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Clerkship-Specific Medical Student Mistreatment

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Abstract

Background

Few meaningful changes have been made to reduce medical student mistreatment despite years of interventions undertaken based on data regarding mistreatment gathered annually in the Association of American Medical College’s (AAMC) Medical School Graduation Questionnaire (GQ). No studies to date have compared clerkship-specific mistreatment to identify problems unique to individual learning environments. The purpose of this study was to investigate medical student mistreatment during third-year clerkships at a university-based medical school and to evaluate specific mistreatment patterns by clerkship.

Methods

In the 2012–2013 academic year, 122 third-year medical students were surveyed using the AAMC GQ questions on mistreatment behaviors witnessed or experienced during medical school. During each of their clerkships, students were asked to report mistreatment and to specify the individuals responsible for it.

Results

Public humiliation was the most commonly reported form of mistreatment. This was more prominent on Surgery (23.8%), Obstetrics and Gynecology (15.2%), and Internal Medicine (12.4%) versus Neurology (4.8%), Psychiatry (4.3%), Pediatrics (2.1%), and Family Medicine (0%). Faculty (36–64%) and residents (29–50%) were primarily responsible for mistreatment. Students identified many instances of mistreatment in the operating room. More students reported being denied opportunities based solely on gender during Obstetrics and Gynecology than all other clerkships (12 versus 0–2%).

Conclusions

Students reported higher incidences of mistreatment on Surgery, Obstetrics and Gynecology, and Internal Medicine. Operating room culture may contribute to medical student mistreatment. Gender-specific mistreatment occurs during the Obstetrics and Gynecology clerkship, which may affect the educational experience of male students. We recommend a clerkship-specific approach to evaluate mistreatment to successfully identify and address mistreatment across learning environments.

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References

  1. Fnais N, Soobiah C, Chen MH, Lillie E, Perrier L, Tashkhandi M, et al. Harassment and discrimination in medical training: a systematic review and meta-analysis. Acad Med. 2014;89:817–27.

    Article  Google Scholar 

  2. Silver HK. Medical students and medical school. JAMA. 1982;247:309–10.

    Article  Google Scholar 

  3. Fried JM, Vermillion M, Parker NH, Uijtdehaage S. Eradicating medical student mistreatment: a longitudinal study of one institution’s efforts. Acad Med. 2012;87:1191–8.

    Article  Google Scholar 

  4. Association of American Medical Colleges. Medical school graduation questionnaire: 2012 all schools summary report. Washington, D.C.: AAMC; 2012.

    Google Scholar 

  5. Ahmadipour H, Vafadar R. Why mistreatment of medical students is not reported in clinical settings: perspectives of trainees. Indian J Med Ethics. 2016 Oct-Dec;1(4):215–8.

    Google Scholar 

  6. Peres MF, Babler F, Arakaki JN, Quaresma IY, Barreto AD, Silva AT, et al. Mistreatment in an academic setting and medical students’ perceptions about their course in São Paulo, Brazil: a cross-sectional study. Sao Paulo Med J. 2016;134(2):130–7.

    Article  Google Scholar 

  7. Scott KM, Caldwell PH, Barnes EH, Barrett J. “Teaching by humiliation” and mistreatment of medical students in clinical rotations: a pilot study. Med J Aust. 2015;203(4):185e.1–6.

    Google Scholar 

  8. Siller H, Tauber G, Komlenac N, Hochleitner M. Gender differences and similarities in medical students’ experiences of mistreatment by various groups of perpetrators. BMC Med Educ. 2017;17(1):134.

    Article  Google Scholar 

  9. Bursch B, Fried JM, Wimmers PF, Cook IA, Baillie S, Jackson H, et al. Relationship between medical student perceptions of mistreatment and mistreatment sensitivity. Med Teach. 2013;35:e998–1002.

    Article  Google Scholar 

  10. Haviland MG, Yamagata H, Werner LS, Zhang K, Dial TH, Sonne JL. Student mistreatment in medical school and planning a career in academic medicine. Teach Learn Med. 2011;23:231–7.

