Eradicating Medical Student Mistreatment

Joyce M. Fried · Michelle Vermillion · Neil H. Parker · Sebastian H. J. Uijtdehaage

166 citations0/0 files storedAcademic Medicine

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Workplace Violence and Bullying Innovations in Medical Education Diversity and Career in Medicine

Abstract

PURPOSE: Since 1995, the David Geffen School of Medicine at UCLA (DGSOM) has created policies to prevent medical student mistreatment, instituted safe mechanisms for reporting mistreatment, provided resources for discussion and resolution, and educated faculty and residents. In this study, the authors examined the incidence, severity, and sources of perceived mistreatment over the 13-year period during which these measures were implemented. METHOD: From 1996 to 2008, medical students at DGSOM completed an anonymous survey after their third-year clerkships and reported how often they experienced physical, verbal, sexual harassment, ethnic, and power mistreatment, and who committed it. The authors analyzed these data using descriptive statistics and the students' descriptions of these incidents qualitatively, categorizing them as "mild," "moderate," or "severe." They compared the data across four periods, delineated by milestone institutional measures to eradicate mistreatment. RESULTS: Of 2,151 eligible students, 1,946 (90%) completed the survey. More than half (1,166/1,946) experienced some form of mistreatment. Verbal and power mistreatment were most common, but 5% of students (104/1,930) reported physical mistreatment. The pattern of incidents categorized as "mild," "moderate," or "severe" remained across the four study periods. Students most frequently identified residents and clinical faculty as the sources of mistreatment. CONCLUSIONS: Despite a multipronged approach at DGSOM across a 13-year period to eradicate medical student mistreatment, it persists. Aspects of the hidden curriculum may be undermining these efforts. Thus, eliminating mistreatment requires an aggressive approach both locally at the institution level and nationally across institutions.

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References

2010Millennials’ (Lack of) Attitude Problem: An Empirical Examination of Generational Effects on Work Attitudes 2010Gender Differences in Academic Productivity and Leadership Appointments of Physicians Throughout Academic Careers 2006Experiences of belittlement and harassment and their correlates among medical students in the United States: longitudinal survey 1991Student perceptions of mistreatment and harassment during medical school. A survey of ten United States schools.2008Sexual harassment during clinical clerkships in Dutch medical schools

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2020Sexual harassment exposure and impaired mental health in medical students. The MESSIAEN national study

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