To Bully and Be Bullied: Harassment and Mistreatment in Medical Education

Major, Ajay

doi:10.1001/virtualmentor.2014.16.03.fred1-1403

Cited by 23 publications

(14 citation statements)

References 11 publications

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“…This demonstration of power (e.g. staff demonstrating power over students) in medicine might result in a transgenerational legacy [ 27 ], in which these practices are passed from university staff to medical students and might also reinforce mistreating behavior in future generations of medical doctors [ 27 , 38 ]. It is suggested that incidences and prevalence of mistreatment not only be studied, but also be brought in association with power relationships and hierarchical structures.…”

Section: Discussionmentioning

confidence: 99%

Gender differences and similarities in medical students’ experiences of mistreatment by various groups of perpetrators

et al. 2017

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BackgroundMistreatment of medical students during medical education is a widespread concern. Studies have shown that medical students report the most mistreatment compared to students of other study programs and that the prevalence of mistreatment peaks during clinical training. For this reason, a study was conducted to assess prevalence of mistreatment among medical students committed by various groups of people. The focus was to identify whether gender was associated with the experience of mistreatment. Additionally, students’ perception of university climate for reporting sexual harassment was assessed.MethodIn the study 88 medical students (45 women, 43 men) participated. A modified version of the Questionnaire on Student Abuse was used to assess students’ experience of various types of mistreatment and associated distress during medical education. To explore factors that could be associated with this experience the organizational climate for reporting sexual harassment was assessed with the Psychological Climate for Sexual Harassment.ResultThe most often cited perpetrators of mistreatment were strangers (79.5%), friends (75.0%) and university staff (68.2%). Strangers mostly committed psychological mistreatment and sexual harassment, whereas friends additionally engaged in physical mistreatment of medical students. The most common form of mistreatment conducted by university staff was humiliation of students. These kinds of psychological mistreatment were reported to be distressing (43%). Gender differences were found in the prevalence of mistreatment. Women experienced more sexual harassment and humiliation than did men. On the other hand, men experienced more physical mistreatment than did women. Women reported experiencing more distress from mistreatment experiences than did men and also more often reported being mistreated by university staff than did men. Women perceived a greater risk in reporting sexual harassment to the organization than did men.ConclusionMistreatment of female and male students should be focused on using a gender perspective because types of mistreatment can differ by gender. Additionally, interventions should include the societal level as there was a high prevalence of mistreatment perpetrated by strangers. Also the issue of trust in the university needs to be addressed and the organization is called on to visibly demonstrate that it represents and protects its students as well as its staff.

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Section: Discussionmentioning

confidence: 99%

Gender differences and similarities in medical students’ experiences of mistreatment by various groups of perpetrators

et al. 2017

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“…We found that legitimacy was also important to staff engagement in CAPLE: a participants’ general sense that a topic (here, bullying) was somehow acceptable for discussion, not ‘off limits.’ Via workshops’ general focus on clinical teaching, we were able to include bullying as part of discussion because of the natural relationship between bullying and teaching, such as academic bullying [5, 36] or how one might behave to a student that you dislike. References to bullying thus came across to participants as incidental, part of a wider or related discussion, perhaps experienced as a ‘softened blow’ in comparison with direct references, which can sound accusatory: … it’s a good way to do it because conversations can be about mostly something else, and it doesn’t sound as accusatory as having it as the only thing.…”

Section: Resultsmentioning

confidence: 99%

“…The nature of clinical student bullying is also well described. The commonest reported bullying acts have been found to be verbal and physical harassment, gender and racial discrimination and, importantly, several forms of academic harassment [3–5]. While any student can suffer bullying, at the hands of any staff member [6–8], students of minority ethnicity, or sexuality, and of the female gender1 are likely to experience it more [4].…”

Section: Introductionmentioning

confidence: 99%

It’s ‘probably the teacher!’ A strategic framework for clinical staff engagement in clinical student bullying intervention

et al. 2019

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Background Student bullying in clinical practice persists, and poor outcomes continue: for learning, academic achievement and career goals, for their mental and physical health and potentially affecting all staff and patients in a clinical workplace. We describe an emergent framework for the strategic design of a bullying intervention, presented as a staff development opportunity. Methods CAPLE (Creating A Positive Learning Environment) was a bullying intervention designed around current best evidence about ameliorating student bullying in the clinical environment. CAPLE was also an action research project delivered in two eight- week cycles, one in 2016 & another in 2017. CAPLE’s primary practical foci were to offer clinical staff in two separate hospital wards an opportunity to develop their clinical teaching skills and to guide them in reflection and cultivation of values around students and learning. Research foci were: 1. to gain insight into staff experiences of CAPLE as a development process and 2. to evaluate how CAPLE might best help staff reflect on, discuss and develop values around student learning, to include bullying. Staff undertook five active learning workshops combined with supportive contact with one researcher over the research period. Data include individual interviews, staff and researchers’ reflective journals and a paper survey about staff experiences of the 2017 intervention. Results We confirm the effectiveness of best evidence from the literature and also that a strategic four-part framework of approach, process, content and person can further enhance a bullying intervention by increasing the likelihood of participant engagement, learning and values change. Conclusions This research aggregates and adds weight to the current literature about student bullying and adds important pragmatic detail about best practice for bullying intervention design and delivery. Ultimately, this emergent framework offers insight to help move past some persistent barriers encountered by those wishing to improve workplace behaviour.

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“…It was a poignant admission of the problem and first major public acknowledgement of the bullying culture by a member of medical profession. [ 12 ] Further on in early 2015, the public media (press and TV) published a number of stories highlighting illegal and inappropriate behavior of surgeons in the workplace. [ 13 ] Most of the large medical organizations including the Australian Medical Association (AMA) and the Royal Australasian College of Surgeons (RACS) responded to the issue and identified bullying and harassment in medicine as a priority area for change.…”

Section: Acknowledging and Finding Effective Solutionsmentioning

confidence: 99%

Abusive culture in medical education: Mentors must mend their ways

Singh

2018

J Anaesthesiol Clin Pharmacol

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To Bully and Be Bullied: Harassment and Mistreatment in Medical Education

Cited by 23 publications

References 11 publications

Gender differences and similarities in medical students’ experiences of mistreatment by various groups of perpetrators

Gender differences and similarities in medical students’ experiences of mistreatment by various groups of perpetrators

It’s ‘probably the teacher!’ A strategic framework for clinical staff engagement in clinical student bullying intervention

Abusive culture in medical education: Mentors must mend their ways

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