{"id":72503,"date":"2024-06-10T12:21:28","date_gmt":"2024-06-10T04:21:28","guid":{"rendered":"https:\/\/medicine.nus.edu.sg\/taps\/?post_type=issues&#038;p=72503"},"modified":"2024-10-01T07:21:44","modified_gmt":"2024-09-30T23:21:44","slug":"what-dress-code-do-we-teach-students-and-residents-a-survey-of-patients-and-their-families-preferences-regarding-physicians-appearance","status":"publish","type":"issues","link":"https:\/\/medicine.nus.edu.sg\/taps\/issues\/what-dress-code-do-we-teach-students-and-residents-a-survey-of-patients-and-their-families-preferences-regarding-physicians-appearance\/","title":{"rendered":"What dress code do we teach students and residents? A survey of patients\u2019 and their families\u2019 preferences regarding physicians\u2019 appearance"},"content":{"rendered":"<p>Submitted: 1 September 2023<br \/>\r\nAccepted: 29 January 2024<br \/>\r\nPublished online: 2 July, TAPS 2024, 9(3), 32-40<br \/>\r\n<a href=\"https:\/\/doi.org\/10.29060\/TAPS.2024-9-3\/OA3127\">https:\/\/doi.org\/10.29060\/TAPS.2024-9-3\/OA3127<\/a><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">Michiko Goto<sup>1<\/sup>,<sup> <\/sup>Ryota Sakamoto<sup>2<\/sup>,<sup> <\/sup>Hideki Wakabayashi<sup>3<\/sup> <\/span><span lang=\"EN-GB\">&amp;<\/span><span lang=\"EN-GB\"> Yousuke Takemura<sup>4<\/sup><\/span><\/p>\r\n<p style=\"text-align: justify;\"><i><sup><span lang=\"EN-GB\">1<\/span><\/sup><\/i><i><span lang=\"EN-GB\">Department of General Medicine, Mie University School of Medicine<\/span><\/i><i><span lang=\"EN-GB\">,<\/span><\/i><i><span lang=\"EN-GB\"> <\/span><\/i><i><span lang=\"EN-GB\">Japan<\/span><\/i><i><span lang=\"EN-GB\">; <sup>2<\/sup>Department <\/span><\/i><i><span lang=\"EN-GB\">of Medical Informatics, Mie University Hospital<\/span><\/i><i><span lang=\"EN-GB\">, Japan; <\/span><\/i><i><sup><span lang=\"EN-GB\">3<\/span><\/sup><\/i><i><span lang=\"EN-GB\">Department <\/span><\/i><i><span lang=\"EN-GB\">of Community Medicine, Mie University School of Medicine, Japan; <\/span><\/i><i><sup><span lang=\"EN-GB\">4<\/span><\/sup><\/i><i><span lang=\"EN-GB\">Department of General Medicine, Tokyo Women\u2019s Medical University, Japan<\/span><\/i><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: center;\"><b><span lang=\"EN-GB\">Abstract <\/span><\/b><\/p>\r\n<p style=\"text-align: justify;\"><b><span lang=\"EN-GB\">Introduction:<\/span><\/b><span lang=\"EN-GB\"> From the late 1960s to the present, physicians\u2019 dress codes have been actively studied in Western countries. Until the early 21st century, patients tended to prefer a conservative dress style, such as \u201cshirt and tie or skirt\u201d with white coats for physicians. However, as attitudes toward dress codes have changed, knowledge regarding this issue needs to be updated. A variety of <\/span><span lang=\"EN-GB\">colours<\/span><span lang=\"EN-GB\"> of scrubs are currently commonly used by medical professionals, but it is not known whether all <\/span><span lang=\"EN-GB\">colours<\/span><span lang=\"EN-GB\"> are acceptable to patients.<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">The current study sought to investigate the acceptability of various dress codes for physicians from the patients\u2019 perspective, to inform medical education.<\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: justify;\"><b><span lang=\"EN-GB\">Methods<\/span><\/b><span lang=\"EN-GB\">:<b><i> <\/i><\/b>Outpatients and their family members at a university hospital and a small-to-medium-sized hospital were surveyed. We inquired about which of the different styles of white coats and different colours of scrubs were most desirable for male and female physicians. We used Scheffe\u2019s paired comparison method to determine rankings.<\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: justify;\"><b><span lang=\"EN-GB\">Results<\/span><\/b><span lang=\"EN-GB\">:<b> <\/b>Patients and their family members expected their physicians to wear white coats rather than scrubs. Furthermore, a more traditional and formal dress code was preferred. The least preferred colour of scrubs was yellow.<\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: justify;\"><b><span lang=\"EN-GB\">Conclusion<\/span><\/b><span lang=\"EN-GB\">: The current results indicated that patients\u2019 preference for a traditional, conservative appearance has not changed over time<\/span><span lang=\"EN-GB\">.<\/span><span lang=\"EN-GB\"> This finding does not match current perspectives on infection prevention.<\/span><span lang=\"EN-GB\"> Both patient preferences and infection prevention are important for informing education and gaining patient trust.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><b><span lang=\"EN-GB\">Keywords<\/span><\/b><b><span lang=\"EN-GB\">:<\/span><\/b><span lang=\"EN-US\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><i><span lang=\"EN-GB\">White Coat, Scrub<\/span><\/i><i><span lang=\"EN-GB\"> <\/span><\/i><i><span lang=\"EN-GB\">Colour<\/span><\/i><i><span lang=\"EN-GB\">, Physicians\u2019 Appearance, Medical Education, Doctor-Patient Communication<\/span><\/i><i><span lang=\"EN-GB\"><\/span><\/i><\/p>\r\n<p align=\"center\" style=\"text-align: center;\"><strong><span lang=\"EN-GB\">Practice Highlights<\/span><\/strong><\/p>\r\n<ul>\r\n\t<li style=\"text-align: justify;\"><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">The physician\u2019s traditional white coat may be associated with a sense of trust, and is most preferred by patients and their family members. This trend has not changed over time.<\/span><\/li>\r\n\t<li style=\"text-align: justify;\"><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">Among the scrub colours, bright colours are not preferred, and black and red may have a negative meaning for patients and their family members.<\/span><\/li>\r\n\t<li style=\"text-align: justify;\"><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">Regarding dress code education, patient\/family perspectives, infection prevention, and sociocultural background should all be considered.<\/span><span lang=\"EN-GB\"><\/span><\/li>\r\n<\/ul>\r\n<div>\r\n<p align=\"center\" style=\"text-align: center;\"><strong><span lang=\"EN-GB\">I. <\/span><span lang=\"EN-GB\">INTRODUCTION<\/span><\/strong><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">Hippocrates proposed that physicians should \u201cbe clean in person, well dressed, and anointed with sweet smelling unguents\u201d <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Hippocrates,<\/span><span lang=\"EN-GB\"> 1923<\/span><span lang=\"EN-GB\">)<\/span><span lang=\"EN-GB\">. <sup>\u00a0<\/sup>However, it has not been proven that physicians\u2019 appearance affects their competence or patients\u2019 satisfaction<\/span><span lang=\"EN-GB\"> (<\/span><span lang=\"EN-GB\">Hennessy et al.,<\/span><span lang=\"EN-GB\"> 1993; <\/span><span lang=\"EN-GB\">Neinstein et al.,<\/span><span lang=\"EN-GB\"> 1985; Takemura et al., 2008)<\/span><span lang=\"EN-GB\">. Nevertheless, some researchers have reported that a physician\u2019s appearance is \u201cimportant\u201d <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Brandt, 2003) as a surrogate for proof of physicians\u2019 competence among unfamiliar patients (Jacob, 2007), and others have given credence to this notion <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Baxter et al., 2010). While the white coat is considered to be a symbol of power and authority <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Bond et al., 2010<\/span><span lang=\"EN-GB\">)<\/span><span lang=\"EN-GB\">, it has also been reported to be a sign of trust and credibility <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Brandt, 2003;<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">Gherardi et al., 2009; Nair et al., 2002; Rehman et al.,<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">2005<\/span><span lang=\"EN-GB\">). Additionally, an unkempt appearance may be interpreted as reflecting a lack of skill and care <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Gjerdingen et al.,<\/span><span lang=\"EN-GB\"> 1987)<\/span><span lang=\"EN-GB\">.