More on Learner Mistreatment

Mistreatment Lots of groups are addressing the issue of learner mistreatment.  Mavis et al discuss longitudinal data from the AAMC’s Graduation Questionnaire.  Over the years, the percentage of medical students reporting mistreatment has remained stubbornly high, with attendings, residents, nurses, and other students being the most common sources, and verbal humiliation being the most common type of mistreatment.  On a positive note, more students are now aware of their school’s policies for dealing with mistreatment.  Fnais et al performed a systematic review of 62 studies of mistreatment of medical trainees at all levels in 14 countries, with a majority in USA or Canada.  Rates were remarkably similar across sites (63.6% for USA and Canada combined).   Again, verbal harassment was the most common type of mistreatment reported; the most common sources were attendings, patients and families, nurses, and residents/fellows.  Risk factors for abuse included:  female sex; nonwhite ethnicity (and Middle Eastern background in one USA study); and surgical training program.  Oser et al surveyed students from one medical school regarding a form of mistreatment not addressed by the Graduation Questionnaire, negative interactions generated by the student’s specialty choice.  This was quite common across all types of students and clerkships; residents were the most common source.  For example, 65% of students reported that frequently they were “told directly or overheard negative comments about (their) specialty/career interest,” and 45% reported that frequently they “believed (they) had to be less than completely honest about (their) specialty/career interest to receive fair treatment.” – Laura Willett, MD

Mavis B, Sousa A, Lipscomb W, Rappley MD. Learning about medical student mistreatment from responses to the medical school graduation questionnaire. Acad Med. 2014 May;89(5):705-11.

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Fnais N, Soobiah C, Chen MH, Lillie E, Perrier L, Tashkhandi M, Straus SE, Mamdani M, Al-Omran M, Tricco AC. Harassment and discrimination in medical training: a systematic review and meta-analysis. Acad Med. 2014 May;89(5):817-27.

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Oser TK, Haidet P, Lewis PR, Mauger DT, Gingrich DL, Leong SL. Frequency and negative impact of medical student mistreatment based on specialty choice: a longitudinal study. Acad Med. 2014 May;89(5):755-61.

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