Peer physical examination (PPE) is a learning activity whereby medical students examine each other to learn physical examination skills [
1] and PPE is now a common part of medical curricula [
2,
3] and other health science programs [
4]. This has occurred as large student cohorts have created pressure on health systems, and patients in hospital are less willing or able to assist junior medical students in practicing examination skills [
5]. Thus PPE presents a straightforward, inexpensive means by which students learn early examination skills, with advantages including saving patients the potential distress of being examined by early learners [
2]; allowing discrete parts of the physical examination to be taught in a controlled manner; permitting repetition and prompting feedback from tutor and examinee [
5,
6]. From the student perspective, PPE encourages learning about normality and students find peers less challenging to examine than real patients [
7]. However, it is an activity which may challenge student beliefs and two broad factors documented in the literature which impact on student engagement with PPE are gender and what we describe here as student outlook [
2,
3,
6,
8]. Whilst the overall acceptability of non-intimate PPE is high, often above 90% [
9,
10], gender has a strong effect on acceptability of PPE, with male medical students being more comfortable with PPE than their female counterparts [
2]. In addition, same gender pairing for examination is more acceptable than mixed gender pairings [
2,
10] and the preference for same gender pairing was greater in female students [
5,
6,
9]. The literature also suggests that individual perspectives on intra- and inter-gender interaction (henceforth: ‘outlook’) may impact the way health professionals interact with their patients [
11]. Student outlook is a self-referenced personal estimation, on a spectrum of liberalism to conservatism, based on their attitudes and beliefs and arising from their personal attributes and experiences. A variety of aspects of outlook have been studied, including religious and cultural issues. Groups broadly identified as non-white found PPE to be less acceptable [
2,
10] and students of faith or with certain cultural expectations are less comfortable with PPE [
5,
9,
10]. However, much data gathered have reflected a hypothetical willingness to participate rather than ratings of willingness based on actual participation [
10]. Aspects of a student’s outlook appear to influence the student’s willingness to participate in PPE in a highly personal and individualized manner [
9,
10]. Thus, it seems reasonable to question whether overall student outlook and actual student action during specific examinations may be at variance. In this regard, fewer students (of either gender) actually performed PPE despite claiming to be willing to do so for all body regions, on both genders, whether examining or being examined by a peer: authors termed this phenomenon ‘attitude-behaviour inconsistency’ [
2]. In light of this data, this study focuses on what impacts on the actual practice of PPE by students. Thus, it is about experience, not prior expectations. First, we ask whether gender affects engagement in PPE? And second, do student self-ratings of outlook affect engagement in PPE?