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">As lifestyles have changed with the development of new materials, attitudes toward clothing have also changed. However, patients\u2019 viewpoints regarding physicians\u2019 clothing have not been evaluated since the end of the \u201cformal dress: shirt and tie\u201d era<\/span><span lang=\"EN-GB\"> (<\/span><span lang=\"EN-GB\">Toquero et al.,<\/span><span lang=\"EN-GB\"> 2011)<\/span><span lang=\"EN-GB\">. Therefore, there is a need to conduct dress code surveys to update current knowledge regarding the consequences of these changes. <\/span><span lang=\"EN-GB\">From<\/span><span lang=\"EN-GB\"> the late 1960s to the present, dress codes have been actively studied in the West <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Blumhagen, 1979; Gledhill et al., 1997; Menahem &amp; Shvaretzman, 1998). Studies conducted at the beginning of the 21<sup>st<\/sup> century reported that patients tended to prefer physicians wearing white coats over formal attire <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Keenum et al., 2003<\/span><span lang=\"EN-GB\">; <\/span><span lang=\"EN-GB\">Nair et al., 2002). In Japan, there have been very few studies of physicians\u2019 dress codes <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Ikusaka et al., 1999; Yamada et al., 2010). However, in a survey of more than 2,000 patients, Yamada et al. (2010) reported that white coats and ties worn by male physicians and knee-length skirts and white coats worn by female physicians were the dress codes considered most acceptable by patients.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">The outbreak of severe acute respiratory syndrome mainly in Canada and Asian countries east of India substantially changed the medical environment and the dress code for physicians (Au-Yeung, 2005).<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">The \u201cscrub,\u201d a surgical garment that can be easily worn in medical settings, is used by many healthcare professionals as daily medical clothing, and its use has continued to increase even after the severe acute respiratory syndrome epidemic ended, thus making scrubs an important focus of dress code research <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Gherardi et al., 2009). The bare below the elbows (BBE) policy specifies that sleeves should be rolled up to avoid infection, and research has been conducted to determine the extent to which patients are willing to accept this attire <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Aitken et al., 2014; Bond et al., 2010). In 2005, Japan\u2019s Ministry of the Environment promoted the Cool Biz initiative, which encourages workplaces to use \u201cappropriate room temperature settings and encourage employees to wear light clothing appropriate to those temperatures during the summer months\u201d (Ministry of the Environment, 2017). <\/span><span lang=\"EN-GB\">In 2011, a<\/span><span lang=\"EN-GB\">s these changes began to spread among the general public, the Great East Japan Earthquake occurred, resulting in the Fukushima power plant meltdown. Emergency national energy-saving measures were implemented, which accelerated the adoption of the Cool Biz approach. <\/span><span lang=\"EN-GB\">The concept of Cool Biz, as promoted by the Japan government, spread rapidly, with several surveys reporting a sharp decline in the wearing of ties in offices (Nishihara et al., 2010<\/span><span lang=\"EN-GB\">; <\/span><span lang=\"EN-GB\">Nishina et al., 2007). Many hospital directors of medical institutions asked patients to accept their staff wearing light clothing during the summer, such as dressing without neckties; thus, we assume that dressing without a tie also became widespread in medical settings (Keio University Hospital, 2014).<\/span><span lang=\"EN-GB\"> We speculate that the number of physicians who dress formally was reduced following this trend. <\/span><span lang=\"EN-GB\">Moreover, <\/span><span lang=\"EN-GB\">although no systematic evidence has been reported, as noted in a study by Kurihara et al. (2014), more doctors began to wear scrubs and Crocs-style shoes, possibly because of the influence of American TV dramas and medical films.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">As a result, these changes in the environment led to confusion in medical education, with different teachers providing different dress instructions, and students having difficulty understanding the rationale for teachers\u2019 dress instructions.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">The aim of the current study was to investigate the acceptability of dress codes from the patients\u2019 perspectives, and to inform medical education.<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">The findings of this study<\/span><span lang=\"EN-GB\"> may be useful for medical teachers, doctors, and medical institutions as a reference when instructing medical students and doctors regarding how to choose clothing.<\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: center;\"><strong><span lang=\"EN-GB\">II. <\/span><span lang=\"EN-GB\">METHODS<\/span><\/strong><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">Convenience sampling was conducted among outpatients and their family members while they were waiting for treatment at<\/span><span lang=\"EN-GB\"> two medical institutions: a university hospital with 6<\/span><span lang=\"EN-GB\">55<\/span><span lang=\"EN-GB\"> beds in a central area of Tsu city, and a primary care centr<\/span><span lang=\"EN-GB\">e with <\/span><span lang=\"EN-GB\">82<\/span><span lang=\"EN-GB\"> beds in a rural area on the outskirts of Tsu city, Japan. Tsu has a population of 2<\/span><span lang=\"EN-GB\">7<\/span><span lang=\"EN-GB\">0,000 people, and is located 400 km south-west of Tokyo.<\/span><span lang=\"EN-GB\"> The main industries in the city are the manufacturing of transport machinery, information and communication equipment, and foodstuffs, but there are also many agricultural workers in the surrounding area, making it a typical regional city in Japan in many respects. The study period was 3 years, from April 2012 to August 2015. The subjects were asked about their sex, age, and the department in which they were treated. The surveyed items included various styles of dress mentioned in previous studies (formal, casual, and scrubs) and variations in wearing practices that have been observed in the field (open-front white coats, masks, slippers, rolled-up sleeves, Casey [A short white coat with a closed front] short sleeves, and open-front scrubs). This ultimately resulted in nine different styles for men and seven different styles for women (excluding ties and Casey short sleeves). Moreover, 15 different <\/span><span lang=\"EN-GB\">colours<\/span><span lang=\"EN-GB\"> of scrubs<\/span><span lang=\"EN-GB\"> were selected to cover most of the available <\/span><span lang=\"EN-GB\">colours<\/span><span lang=\"EN-GB\"> ones on the market<\/span><span lang=\"EN-GB\">\u00a0(Figure\u00a01) for a survey on undesirable <\/span><span lang=\"EN-GB\">colours for physician&#8217;s wear.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><i><span lang=\"EN-GB\">A. <\/span><\/i><i><span lang=\"EN-GB\">Survey<\/span><\/i><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">For Question 1, participants were asked to compare pictures of two doctors and to choose one of four levels of response (completely A, more like A, or more like B, completely B). Participants were instructed to choose one of them, even if it was difficult to decide.<\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">Images of nine different types of attire for male physicians and seven different types of attire for female physicians were prepared, in mature and younger versions. The nine types of attire for men were as follows:<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">\u2460<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">tie + white coat with front closed, <\/span><span lang=\"EN-GB\">\u2461<\/span><span lang=\"EN-GB\"> tie + white coat with front open, <\/span><span lang=\"EN-GB\">\u2462<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">white coat with no tie, <\/span><span lang=\"EN-GB\">\u2463<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">slippers, <\/span><span lang=\"EN-GB\">\u2464<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">mask, <\/span><span lang=\"EN-GB\">\u2465<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">Casey, <\/span><span lang=\"EN-GB\">\u2466<\/span><span lang=\"EN-GB\"> rolled-up sleeves, <\/span><span lang=\"EN-GB\">\u2467<\/span><span lang=\"EN-GB\"> scrubs + white coat, and <\/span><span lang=\"EN-GB\">\u2468<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">scrubs. The seven types for women were as follows: <\/span><span lang=\"EN-GB\">\u2460<\/span><span lang=\"EN-GB\"> white coat with front closed, <\/span><span lang=\"EN-GB\">\u2461<\/span><span lang=\"EN-GB\"> white coat with front open, <\/span><span lang=\"EN-GB\">\u2462<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">rolled-up sleeves, <\/span><span lang=\"EN-GB\">\u2463<\/span><span lang=\"EN-GB\"> sandals,<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">\u2464<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">mask, <\/span><span lang=\"EN-GB\">\u2465<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">scrubs + white coat, and<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">\u2466<\/span><span lang=\"EN-GB\"> scrubs.