    Article  Google Scholar 

  11. Oser TK, Haidet P, Lewis PR, Maugher DT, Gingrich DL, Leong SL. Frequency and negative impact of medical student mistreatment based on specialty choice: a longitudinal study. Acad Med. 2014;89:755–61.

    Article  Google Scholar 

  12. Cook AF, Arora VM, Rasinski KA, Curlin FA, Yoon JD. The prevalence of medical student mistreatment and its association with burnout. Acad Med. 2014;89:749–54.

    Article  Google Scholar 

  13. Mavis B, Sousa A, Lipscomb W, Rappley MD. Learning about medical student mistreatment from responses to the medical school graduation questionnaire. Acad Med. 2014;89:705–11.

    Article  Google Scholar 

  14. Stone JP, Charette JH, McPhalen DF, Temple-Oberle C. Under the knife: medical student perceptions of intimidation and mistreatment. J Surg Educ. 2015;72(4):749–53.

    Article  Google Scholar 

  15. Chapman SJ, Hakeem AR, Marangoni G, Raj Prasad K. How can we enhance undergraduate medical training in the operating room? A survey of student attitudes and opinions. J Surg Educ. 2013;70:326–33.

    Article  Google Scholar 

  16. Ahmer S, Yousafzai AW, Bhutto N, Alam S, Sarangzai AK, Iqbal A. Bullying of medical students in Pakistan: a cross-sectional questionnaire survey. PLoS One. 2008;3(12):e3889.

    Article  Google Scholar 

  17. Gan R, Snell L. When the learning environment is suboptimal: exploring medical students’ perceptions of “mistreatment”. Acad Med. 2014;89(4):608–17.

    Article  Google Scholar 

  18. Ogden PE, Wu EH, Elnicki MD, Battistone MJ, Cleary LM, Fagan MJ, et al. Do attending physicians, nurses, residents, and medical students agree on what constitutes medical student abuse? Acad Med. 2005;80(Suppl):S80–3.

    Article  Google Scholar 

  19. Chang JC, Odrobina MR, McIntyre-Seltman K. The effect of student gender on the obstetrics and gynecology clerkship experience. J Women’s Health. 2010;19:87–92.

    Article  Google Scholar 

  20. Kristoffersson E, Andersson J, Bengs C, Hamberg K. Experiences of the gender climate in clinical training—a focus group study among Swedish medical students. BMC Med Educ. 2016 Oct 26;16(1):283.

    Article  Google Scholar 

  21. Emmons SL, Adams KE, Nichols M, Cain J. The impact of perceived gender bias on obstetrics and gynecology skills acquisition by third-year medical students. Acad Med. 2004;79:326–32.

    Article  Google Scholar 

  22. Dent GA. Anonymous surveys to address mistreatment in medical education. Virtual Mentor. 2014;16:200–3.

    Article  Google Scholar 

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Acknowledgements

The University of Michigan Medical School has grant funding for Accelerating Change in Medical Education from the American Medical Association.

Funding

American Medical Association.

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Author notes

  1. Christopher Breed

    Present address: University of Colorado School of Medicine, 13001 E 17th Place, Aurora, CO, 80045, USA

  2. Amanda Opaskar

    Present address: University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA

Authors and Affiliations

  1. University of Michigan Medical School, 1301 Catherine St., Ann Arbor, MI, 48109, USA

    Christopher Breed, Bethany Skinner, Joel Purkiss, Amanda Opaskar, Sally A. Santen, Rishindra Reddy, Joel Heidelbaugh & Maya Hammoud

  2. Department of Obstetrics and Gynecology, L 4100 Women’s Hospital SPC 5276, 1500 E Medical Center Dr, Ann Arbor, 48109, MI, USA

    Bethany Skinner

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  1. Christopher Breed
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Correspondence to Bethany Skinner.

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Breed, C., Skinner, B., Purkiss, J. et al. Clerkship-Specific Medical Student Mistreatment. Med.Sci.Educ. 28, 477–482 (2018). https://doi.org/10.1007/s40670-018-0568-8

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  • DOI: https://doi.org/10.1007/s40670-018-0568-8

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