fac... more A shortage of primary care physicians exists in the US, and medical schools are investigating factors that influence specialty choice. To better understand the factors associated with medical students choosing primary care specialties, a longitudinal annual survey from 2013 to 2019 was administered to students at the University of Iowa Carver College of Medicine, starting pre-matriculation. A logistic regression model examined factors of interest. Matching into a primary care specialty (family medicine, internal medicine, pediatrics) for residency was the primary outcome. Our study compared factors students reported in annual surveys: demographics, mentorship, debt, and lifestyle. Factors significantly associated with primary care specialty included pre-medical and medical school research, a family member in primary care, student age and gender. 28% of men chose primary care, and 47% of women. Although there was no gender difference in rates of medical education debt (N = 286,χ2(1) = 0.28, p = 0.60), men were more likely to report being influenced by debt (N = 278, χ2 (1) = 10.88, p = 0.001), and students who reported debt-influenced specialty choice were one-third as likely to enter primary care (N = 189, 95% CI [0.11–1.06], p = 0.06). For men, potential salary was negatively associated with entering primary care (p = 0.03). Women were more likely to have a mentor in primary care (N = 374, χ2(1) = 13.87, p < 0.001), but this was not associated with an increased likelihood of entering primary care for men or women. Having a family member who practices primary care was associated with a 2.87 times likelihood of entering primary care (N = 303, 95% CI [1.14–7.19], p = 0.03). The decision to enter primary care is influenced by many factors; a key gender differentiator is that men’s specialty choice is more negatively influenced by financial concerns.
The impact of testosterone on decision-making is a growing literature, with several reports of ec... more The impact of testosterone on decision-making is a growing literature, with several reports of economically relevant outcomes. Similar to Wibral et al. (2012), we investigate the effects of exogenous testosterone administration on deception in a double-blind placebo controlled study. Participants (N = 242) were asked to roll a die in private and were paid according to their reported roll, which creates the opportunity to lie about the outcome to increase earnings. We find evidence for self-serving lying in both treatment and control groups and a statistically insignificant negative effect (d = −0.17, 95% CI[−0.42, 0.08]) indicating more honest behavior (i.e., lower reports) following testosterone administration. Although insignificant, the direction was the same as in the Wibral et al. study, and the meta-analytic effect of the two studies demonstrates lower reporting (i.e., more honesty) following testosterone (vs. placebo) administration, significant at the 0.05 level (d = −0.27, 95% CI[−0.49, −0.06]). We discuss how our results and methodology compare with Wibral et al. and identify potential causes for differences in findings. Finally, we consider several plausible connections between testosterone and lying that may be further investigated using alternative methodologies. Lying plays an important role in interpersonal relationships and many types of economic transactions, as it can create strategic advantages from informational asymmetries. Investigations of the determinants of lying have recently attracted widespread attention, and include research of the roles played by other-regarding preferences 1 , social and cultural norms 2,3 , the size and nature of incentives 4–6 , the likelihood and costs of detection 7 , performance in an antecedent competition 8 , the opportunity for self-justification or self-signalling 9–11 , and the role of individual differences, and gender in particular 12,13. Deception is a part of the behavioral repertoire of many animal species 14–16. The understanding of the biological foundations of deceptive behavior or lying in humans, however, is limited. Functional Magnetic Resonance Imaging (fMRI) studies suggest that deception is associated with increased activation in brain regions involved in socio-cognitive processes, such as the right tempero-parietal junction, precuneus and anterior frontal gyrus, and executive functions, such as the anterior cingulate cortex and amygdala 17–20. In addition, two studies reported that intranasal administration of the neuropeptide oxytocin promotes group-serving dishonesty 21 and decreases the ability to detect lies told by members of the opposite sex 22. However, it should be noted that several methodo-logical reviews have recently challenged the validity of the intranasal oxytocin literature, casting uncertainty over these findings 23–25. The male sex steroid hormone testosterone plays a central role in physical development, and has been shown to have considerable psychological effects, such as on mood in hypogonadal men 26,27 and cognition 28–31. There are also several reports documenting the hormone's impact on decision making in a variety of economically important contexts, such as financial risk taking 32 , asset trading 33–35 , and economic games assessing trust, reciprocity, and cooperation 36–38. Published: xx xx xxxx OPEN
The study of effort provision in a controlled setting is a key research area in experimental econ... more The study of effort provision in a controlled setting is a key research area in experimental economics. There are two major methodological paradigms in this literature: stated effort and real effort. In the stated-effort paradigm the researcher uses an " effort function " that maps choices to outcomes. In the real-effort paradigm, participants work on a task, and outcomes depend on their performance. The advantage of the stated-effort design is the control the researcher has over the cost of effort, which is particularly useful when testing theory. The advantage of the real-effort design is that it may be a better match to the field environment, particularly with respect to psychological aspects that affect behavior. An open question in the literature is the degree to which the results obtained by the two paradigms differ, and if they do, why. We present a review of methods used and discuss the results obtained from using these different approaches, and issues to consider when choosing and implementing a task.
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one-third as likely to enter primary care (N = 189, 95% CI [0.11–1.06], p = 0.06). For men, potential salary was negatively associated with entering primary care (p = 0.03). Women were more likely to have a mentor in primary care (N = 374, χ2(1) = 13.87, p < 0.001), but this was
not associated with an increased likelihood of entering primary care for men or women. Having a family member who practices primary care was associated with a 2.87 times likelihood of entering primary care (N = 303, 95% CI [1.14–7.19], p = 0.03). The decision to enter primary care is influenced by many factors; a key gender differentiator is that men’s specialty choice is more negatively influenced by financial concerns.
one-third as likely to enter primary care (N = 189, 95% CI [0.11–1.06], p = 0.06). For men, potential salary was negatively associated with entering primary care (p = 0.03). Women were more likely to have a mentor in primary care (N = 374, χ2(1) = 13.87, p < 0.001), but this was
not associated with an increased likelihood of entering primary care for men or women. Having a family member who practices primary care was associated with a 2.87 times likelihood of entering primary care (N = 303, 95% CI [1.14–7.19], p = 0.03). The decision to enter primary care is influenced by many factors; a key gender differentiator is that men’s specialty choice is more negatively influenced by financial concerns.