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">Nine photos of men in pairs (one adult version and one young version) were presented in a round-robin fashion on an iPad. Seven photos of pairs of women (one adult version and one young version) were shown in the same way. Patients and their family members were asked to compare the two photos and to select the one that they felt was more appropriate as their physician\u2019s appearance, using four<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">levels of response. We also asked participants to identify any images showing an \u201cunacceptable appearance.\u201d<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">For Question 2, patients were instructed to identify any <\/span><span lang=\"EN-GB\">colours<\/span><span lang=\"EN-GB\"> that they felt were not desirable for a doctor to wear. The commercially available <\/span><span lang=\"EN-GB\">colours<\/span><span lang=\"EN-GB\"> used were a mix of cold and warm <\/span><span lang=\"EN-GB\">colours<\/span><span lang=\"EN-GB\">. Fifteen images of scrubs (black, grey, light blue, light purple, dark blue, blue-green, dark blue-green, dark green, yellow, orange, brown, pink, dark pink, red, and red-purple) were shown on an iPad to the subjects, who were then asked to indicate any unacceptable <\/span><span lang=\"EN-GB\">colours<\/span><span lang=\"EN-GB\"> (Figure 1).<\/span><\/p>\r\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/taps\/wp-content\/uploads\/sites\/10\/2024\/05\/OA3127_Figure-1-1.png\" alt=\"\" class=\"aligncenter wp-image-72505 size-full\" width=\"360\" height=\"288\" srcset=\"https:\/\/medicine.nus.edu.sg\/taps\/wp-content\/uploads\/sites\/10\/2024\/05\/OA3127_Figure-1-1.png 360w, https:\/\/medicine.nus.edu.sg\/taps\/wp-content\/uploads\/sites\/10\/2024\/05\/OA3127_Figure-1-1-300x240.png 300w\" sizes=\"auto, (max-width: 360px) 100vw, 360px\" \/><\/p>\r\n<\/div>\r\n<p align=\"center\" style=\"text-align: center;\"><span lang=\"EN-GB\">Figure 1. Scrubs in 15 different colours<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">1: black, 2: <\/span><span lang=\"EN-GB\">grey, 3: light blue, 4: light purple, 5: dark blue, 6: blue-green, 7: dark blue-green, 8: dark green, 9:\u00a0 yellow, 10: orange, 11: brown, 12: pink, 13: dark pink, 14: red, 15: red-purple<\/span><\/p>\r\n<div>\r\n<p style=\"text-align: justify;\"><i><span lang=\"EN-GB\">B. <\/span><\/i><i><span lang=\"EN-GB\">Statistical analysis<\/span><\/i><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">For Question 1, we used Scheffe\u2019s paired comparison method (Nakaya\u2019s variant) to rank data as completely A +2, more like A +1; unanswered\/invalid 0, more like B \u22121; and completely B \u22122, as fitted. A one-way analysis of variance was performed within subjects.<\/span><\/p>\r\n<p align=\"center\" style=\"text-align: center;\"><strong><span lang=\"EN-GB\">III. <\/span><span lang=\"EN-GB\">RESULTS<\/span><\/strong><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">We received 869 responses regarding the appearance of young men and women, 824 responses regarding the appearance of mature men and women, and 867 responses regarding unacceptable scrub <\/span><span lang=\"EN-GB\">colours<\/span><span lang=\"EN-GB\">.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><i><span lang=\"EN-GB\">A. <\/span><\/i><i><span lang=\"EN-GB\">Question 1 <\/span><\/i><\/p>\r\n<p style=\"text-align: justify;\"><i><span lang=\"EN-GB\">1) <\/span><\/i><i><span lang=\"EN-GB\">Young men: <\/span><\/i><span lang=\"EN-GB\">The descending order of preference for young men was as follows: <\/span><span lang=\"EN-GB\">\u2460<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">tie + white coat, <\/span><span lang=\"EN-GB\">\u2465<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">Casey,<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">\u2466<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">rolled-up sleeves,<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">\u2462<\/span><span lang=\"EN-GB\"> no tie + white coat,<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">\u2461<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">tie + open-front white coat, <\/span><span lang=\"EN-GB\">\u2463<\/span><span lang=\"EN-GB\"> slippers,<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">\u2467<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">scrubs + white coat,<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">\u2464<\/span><span lang=\"EN-GB\"> mask, and<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">\u2468<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">scrubs (Figure 2). Clearly, <\/span><span lang=\"EN-GB\">\u2463<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">slippers and below constituted the subgroups, and there was no significant difference between<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">\u2464<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">mask and<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">\u2468<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">scrubs (Figure 2).<b><\/b><\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">A total of 300 individuals reported 427 images showing unacceptable appearances, of which 42% showed the physician wearing scrubs (Table 1). <\/span><\/p>\r\n<p style=\"text-align: justify;\"><i><span lang=\"EN-GB\">2) <\/span><\/i><i><span lang=\"EN-GB\">Mature men: <\/span><\/i><span lang=\"EN-GB\">The descending order of preference for mature men was as follows:<b> <\/b><\/span><span lang=\"EN-GB\">\u2460<\/span><span lang=\"EN-GB\"> tie + white coat, <\/span><span lang=\"EN-GB\">\u2465<\/span><span lang=\"EN-GB\"> Casey, <\/span><span lang=\"EN-GB\">\u2461<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">tie + white coat with front opening, <\/span><span lang=\"EN-GB\">\u2462<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">no tie + white coat, <\/span><span lang=\"EN-GB\">\u2466<\/span><span lang=\"EN-GB\"> rolled-up sleeves, <\/span><span lang=\"EN-GB\">\u2463<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">slippers, <\/span><span lang=\"EN-GB\">\u2464<\/span><span lang=\"EN-GB\"> mask, <\/span><span lang=\"EN-GB\">\u2468<\/span><span lang=\"EN-GB\"> scrubs, and <\/span><span lang=\"EN-GB\">\u2467<\/span><span lang=\"EN-GB\"> scrubs + white coat. As in the case of the young men, <\/span><span lang=\"EN-GB\">\u2463<\/span><span lang=\"EN-GB\"> slippers and below constituted a lower group, and there was no significant difference between <\/span><span lang=\"EN-GB\">\u2468<\/span><span lang=\"EN-GB\"> scrubs and <\/span><span lang=\"EN-GB\">\u2467<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">scrubs + white coat (Figure 2). <\/span><span lang=\"EN-GB\">\u00a0<\/span><\/p>\r\n<\/div>\r\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/taps\/wp-content\/uploads\/sites\/10\/2024\/05\/OA3127_Figure-2.jpg\" alt=\"\" class=\"aligncenter wp-image-72506 size-full\" width=\"837\" height=\"1033\" srcset=\"https:\/\/medicine.nus.edu.sg\/taps\/wp-content\/uploads\/sites\/10\/2024\/05\/OA3127_Figure-2.jpg 837w, https:\/\/medicine.nus.edu.sg\/taps\/wp-content\/uploads\/sites\/10\/2024\/05\/OA3127_Figure-2-243x300.jpg 243w, https:\/\/medicine.nus.edu.sg\/taps\/wp-content\/uploads\/sites\/10\/2024\/05\/OA3127_Figure-2-830x1024.jpg 830w, https:\/\/medicine.nus.edu.sg\/taps\/wp-content\/uploads\/sites\/10\/2024\/05\/OA3127_Figure-2-768x948.jpg 768w\" sizes=\"auto, (max-width: 837px) 100vw, 837px\" \/><\/p>\r\n<p align=\"center\" style=\"text-align: center;\"><span lang=\"EN-GB\">Figure 2. Nine types of attire for mature and young male physicians, each in order of patient preference with scale chart of average degree of preference<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">*The yard stick values were <\/span>Y<sub>0.05<\/sub>=0.052 for young men and 0.054 <span lang=\"EN-GB\">for mature men<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">A total of 264 individuals reported 354 images showing unacceptable appearances, of which 40% showed the physician wearing scrubs (Table 1). <\/span><\/p>\r\n<p style=\"text-align: justify;\"><i><span lang=\"EN-GB\"><\/span><\/i><i><span lang=\"EN-GB\">3) Young women: <\/span><\/i><span lang=\"EN-GB\">The descending order of preference for images of young women was as follows: <\/span><span lang=\"EN-GB\">\u2460<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">white coat, <\/span><span lang=\"EN-GB\">\u2462<\/span><span lang=\"EN-GB\"> sandals, <\/span><span lang=\"EN-GB\">\u2461<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">open-front white coat, <\/span><span lang=\"EN-GB\">\u2463<\/span><span lang=\"EN-GB\"> mask, <\/span><span lang=\"EN-GB\">\u2464<\/span><span lang=\"EN-GB\"> rolled-up sleeves, <\/span><span lang=\"EN-GB\">\u2465<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">scrubs + white coat, and <\/span><span lang=\"EN-GB\">\u2466<\/span><span lang=\"EN-GB\"> scrubs (Figure 3). Moreover, <\/span><span lang=\"EN-GB\">\u2460<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">white coat and <\/span><span lang=\"EN-GB\">\u2462<\/span><span lang=\"EN-GB\"> sandals formed the top group; <\/span><span lang=\"EN-GB\">\u2461<\/span><span lang=\"EN-GB\"> open-front white coat and <\/span><span lang=\"EN-GB\">\u2463<\/span><span lang=\"EN-GB\"> mask formed the middle group; and <\/span><span lang=\"EN-GB\">\u2464<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">rolled-up sleeves, <\/span><span lang=\"EN-GB\">\u2465<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">scrubs + white coat and <\/span><span lang=\"EN-GB\">\u2466<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">scrubs formed the lower group. There were no significant differences between the groups (Figure 3).<b><\/b><\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">A total of 403 individuals reported 535 images showing unacceptable appearances, of which 57% featured rolled-up sleeves and 33% featured scrubs (Table 1).<\/span><\/p>\r\n<div align=\"center\">\r\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"94.1261%\" class=\" aligncenter\" style=\"width: 94.1261%;\">\r\n<tbody>\r\n<tr>\r\n<td width=\"235\" valign=\"bottom\" style=\"width: 39.6934%;\">\r\n<p><span lang=\"EN-GB\">Physician&#8217;s Appearances<\/span><\/p>\r\n<\/td>\r\n<td width=\"84\" style=\"width: 14.3101%;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">Young man<\/span><\/p>\r\n<p align=\"center\"><span lang=\"EN-GB\"> n = 300<\/span><\/p>\r\n<\/td>\r\n<td width=\"87\" style=\"width: 14.8211%;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">Mature man <\/span><\/p>\r\n<p align=\"center\"><span lang=\"EN-GB\">n = 403<\/span><\/p>\r\n<\/td>\r\n<td width=\"88\" style=\"width: 14.9915%;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">Young woman <\/span><\/p>\r\n<p align=\"center\"><span lang=\"EN-GB\">n = 264<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"width: 15.6729%;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">Mature woman<\/span><\/p>\r\n<p align=\"center\"><span lang=\"EN-GB\">n = 172<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td width=\"235\" style=\"width: 39.6934%;\">\r\n<p><span lang=\"EN-GB\">Tie + white coat<\/span><\/p>\r\n<\/td>\r\n<td width=\"84\" style=\"width: 14.3101%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">0%<\/span><\/p>\r\n<\/td>\r\n<td width=\"87\" style=\"width: 14.8211%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">2%<\/span><\/p>\r\n<\/td>\r\n<td width=\"88\" style=\"width: 14.9915%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">\u00a0<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"width: 15.6729%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">\u00a0<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td width=\"235\" style=\"width: 39.6934%;\">\r\n<p><span lang=\"EN-GB\">No tie + white coat<\/span><\/p>\r\n<\/td>\r\n<td width=\"84\" style=\"width: 14.3101%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">5%<\/span><\/p>\r\n<\/td>\r\n<td width=\"87\" style=\"width: 14.8211%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">7%<\/span><\/p>\r\n<\/td>\r\n<td width=\"88\" style=\"width: 14.9915%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">\u00a0<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"width: 15.6729%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">\u00a0<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td width=\"235\" style=\"width: 39.6934%;\">\r\n<p><span lang=\"EN-GB\">White coat<\/span><\/p>\r\n<\/td>\r\n<td width=\"84\" style=\"width: 14.3101%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">\u00a0<\/span><\/p>\r\n<\/td>\r\n<td width=\"87\" style=\"width: 14.8211%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">\u00a0<\/span><\/p>\r\n<\/td>\r\n<td width=\"88\" style=\"width: 14.9915%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">2%<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"width: 15.6729%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">1%<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td width=\"235\" style=\"width: 39.6934%;\">\r\n<p><span lang=\"EN-GB\">Tie + open-front white coat<\/span><\/p>\r\n<\/td>\r\n<td width=\"84\" style=\"width: 14.3101%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">18%<\/span><\/p>\r\n<\/td>\r\n<td width=\"87\" style=\"width: 14.8211%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">17%<\/span><\/p>\r\n<\/td>\r\n<td width=\"88\" style=\"width: 14.9915%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">\u00a0<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"width: 15.6729%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">\u00a0<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td width=\"235\" style=\"width: 39.6934%;\">\r\n<p><span lang=\"EN-GB\">Open-front white coat<\/span><\/p>\r\n<\/td>\r\n<td width=\"84\" style=\"width: 14.3101%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">\u00a0<\/span><\/p>\r\n<\/td>\r\n<td width=\"87\" style=\"width: 14.8211%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">\u00a0<\/span><\/p>\r\n<\/td>\r\n<td width=\"88\" style=\"width: 14.9915%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">8%<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"width: 15.6729%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">16%<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td width=\"235\" style=\"width: 39.6934%;\">\r\n<p><span lang=\"EN-GB\">Slippers<\/span><\/p>\r\n<\/td>\r\n<td width=\"84\" style=\"width: 14.3101%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">20%<\/span><\/p>\r\n<\/td>\r\n<td width=\"87\" style=\"width: 14.8211%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">9%<\/span><\/p>\r\n<\/td>\r\n<td width=\"88\" style=\"width: 14.9915%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">18%<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"width: 15.6729%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">23%<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td width=\"235\" style=\"width: 39.6934%;\">\r\n<p><span lang=\"EN-GB\">Mask<\/span><\/p>\r\n<\/td>\r\n<td width=\"84\" style=\"width: 14.3101%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">28%<\/span><\/p>\r\n<\/td>\r\n<td width=\"87\" style=\"width: 14.8211%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">20%<\/span><\/p>\r\n<\/td>\r\n<td width=\"88\" style=\"width: 14.9915%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">2%<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"width: 15.6729%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">2%<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td width=\"235\" style=\"width: 39.6934%;\">\r\n<p><span lang=\"EN-GB\">Casey<\/span><\/p>\r\n<\/td>\r\n<td width=\"84\" style=\"width: 14.3101%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">3%<\/span><\/p>\r\n<\/td>\r\n<td width=\"87\" style=\"width: 14.8211%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">4%<\/span><\/p>\r\n<\/td>\r\n<td width=\"88\" style=\"width: 14.9915%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">\u00a0<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"width: 15.6729%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">\u00a0<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td width=\"235\" style=\"width: 39.6934%;\">\r\n<p><span lang=\"EN-GB\">Rolled-up sleeves<\/span><\/p>\r\n<\/td>\r\n<td width=\"84\" style=\"width: 14.3101%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">5%<\/span><\/p>\r\n<\/td>\r\n<td width=\"87\" style=\"width: 14.8211%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">9%<\/span><\/p>\r\n<\/td>\r\n<td width=\"88\" style=\"width: 14.9915%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">57%<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"width: 15.6729%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">15%<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td