Student Mistreatment is Partly in the Eye of the Beholder

MistreatmentIn this interesting focus group study, 41 senior medical students from McGill were asked to comment on suboptimal learning experiences and mistreatment.  Ninety percent reported any mistreatment during medical school; about half of the incidents had been officially reported by the student.  Mistreatment was most common on clinical rotations in surgery, obstetrics/gynecology, and internal medicine, and the attending physician was the most common perpetrator.  In their discussions, students differentiated between the rare “mistreatment with a capital M”, such as racial insults or sexual harassment, and a more pervasive subtle form of mistreatment, which overlapped with a suboptimal learning environments.  These types of mistreatment were often characterized by perceived lack of respect for students, an emphasis on working as opposed to learning, the perception that student assessments of patients were dismissed, feeling coerced to go along with unprofessional behavior, or feeling unable to respond to an unfair evaluation.  Students felt that four factors influenced whether these more subtle situations would be perceived as mistreatment by a student:  the student’s baseline sensitivity; the power dynamic of the situation; the student’s current emotional state; and the perceived intent of and relationship with the teacher.  A minority of students felt that these challenging situations could lead to growth and resiliency.–Laura Willett, MD

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

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