Frequency and Negative Impact of Medical Student Mistreatment Based on Specialty Choice

Oser, Tamara K.; Haidet, Paul; Lewis, Peter R.; Mauger, David T.; Gingrich, Dennis; Leong, Shou Ling

doi:10.1097/acm.0000000000000207

Cited by 63 publications

(46 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The prevalence of reported mistreatment among graduating medical students has consistently ranged between 17 and 20% annually [5]. Beyond hampering the clinical learning environment (CLE), the negative consequences of this behavior on trainees have been well documented [6–13]. Some authors have conceded that efforts to eradicate learner mistreatment have been hindered by the effect of the “hidden curriculum [14]”.…”

Section: Introductionmentioning

confidence: 99%

Perceptions of mistreatment among trainees vary at different stages of clinical training

et al. 2017

View full text Add to dashboard Cite

BackgroundMistreatment of trainees remains a frequently reported phenomenon in medical education. One barrier to creating an educational culture of respect and professionalism may be a lack of alignment in the perceptions of mistreatment among different learners. Through the use of clinical vignettes, our aim was to assess the perceptions of trainees toward themes of potential mistreatment at different stages of training.MethodsBased on observations from external experts embedded in the clinical learning environment, six thematic areas of potential mistreatment were identified: verbal abuse, specialty-choice discrimination, non-educational tasks, withholding/denying learning opportunities, neglect and gender/racial insensitivity. Corresponding clinical vignettes were created and distributed to 1) medical students, 2) incoming interns, 3) residents/fellows. Perceptions of the appropriateness of the interactions depicted in the vignettes were measured on a 5-point Likert scale. Scores were categorized into neutral or appropriate (≤3) or inappropriate (i.e. mistreatment) (>3) and compared using chi-squared tests.ResultsFour hundred twenty seven trainees participated (182 students, 120 interns, 125 residents/fellows). Proportions of students perceiving mistreatment differed significantly from those of interns and residents/fellows in domains of verbal abuse, specialty discrimination and gender/racial insensitivity (p < 0.05). In scenarios comparing interns to residents/fellows, no significant differences were noted in perceptions of mistreatment in the domains of non-educational tasks, withholding learning and neglect.ConclusionsPerceptions of mistreatment differ at different developmental stages of medical training. After exposure to the clinical learning environment, perceptions of incoming interns did not differ from those of residents/fellows, implicating clinical rotations as a key period in indoctrinating students into the prevailing culture. More longitudinal studies are needed to confirm or better examine this phenomenon.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0853-4) contains supplementary material, which is available to authorized users.

show abstract

Section: Introductionmentioning

confidence: 99%

Perceptions of mistreatment among trainees vary at different stages of clinical training

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Mistreatment may lead to burnout, stress, depressive symptoms, marginalization, cynicism and 'moral distress' among medical students [12][13][14][15][16]. In clinical settings, mistreatment also undermines teamwork, quality of care, and patient safety [1,[5][6][7][8][9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

“…Medical students who experience mistreatment report higher rates of burnout, depression, anxiety, and substance use disorders. [1,[5][6][7][8][9][10][11][12][13] Demeaning, humiliating, and disrespectful comments directed at students also contribute to cynicism and an erosion of humanistic values [12][13][14][15][16][17][18]. Additionally, in clinical settings, disrespectful and dehumanizing comments interfere with communication and erode trust among health-care team members, which threatens the quality of care and patient safety.…”

mentioning

confidence: 99%

“…Additionally, in clinical settings, disrespectful and dehumanizing comments interfere with communication and erode trust among health-care team members, which threatens the quality of care and patient safety. [1,6,10,[19][20][21] Today, medical student mistreatment is widely recognized, and mistreatment rates are measured annually on the Association of American Medical Colleges (AAMC) Graduation Questionnaire (GQ) [1,11,22,23]. In 2019, across all US medical schools, 40.4% of the students reported experiencing mistreatment at least once during medical school, [24] and reducing the rate of student mistreatment has become a priority for medical schools and for the Liaison Committee on Medical Education [19,25].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Ending student mistreatment: early successes and continuing challenges

Lind

Osborne

Badesch

et al. 2019

Medical Education Online

View full text Add to dashboard Cite

Problem: Student mistreatment represents an ongoing challenge for US medical schools. Students experiencing mistreatment may become marginalized and cynical, and they have higher rates of burnout, depression and substance use disorders. Although numerous attempts to eliminate mistreatment have been proposed, best practices remain elusive. We formed a unique student-faculty collaboration (the Ending Mistreatment Task Force) that allowed all voices to be heard and enabled identification of five interventions to reduce mistreatment.Intervention: The EMTF developed and implemented five key interventions: 1) a shared mistreatment definition; 2) measures to increase faculty accountability, including adding professionalism expectations to faculty members’ contracts and performance reviews; 3) a Professionalism Office to respond promptly to students’ reports of mistreatment and provide feedback to faculty; 4) tools to help teachers provide authentic learning environments for students, while addressing generational misunderstandings; and 5) student-produced videos, helping faculty understand the impact of mistreatment as seen through students’ eyes.Context: These interventions occurred at one medical school where mistreatment reports were consistently above national averages.Impact: Over 6 years, the interventions helped reduce the rate of student-reported mistreatment by 36% compared with a 4% decline across all US medical schools.Lessons: The collaborations between students and faculty helped each party identify unexpected misunderstandings and challenges. We learned that students want hard questions, although faculty are often afraid to challenge students for fear of offending them or being reported. We clarified differences between mistreatment and sub-optimal learning environments and openly discussed the pervasive opinion that ‘some’ mistreatment is important for learning. We also identified ongoing challenges, including the need to solicit residents’ perspectives regarding mistreatment and develop proper responses to disrespectful comments directed at patients, family and colleagues. The collaboration reinforced students’ and faculty members’ shared commitment to upholding a respectful learning and clinical care environment and ending mistreatment.

show abstract

“…Wear and Skillicorn proposed that the attending physicians interviewed as part of the focus group may have been the "good" role models who were not imparting these negative messages. But others have brought up the idea that attending physicians may have impacts on students and trainees of which they are unaware [7]. Often professionals are so entrenched in the culture of medicine that they are not cognizant of some of the hidden messages that are being imparted.…”

mentioning

confidence: 99%

Role Models' Influence on Medical Students' Professional Development

2015

AMA Journal of Ethics

View full text Add to dashboard Cite

Frequency and Negative Impact of Medical Student Mistreatment Based on Specialty Choice

Cited by 63 publications

References 26 publications

Perceptions of mistreatment among trainees vary at different stages of clinical training

Perceptions of mistreatment among trainees vary at different stages of clinical training

Ending student mistreatment: early successes and continuing challenges

Role Models' Influence on Medical Students' Professional Development

Contact Info

Product

Resources

About