width=\"235\" style=\"width: 39.6934%;\">\r\n<p><span lang=\"EN-GB\">Scrub + white coat<\/span><\/p>\r\n<\/td>\r\n<td width=\"84\" style=\"width: 14.3101%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">21%<\/span><\/p>\r\n<\/td>\r\n<td width=\"87\" style=\"width: 14.8211%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">26%<\/span><\/p>\r\n<\/td>\r\n<td width=\"88\" style=\"width: 14.9915%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">12%<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"width: 15.6729%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">25%<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td width=\"235\" style=\"width: 39.6934%;\">\r\n<p><span lang=\"EN-GB\">Scrub<\/span><\/p>\r\n<\/td>\r\n<td width=\"84\" style=\"width: 14.3101%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">42%<\/span><\/p>\r\n<\/td>\r\n<td width=\"87\" style=\"width: 14.8211%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">40%<\/span><\/p>\r\n<\/td>\r\n<td width=\"88\" style=\"width: 14.9915%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">33%<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"width: 15.6729%; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-GB\">48%<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/div>\r\n<p align=\"center\" style=\"text-align: center;\"><span lang=\"EN-GB\">Table 1. <\/span><span lang=\"EN-GB\">The characteristics of images that were identified as showing an unacceptable<\/span><span lang=\"EN-GB\"> appearance by patients and their family members, and the percentage of respondents that deemed the image unacceptable<\/span><\/p>\r\n<p style=\"text-align: justify;\"><i><span lang=\"EN-GB\"><\/span><\/i><i><span lang=\"EN-GB\">4) Mature women: <\/span><\/i><span lang=\"EN-GB\">The descending order of preference for images of mature women was as follows: <\/span><span lang=\"EN-GB\">\u2460<\/span><span lang=\"EN-GB\"> white coat, <\/span><span lang=\"EN-GB\">\u2462<\/span><span lang=\"EN-GB\"> sandals, <\/span><span lang=\"EN-GB\">\u2463<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">mask, <\/span><span lang=\"EN-GB\">\u2461<\/span><span lang=\"EN-GB\"> open-front white coat,<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">\u2466<\/span><span lang=\"EN-GB\"> scrubs, <\/span><span lang=\"EN-GB\">\u2464<\/span><span lang=\"EN-GB\"> rolled-up sleeves, and <\/span><span lang=\"EN-GB\">\u2465<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">scrubs + white coat (Figure 3). There was no significant difference between the components <\/span><span lang=\"EN-GB\">\u2460<\/span><span lang=\"EN-GB\"> white coat and<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">\u2462<\/span><span lang=\"EN-GB\"> sandals in the top group. Moreover, <\/span><span lang=\"EN-GB\">\u2460<\/span><span lang=\"EN-GB\"> white coat and <\/span><span lang=\"EN-GB\">\u2462<\/span><span lang=\"EN-GB\"> sandals were components of the top group, similar to the case for images of young women, and there was no significant difference between them (Figure 3).<\/span><\/p>\r\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/taps\/wp-content\/uploads\/sites\/10\/2024\/05\/OA3127_Figure-3.jpg\" alt=\"\" class=\"aligncenter wp-image-72507 size-full\" width=\"768\" height=\"986\" srcset=\"https:\/\/medicine.nus.edu.sg\/taps\/wp-content\/uploads\/sites\/10\/2024\/05\/OA3127_Figure-3.jpg 768w, https:\/\/medicine.nus.edu.sg\/taps\/wp-content\/uploads\/sites\/10\/2024\/05\/OA3127_Figure-3-234x300.jpg 234w\" sizes=\"auto, (max-width: 768px) 100vw, 768px\" \/><\/p>\r\n<p align=\"center\" style=\"text-align: center;\"><span lang=\"EN-GB\">Figure 3. Seven types of attire for mature and young female physicians, each in order of patient preference with scale chart of average preference<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">*The yard stick values are <\/span>Y<sub>0.05<\/sub>=0.054 for young women and 0.061 for mature women<\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">A total of 172 individuals reported 222 images showing unacceptable appearances, of which 48% featured scrubs (Table 1). <\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">We examine<\/span><span lang=\"EN-GB\">d the <\/span><span lang=\"EN-GB\">trends by participants\u2019 gender and age. The results revealed no differences between men and women and in each age group. However, participants over 70 years old tended to prefer tie + closed- and open-front white coat compared with participants under 70, and tended not to <\/span><span lang=\"EN-GB\">favour female doctors with rolled-up sleeves.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><i><span lang=\"EN-GB\">B. Question 2<\/span><\/i><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\"><\/span><i><span lang=\"EN-GB\">1) Scrub colour: <\/span><\/i><span lang=\"EN-GB\">The colours and percentages of scrubs that were identified as unacceptable were, in descending order, as follows: 52%, yellow; 46%, red; 42%, dark pink; 33%, pink; 27%, black; 23%, orange; 20%, blue-green; 16%, grey; 17%, red-purple; 14% brown; 11%, dark blue-green; 8%, light blue; 7%, dark green; 6%, light purple; and 4%, dark blue (Figure 4).<\/span><\/p>\r\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/taps\/wp-content\/uploads\/sites\/10\/2024\/05\/OA3127_Figure-4.png\" alt=\"\" class=\"aligncenter wp-image-72508 size-full\" width=\"651\" height=\"609\" srcset=\"https:\/\/medicine.nus.edu.sg\/taps\/wp-content\/uploads\/sites\/10\/2024\/05\/OA3127_Figure-4.png 651w, https:\/\/medicine.nus.edu.sg\/taps\/wp-content\/uploads\/sites\/10\/2024\/05\/OA3127_Figure-4-300x281.png 300w\" sizes=\"auto, (max-width: 651px) 100vw, 651px\" \/><\/p>\r\n<p align=\"center\" style=\"text-align: center;\"><span lang=\"EN-GB\">Figure 4. Percentage of scrub colours not preferred by patients and their family members.<\/span><\/p>\r\n<p style=\"text-align: center;\"><span lang=\"EN-GB\"><\/span><strong><span lang=\"EN-GB\">IV. DISCUSSION<\/span><\/strong><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">Many patients and their family members expected their physicians to wear white coats rather than scrubs. On average, a traditional and formal dress style was most preferred by patients and their family members (buttoned white coat and tie for men, leather shoes, and buttoned white coat for women). In a 2010 study conducted in Japan by Yamada et al., the most favoured formality attire by patients was white coats (but skirts for women). Pronchik, who investigated the benefits of neckties prior to the BBE policy (King &amp; Infection Prevention and Control Nurse, 2022), concluded that in an emergency room in the United States (US), patients preferred their physicians to wear ties, and patient satisfaction was high <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Pronchik et al., 1998). <\/span><span lang=\"EN-GB\">The survey found that people in older age groups in particular preferred doctors to wear ties.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">The results suggest that patients\u2019 preferences regarding physicians\u2019 appearance have not changed substantially. One study found that patients in the United Kingdom (UK) who were briefed on the BBE policy felt that conservatively dressed doctors looked more professional <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Toquero et al., 2011).<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">The second-most preferred attire for male physicians was the Casey, followed by the white coat with rolled-up sleeves for younger men. However, this attire was not ranked highly for women or mature men. This indicates that patients perceived the Casey as a traditional style of dress for men, and that the preference was not necessarily based on the prevalence of the BBE concept or concerns about cleanliness. The pros and cons of rolling up the sleeves of white coats are often discussed in medical student dress guidance, including in a study by Bond <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Bond et al., 2010). In the current study, rolled-up sleeves were not preferred by patients. However, it is known that the sleeves of white coats can become contaminated <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Banu et al., 2012), and Wong et al. pointed out that the risk of contamination may be increased by pathogens in ties, cuffs, and pockets <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Wong et al., 1991). The current results indicated that patients in their 70s and older were not comfortable with female doctors rolling up the sleeves of their white coats. Although this finding may be related to cultural factors, to the best of our knowledge, this phenomenon has not been previously reported in the literature. <\/span><span lang=\"EN-GB\">The<\/span><span lang=\"EN-GB\"> results suggest that patients\u2019 concepts of professionalism and infection prevention are not directly connected. When instructing students about dress code, they should be told that patients may not approve of rolling up their sleeves.