Abstract
Objective
To evaluate the medical student perception of unprofessional experiences on the obstetrics and gynecology clerkship through evaluation of reflective essays using qualitative research and grounded theory.
Methods
All third year medical students rotating through OBGYN were required to write an essay on an experience they had with positive and/or negative professionalism during their clinical rotation. Essays were analyzed from a total of 220 students and coded into eight domains with subcategories. Inter-rater reliability was established with two of the coders (MR and BG) with high levels of correlation kappa’s agreement 0.73 CI (0.57, 0.88). Qualitative analysis using grounded theory was deployed for essay theme analysis. Frequencies were used for descriptive purposes.
Results
Most students chose to write about incidents of negative professionalism that they observed. The most common domain themes were medical team dynamics (19%), inpatient interactions (20%), and inappropriate remarks about a patient (16%). A quarter (26%) of the essays also included an observation of a positive demonstration of professionalism.
Conclusion
Students frequently report experiencing mistreatment through the perception of a hostile learning environment. The essays described frequent exposure to unprofessional actions that can create a hostile learning environment and thus potential mistreatment. The students frequently wrote about witnessing unprofessional comments made by team members about patients, residents, and other students. All medical educators need to work to reduce student mistreatment through reducing unprofessional behavior.
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Acknowledgments
The authors thank all students who rotate through the Obstetrics and Gynecology clerkship; they have been our educators through sharing their experiences.
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Ethics declarations
The Thomas Jefferson University Institutional Review Board approved this study of de-identified essays with a designation of exempt.
Source of the Work
Essays gathered from clerkship students at Thomas Jefferson University
Conflict of Interest
The authors declare that they have no conflict of interest.
Additional information
Precis: Medical students witness unprofessional behavior on their clerkships that can be detrimental to their professional development and should be eradicated through faculty awareness and development.
This abstract was presented orally at the APGO/CREOG meeting in Orlando, FL, March 2017. The abstract was published in the Green Journal Educational Supplement, October 2017.
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Lackritz, K., Braverman, A., Wolf, A. et al. Examining Unprofessional Behavior in the Obstetrics and Gynecology Clerkship: a Qualitative Study of Essays Written by Students. Med.Sci.Educ. 28, 483–488 (2018). https://doi.org/10.1007/s40670-018-0570-1
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DOI: https://doi.org/10.1007/s40670-018-0570-1