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">Men wearing masks were rated less favourably, while women wearing masks were not rated less favourably. For women, there may be something to compensate for the facial expressions hidden by masks. Because wearing a mask and other prophylactic devices has been essential for physicians since the beginning of the COVID-19 pandemic, the impressions of patients and family members should be examined in future studies.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">Although scrubs are often rated as hygienic <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Bond et al., 2010; Lightbody<\/span><span lang=\"EN-GB\"> &amp;<\/span><span lang=\"EN-GB\"> Wilkie, 2013), the current survey revealed that scrubs were not rated as a preferred attire for physicians by patients and their family members. In the survey by Aitkin et al. mentioned above, scrubs also received the lowest ratings. However, previous studies in the US reported no influence of scrubs and other types of attire on patient satisfaction and perceptions of professionalism <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Fischer et al., 2007<\/span><span lang=\"EN-GB\">; <\/span><span lang=\"EN-GB\">Li <\/span><span lang=\"EN-GB\">&amp;<\/span><span lang=\"EN-GB\"> Haber, 2005). Additionally, a recent survey in the UK reported a clear downward trend in resistance to scrubs, with a survey by Palazzo and Hocken reporting that white coats and ties are no longer expected by patients <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Palazzo <\/span><span lang=\"EN-GB\">&amp;<\/span><span lang=\"EN-GB\"> Hocken,<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">2010). In a study in the US, patients undergoing surgery reported that scrubs were most favoured in outpatient settings <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Edwards et al., 2012). These findings suggest that the resistance to scrubs in Japan may disappear in the near future.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">Brightly <\/span><span lang=\"EN-GB\">coloured<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">yellow, red, and pink) and black scrubs were considered to be less acceptable than others, and those in pale and cold <\/span><span lang=\"EN-GB\">colours<\/span><span lang=\"EN-GB\">, such as dark blue and light blue, were preferred. This may have occurred because red and black are associated with negative emotions such as anger, anxiety and fear, whereas cold colours are associated with calm and quiet <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Oyama et al., 1963<\/span><span lang=\"EN-GB\">). Some patients commented that black reminded them of death and red reminded them of blood. Bright <\/span><span lang=\"EN-GB\">colours<\/span><span lang=\"EN-GB\"> may be irritating to patients. To the best of our knowledge, no previous studies have examined colo<\/span><span lang=\"EN-GB\">u<\/span><span lang=\"EN-GB\">r preferences for scrubs <\/span><span lang=\"EN-GB\">among patients,<\/span><span lang=\"EN-GB\"> suggesting that these <\/span><span lang=\"EN-GB\">findings are novel<\/span><span lang=\"EN-GB\">.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">In the 20th century, physicians in many countries were required to wear white coats <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Gooden et al., 2001; Harnette, 2001). It is not surprising that preferences regarding physicians\u2019 appearance have changed in the 21st century, as many people have started to become more familiar with the threat of infection and changes in the global medical environment. However, the concept of BBE is still not pervasive, and the appearance of attire required to be worn by physicians has not changed significantly. The current results are consistent with the findings of the largest study of this issue conducted in the UK <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Jacob, 2007), which reported the following: \u201cif there is deemed to be no significant infection risk from any given variation of workwear, our patients would like us to wear a shirt and tie.\u201d Patients\u2019 awareness regarding infection needs to be investigated, but patients will accept physicians\u2019 suggestions if they understand the need for them <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Collins et al., 2013).<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">Shelton et al. conducted an experiment in the UK to reduce cross-infection between doctors and patients, and reported that there was no significant difference in patient preferences between different types of attire before explaining the importance of clothing to patients; however, after the explanation, scrubs and short-sleeved shirts were most preferred <\/span><span lang=\"EN-GB\">(<\/span><span lang=\"EN-GB\">Shelton et al., 2010<\/span><span lang=\"EN-GB\">)<\/span><span lang=\"EN-GB\">. When considering physicians\u2019 dress code, we need to understand both the patient\u2019s preferences and infection control factors. We propose that a dress code should be developed that does not compromise patients\u2019 trust and confidence, but also takes safety into consideration.<\/span><\/p>\r\n<p style=\"text-align: left;\"><i><span lang=\"EN-GB\"><\/span><\/i><i><span lang=\"EN-GB\">A. Limitations<\/span><\/i><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">Although the types of clothing shown in the photos in the current study were based on a prior survey, it may not have been comprehensive. Moreover, using different models in the photographs may have influenced the results, and the potential effects of measurement bias cannot be excluded.<\/span><span lang=\"EN-GB\"> It is unclear from the current findings why certain appearances were preferred or deemed unacceptable. Furthermore, the current study did not examine doctors\u2019 preferences. Medical practitioners\u2019 preferences need to be taken into account when making workplace attire choices in hospitals. Further research will be needed to identify the preferred attire for both patients and doctors.<\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: center;\"><span lang=\"EN-GB\"><\/span><strong><span lang=\"EN-GB\">V. CONCLUSION<\/span><\/strong><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">The current findings indicated that patients exhibited a preference for physicians dressed in traditional attire. Even though times have changed, people may still associate trust, credibility, and respect with the formal appearance of their physicians. The current findings also suggested that patients were not aware of the BBE policy. The results of this study may be helpful for informing teaching approaches regarding the appearance of medical students and residents<\/span><span lang=\"EN-GB\">.<\/span><\/p>\r\n<p align=\"center\" style=\"text-align: center;\"><strong><span lang=\"EN-GB\">Notes on Contributors<\/span><\/strong><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">MG developed the research idea and design with YT. The data collection was performed by MG. The data were <\/span><span lang=\"EN-GB\">analysed by RS. HW performed the data interpretation with MG. MG wrote the article with revision by HW. All the authors read and agreed with the final manuscript.<\/span><\/p>\r\n<p align=\"center\" style=\"text-align: center;\"><strong><span lang=\"EN-GB\">Ethical Approval<\/span><\/strong><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">Verbal informed consent was obtained from all participants for publication and this procedure was approved by the Mie University Ethics Committee. The <\/span><span lang=\"EN-GB\">Ethical Review Committee of <\/span><span lang=\"EN-GB\">Mie University<\/span><span lang=\"EN-GB\"> committee approved this study (No. 1237). All methods were performed in accordance with the relevant guidelines and regulations.<\/span><\/p>\r\n<p align=\"center\" style=\"text-align: center;\"><strong><span lang=\"EN-GB\">Data Availability<\/span><\/strong><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">The data that support the findings of this RCT study are openly available at a Figshare repository, <\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.6084\/m9.figshare.23936379.v1\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.6084\/m9.figshare.23936379.v1<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p align=\"center\" style=\"text-align: center;\"><strong><span lang=\"EN-GB\">Acknowledgements<\/span><\/strong><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">We would like to express our heartfelt gratitude to the models for their cooperation in creating the photograph stimuli, and to Goto F, Makita H, Yin M, Kasyo K, Sakaguchi R, Masukawa E, Tsunoda K, Shimada K, and Tanaka K<\/span><span lang=\"EN-GB\">, for collecting the data. We thank Benjamin Knight, MSc., from Edanz (<\/span><a href=\"https:\/\/edanz.com\"><span lang=\"EN-GB\">https:\/\/edanz.com<\/span><\/a><span lang=\"EN-GB\">) for editing a draft of this manuscript. This paper has been preprinted. <\/span><span lang=\"EN-GB\">M Goto et al. What dress code do we teach students and residents? A survey of patients&#8217; and their families&#8217; preferences regarding physicians&#8217; appearance. 23 Mar, 2022<\/span><span lang=\"EN-US\">\uff08<\/span><span lang=\"EN-GB\">Version 1<\/span><span lang=\"EN-US\">\uff09<\/span><span lang=\"EN-GB\">available at Research Square<\/span><span lang=\"EN-GB\"> (<\/span><a href=\"https:\/\/doi.org\/10.21203\/rs.3.rs-1430222\/v1\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.21203\/rs.3.rs-1430222\/v1<\/span><\/a><span lang=\"EN-GB\">).<\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p align=\"center\" style=\"text-align: center;\"><strong><span lang=\"EN-GB\">Funding<\/span><\/strong><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">This study was supported by research grants from the Kameyama City Department of Community Medicine [No. J12061L005] and the Tsu City<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">Department of Community Medicine [No. J12061L008].<\/span><\/p>\r\n<p align=\"center\" style=\"text-align: center;\"><strong><span lang=\"EN-GB\">Declaration of Interest <\/span><\/strong><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">No conflict of interest, financial or otherwise, exists.<\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p align=\"center\" style=\"text-align: center;\"><strong><span lang=\"EN-GB\">References<\/span><\/strong><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Aitken<\/span><span lang=\"EN-GB\">,<\/span><span lang=\"EN-GB\"> S. A., Tinning, C. G., Gupta, S., Medlock, G., Wood, A. M., &amp; Aitken, M. A. (2014). The importance of<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">the orthopaedic doctors\u2019 appearance: A cross-regional questionnaire-based study.<i> The Surgeon,<\/i> <i>12<\/i>(1)<\/span><span lang=\"EN-GB\">, <\/span><span lang=\"EN-GB\">40-46.<\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.1016\/j.surge.2013.%2007.002\"><span lang=\"EN-GB\"> https:\/\/doi.org\/10.1016\/j.surge.2013. 07.002<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Au-Yeung, P. K. K. (2005). 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(2012)<\/span><span lang=\"EN-GB\">. <\/span><span lang=\"EN-GB\">White coats as a vehicle for bacterial dissemination. <i>Journal of Clinical and Diagnostic Research<\/i><\/span><i><span lang=\"EN-GB\">,<\/span><\/i><i><span lang=\"EN-GB\"> <\/span><\/i><i><span lang=\"EN-GB\">6<\/span><\/i><span lang=\"EN-GB\">(8), 1381-1384.<\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.7860\/JCDR\/2012\/42%2086.2364\"><span lang=\"EN-GB\"> https:\/\/doi.org\/10.7860\/JCDR\/2012\/42 86.2364<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Baxter, J. A., Dale, O., Morritt, A., &amp; Pollock, J. C. (2010). 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Hospital patients\u2019 views on doctors and white coat. <i>The<\/i> <i>Medical Journal of <\/i><\/span><i><span lang=\"EN-GB\">Australia,<\/span><\/i><i><span lang=\"EN-GB\"> 175<\/span><\/i><span lang=\"EN-GB\">(4), 219<\/span><span lang=\"EN-GB\">&#8211;<\/span><span lang=\"EN-GB\">222. <\/span><a href=\"https:\/\/doi.org\/10.5694\/j.1326-5377.2001.tb143103.x\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.5694\/j.1326-5377.2001.tb143103.x<\/span><\/a><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Harnette, P. R. (2001). Should doctors wear white coat? <i>The<\/i> <i>Medical Journal of <\/i><\/span><i><span lang=\"EN-GB\">Australia<\/span><\/i><i><span lang=\"EN-GB\">, <\/span><\/i><i><span lang=\"EN-GB\">174<\/span><\/i><span lang=\"EN-GB\">(7), 343<\/span><span lang=\"EN-GB\">&#8211;<\/span><span lang=\"EN-GB\">344. <\/span><a href=\"https:\/\/doi.org\/10.5694\/j.1326-5377.2001.tb143310.x\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.5694\/j.1326-5377.2001.tb143310.x<\/span><\/a><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Hennessy, N., Harrison, D. A., &amp; Aitkenhead, A. R. (1993). The effect of the anaesthetist\u2019s attire on patient attitudes. The influence of dress on patient perception of the anaesthetist\u2019s prestige. <i>Anesthesia, 48<\/i>(3), 219-222. <\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.1111\/j.1365-2044%201%20993.tb06905.x\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1111\/j.1365-2044 1 993.tb06905.x<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Hippocrates. (1923). <i>Hippocrates<\/i> (W. H. S. Jones, Trans.) (Vol. 2). Harvard University Press.<\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Ikusaka, M., Kamegai, M., Sunaga, T., Narita, N., Kobayashi, H., Yonenami, K., &amp; Watanabe, M. (1999). Patients\u2019 attitude toward consultations by a physician without a white coat in Japan. <i>Internal Medicin<\/i><i>e, 38<\/i>(7), 533<\/span><span lang=\"EN-GB\">&#8211;<\/span><span lang=\"EN-GB\">536.<\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.2169\/internalmedici%20ne.38.533\"><span lang=\"EN-GB\"> https:\/\/doi.org\/10.2169\/internalmedici ne.38.533<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Jacob, G. (2007). <i>Uniform and workwear: An evidence base for developing local policy<\/i>. National Health Service.<\/span><span lang=\"EN-US\"><a href=\"https:\/\/data.parliament.uk\/DepositedPapers\/Files\/DEP2009-0656\/DEP2009-0656.pdf\"><span lang=\"EN-GB\"> https:\/\/data.parliament.uk\/DepositedPapers\/Files\/DEP2009-0656\/DEP2009-0656.pdf<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Keenum, A. J., Wallace, L. S., &amp; Stevens, A. R. (2003). Patients\u2019 attitude regarding physical characteristics of family practice physicians. <i>Southern Medical Journa<\/i><i>l, 96(<\/i>12), 1190-1194. <\/span><a href=\"https:\/\/doi.org\/10.1097\/01.smj.0000077011.58103.c1\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1097\/01.smj.0000077011.58103.c1<\/span><\/a><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Keio University Hospital<\/span><span lang=\"EN-GB\">. (2014, May 20). <i>Cool Biz no jisshi ni tsuite [About the implementation of Cool Biz]<\/i>. Keio University Hospital.<\/span><span lang=\"EN-US\"><a href=\"https:\/\/www.hosp.keio.ac.jp\/oshirase\/hosp\/detail\/38033\/\"><span lang=\"EN-GB\"> https:\/\/www.hosp.keio.ac.jp\/oshirase\/hosp\/detail\/38033\/<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">King, C., &amp; Infection Prevention and Control Nurse. (2022). <i>Hand hygiene policy: Including bare below the elbows<\/i> (Ver.9). Leicestershire Partnership National Health Service Trust.<\/span><span lang=\"EN-GB\">\u00a0<\/span><span lang=\"EN-US\"><a href=\"https:\/\/www.leicspart.nhs.uk\/wp-content\/uploads\/2022\/06\/Hand-Hygiene-Policy-inc-bare-below-the-elbows.pdf\"><span lang=\"EN-GB\">https:\/\/www.leicspart.nhs.uk\/wp-content\/uploads\/2022\/06\/Hand-Hygiene-Policy-inc-bare-below-the-elbows.pdf<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Kurihara, H., Maeno, T., &amp; Maeno, T. (2014). Importance of physicians\u2019 attire: factors influencing the impression it makes on patients, a cross-sectional study. <\/span><i><span lang=\"EN-GB\">Asia Pacific Family Medicine, 13<\/span><\/i><span lang=\"EN-GB\">(1)<i>, <\/i>2. <\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.1186\/1447-056x-13-2\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1186\/1447-056x-13-2<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Li, S. F., &amp; Haber, M. (2005). Patient attitude toward emergency physician attire. <i>The J<\/i><\/span><i><span lang=\"EN-GB\">ournal of <\/span><\/i><i><span lang=\"EN-GB\">Emergency Medicine<\/span><\/i><i><span lang=\"EN-GB\">,<\/span><\/i><span lang=\"EN-GB\"> <i>29<\/i>(1), 1-3. <\/span><a href=\"https:\/\/doi.org\/10.1016\/j.jemermed.2004.12.014\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1016\/j.jemermed.2004.12.014<\/span><\/a><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Lightbody, K. A., &amp; Wilkie, M. D. (2013). Perceptions of doctors&#8217; dress code: ENT patients\u2019 perspective. Clinical Otolaryngology, <i>38<\/i>(2)<i>,<\/i> 188-190.<\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.1111\/coa.12084\"><span lang=\"EN-GB\"> https:\/\/doi.org\/10.1111\/coa.12084<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Menahem, S., &amp; Shvaretzman, P. (1998). Is our appearance important to our patients? <i>Family Practice, 15<\/i>(5), 391-397. <\/span><a href=\"https:\/\/doi.org\/10.1093\/fampra\/15.5.391\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1093\/fampra\/15.5.391<\/span><\/a><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Ministry of the Environment. (2017, April 25). <i>Heisei 29 nendo Cool Biz ni tsuite [About Cool Biz in 2017]<\/i>. Ministry of the Environment, Japan.<\/span><span lang=\"EN-US\"><a href=\"https:\/\/www.env.go.jp\/press\/103993.html\"><span lang=\"EN-GB\"> https:\/\/www.env.go.jp\/press\/103993.html<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Nair, B. R., Mears, S. R., Hitchcock, K. I., &amp; Attia, J. R. (2002). Evidence-based physicians\u2019 dressing: A crossover trial.<i> The medical Journal of Australia, 177<\/i>(11-12), 681-682. <\/span><a href=\"https:\/\/doi.org\/10.5694\/j.1326-5377.2002.tb05017.x\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.5694\/j.1326-5377.2002.tb05017.x<\/span><\/a><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Neinstein, L. S., Stewart, D., &amp; Gordon, N. (1985).\u00a0 Effect of physician dress style on patient-physician relationship. <i>Journal of Adolescent Health Car, 6<\/i>(6), 456-459<\/span><span lang=\"EN-US\">.\u00a0 <\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.1016\/S0%20197-0070(85)80053-X\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1016\/S0 197-0070(85)80053-X<\/span><\/a><\/span><span lang=\"EN-US\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Nishihara,<\/span><span lang=\"EN-GB\"> N., Haneda, M., &amp; Tanabe, S. (2010). <\/span><span lang=\"EN-GB\">A study of office workers\u2019 clothes and subjective evaluations in an office with a preset air-conditioning temperature of 28\u00b0C in summer<\/span><span lang=\"EN-GB\">. <\/span><i><span lang=\"EN-GB\">Journal of Home Economics of Japan, 61<\/span><\/i><span lang=\"EN-GB\">(3)<i>, <\/i>169-175. <\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.114%2028\/jhej.61.169\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.114 28\/jhej.61.169<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Nishina, D., Murakawa, S., &amp; Uemura, Y. (2007). A Study on the Effects of the Cool Biz introduced into the Regional Joint Government Buildings in Hiroshima. <\/span><i><span lang=\"EN-US\">Technical papers of annual meeting, the<\/span><\/i><i><span lang=\"EN-US\"> Society of Heating, Air-Conditioning and Sanitary Engineers of Japan.<\/span><\/i><span lang=\"EN-GB\"> 1463-1466. <\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.18948\/shasetai%20kai.2007.2.0_1463\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.18948\/shasetai kai.2007.2.0_1463<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Oyama, T., Tanaka, Y., &amp; Haga, J. (1963). Color-affection and color-symbolism in Japanese and American students. <\/span><i><span lang=\"EN-GB\">The<\/span><\/i><span lang=\"EN-GB\"> <\/span><i><span lang=\"EN-GB\">Jap<\/span><\/i><i><span lang=\"EN-GB\">anese <\/span><\/i><i><span lang=\"EN-GB\">Journal of. Psycholog<\/span><\/i><i><span lang=\"EN-GB\">y,<\/span><\/i><span lang=\"EN-GB\"> <i>34<\/i>(3), 109-121.<\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/%2010.4992\/JJPSY.34.109\"><span lang=\"EN-GB\"> https:\/\/doi.org\/ 10.4992\/JJPSY.34.109<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Palazzo, S., &amp; Hocken, D.<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">B. (2010). Patients\u2019 perspectives on how doctors dress.<i> The Journal of Hospital Infection<\/i><i>, 74<\/i>(1), 30-34. <\/span><a href=\"https:\/\/doi.org\/10.1016\/j.jhin.2009.08.021\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1016\/j.jhin.2009.08.021<\/span><\/a><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Pronchik, D. J., Sexton, J. D., Melanson, S. W<\/span><span lang=\"EN-GB\">., <\/span><span lang=\"EN-GB\">Patterson<\/span><span lang=\"EN-GB\">,<\/span><span lang=\"EN-GB\"> J. W., &amp; Heller, M. B.<\/span><span lang=\"EN-GB\"> (1998).<\/span><span lang=\"EN-GB\"> Does wearing a necktie influence patient perceptions of emergency department care?<i> The Journal of Emergency Medicine, 16<\/i>(4), 541-543. \u00a0<\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.1016\/s07%2036-4679(98)00036-5\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1016\/s07 36-4679(98)00036-5<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Rehman, S. U., Nietert, P. J., Cope, D. W., &amp; Kilpatrick, A. O. (2005). What wear today? Effect of doctor\u2019s attire on the trust and confidence of patient. The <i>American Journal of Medicine<\/i><i>,<\/i> <i>118<\/i>(11), 1279-1286. <\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.1016\/j.amjmed.2005.04.026\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1016\/j.amjmed.2005.04.026<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Shelton, C. L., Raistrick, C., Warburton, K., &amp; Siddiqui, K. H. (2010). Can changes in clinical attire reduce<\/span><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">likelihood of cross-infection without jeopardizing the doctor-patient relationship?<i> <\/i><\/span><i><span lang=\"EN-GB\">The <\/span><\/i><i><span lang=\"EN-GB\">J<\/span><\/i><i><span lang=\"EN-GB\">ournal of <\/span><\/i><i><span lang=\"EN-GB\">Hospital Infection<\/span><\/i><span lang=\"EN-GB\">,<\/span><span lang=\"EN-GB\"> <i>74<\/i>(1), 22-29.<\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.10%2016\/j.jhin.2009.07.031\"><span lang=\"EN-GB\"> https:\/\/doi.org\/10.10 16\/j.jhin.2009.07.031<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Takemura, Y., Atsumi, R., &amp; Tsuda, T. (2008). Which medical interview behaviours are associated with patient satisfaction? <i>Family Medicine<\/i>, <i>40<\/i>(4), 253-258.<\/span><span lang=\"EN-GB\"> <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18382837\/\"><span lang=\"EN-US\"><span><span lang=\"EN-GB\">https:\/\/pubmed.ncbi.nlm.nih.gov\/18382837\/<\/span><\/span><\/span><\/a><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Toquero, L., Aboumarzouk, O., Owers, C., Chiang, R., Thiagarajah, S., &amp; Amin, S. (2011, April 02). <i>Bare below the elbows-The patient&#8217;s perspective. Webmed Central<\/i>. <\/span><span lang=\"EN-GB\">WebmedCentral. <\/span><span lang=\"EN-US\"><a href=\"https:\/\/www.webmedcentral.com\/article_view\/1401\"><span lang=\"EN-GB\">https:\/\/www.webmedcentral.com\/article_view\/1401<\/span><\/a><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Wong, D., Nye, K., &amp; Hollis, P. (1991). Microbial flora on doctors\u2019 white coats. <i>British Medical Journal,<\/i><i> 303<\/i>(6817), 1602-1604. <\/span><a href=\"https:\/\/doi.org\/10.1136\/bmj.303.6817.1602\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1136\/bmj.303.6817.1602<\/span><\/a><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Yamada, Y., Takahashi, O., Ohde, S., Deshpande, G. A., &amp; Fukui, T. (2010). Patient\u2019s preference for doctor\u2019s attire in Japan. <i>Internal Medicine<\/i>, <i>49<\/i>(15), 1521<\/span><span lang=\"EN-GB\">&#8211;<\/span><span lang=\"EN-GB\">1526.<\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.2169\/internalme%20dicine.49.3572\"><span lang=\"EN-GB\"> https:\/\/doi.org\/10.2169\/internalme dicine.49.3572<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p>*Hideki Wakabayashi<br \/>\r\nDepartment of Community Medicine,<br \/>\r\nMie University School of Medicine,<br \/>\r\n2-174, Edobashi,<br \/>\r\nTsu, Mie,<br \/>\r\n514-8507, Japan <br \/>\r\n+81-59-231-5290<br \/>\r\nEmail address: hidekiwaka@med.mie-u.ac.jp<\/p>","protected":false},"featured_media":0,"parent":0,"menu_order":4,"template":"","issues_category":[12],"archive_category":[],"issue_type":[25],"volume_category":[61885],"class_list":["post-72503","issues","type-issues","status-publish","hentry","issues_category-original-articles","issue_type-past-issue","volume_category-volume-9-number-3-july-2024"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>What dress code do we teach students and residents? 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