Aligning perceptions of mistreatment among incoming medical trainees

Kulaylat, Afif N.; Qin, Danni; Sun, Susie X.; Hollenbeak, Christopher S.; Schubart, Jane R.; Aboud, Antone J.; Flemming, Donald J.; Bollard, Edward R.; Dillon, Peter W.; Han, David C.

doi:10.1016/j.jss.2016.09.016

Cited by 19 publications

(20 citation statements)

References 33 publications

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“…Of the 4 studies that involved bullying recognition workshops, 3 reported an associated improvement in bullying recognition. 37 42 44 In a study that developed a gender equity office, reporting was handled through an intermediary; decisions were binding with consequences for retaliation including termination of employment 39 and 96% of all formal reports were resolved. In a study where a gender and power abuse committee was formed, there was an associated reduction in academic abuse.…”

Section: Suggested Strategies Interventions and Outcomesmentioning

confidence: 99%

Systematic review of academic bullying in medical settings: dynamics and consequences

2021

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PurposeTo characterise the dynamics and consequences of bullying in academic medical settings, report factors that promote academic bullying and describe potential interventions.DesignSystematic review.Data sourcesWe searched EMBASE and PsycINFO for articles published between 1 January 1999 and 7 February 2021.Study selectionWe included studies conducted in academic medical settings in which victims were consultants or trainees. Studies had to describe bullying behaviours; the perpetrators or victims; barriers or facilitators; impact or interventions. Data were assessed independently by two reviewers.ResultsWe included 68 studies representing 82 349 respondents. Studies described academic bullying as the abuse of authority that impeded the education or career of the victim through punishing behaviours that included overwork, destabilisation and isolation in academic settings. Among 35 779 individuals who responded about bullying patterns in 28 studies, the most commonly described (38.2% respondents) was overwork. Among 24 894 individuals in 33 studies who reported the impact, the most common was psychological distress (39.1% respondents). Consultants were the most common bullies identified (53.6% of 15 868 respondents in 31 studies). Among demographic groups, men were identified as the most common perpetrators (67.2% of 4722 respondents in 5 studies) and women the most common victims (56.2% of 15 246 respondents in 27 studies). Only a minority of victims (28.9% of 9410 victims in 25 studies) reported the bullying, and most (57.5%) did not perceive a positive outcome. Facilitators of bullying included lack of enforcement of institutional policies (reported in 13 studies), hierarchical power structures (7 studies) and normalisation of bullying (10 studies). Studies testing the effectiveness of anti-bullying interventions had a high risk of bias.ConclusionsAcademic bullying commonly involved overwork, had a negative impact on well-being and was not typically reported. Perpetrators were most commonly consultants and men across career stages, and victims were commonly women. Methodologically robust trials of anti-bullying interventions are needed.LimitationsMost studies (40 of 68) had at least a moderate risk of bias. All interventions were tested in uncontrolled before–after studies.

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Section: Suggested Strategies Interventions and Outcomesmentioning

confidence: 99%

Systematic review of academic bullying in medical settings: dynamics and consequences

2021

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“…Our findings, showing that professional role and previous mistreatment as a medical student do influence perceptions of mistreatment, do however align with the findings of prior studies. 13,[17][18][19][20][21] These points must be emphasized in career development sessions delivered to all health professionals. Mistreatment is in the eyes, ears, and feelings of the beholder, and, according to our data, both prior experience and professional role can sensitize physicians to more commonly perceive mistreatment or to perceive more severe mistreatment.…”

Section: Discussionmentioning

confidence: 99%

Perception of Medical Student Mistreatment: Does Specialty Matter?

et al. 2021

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“…Evidently, these curricular interventions fail to reach the clinical environment. When mistreatment is not addressed properly, studies suggest that students may incorporate the bad norms and attitudes of the teaching physicians as part of the hidden curriculum [38,39]. When the teaching physician is being discriminatory, it may cause a negative spiral of these behaviors.…”

Section: Discussionmentioning

confidence: 99%

Medical students’ self-reported gender discrimination and sexual harassment over time

Kisiel

Kühner

Stolare

et al. 2020

Preprint

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BackgroundGender discrimination (GD) and sexual harassment (SH) occur at all academic institutions worldwide. Medical students seem particularly affected, which may negatively affect their education and health. There are indications that policies and reforms on reducing GD/SH are insufficient. Swedish medical students’ experiences of GD/SH are monitored by course-evaluations and bi-annual student union evaluations; however, the response rate is usually low. The aim of this study was to compare the exposure to and context of self-reported GD/SH over an 11-year period amongst medical students at a Swedish university.MethodsIn 2002, a questionnaire (n=622) was mailed to medical students’ home addresses. It was repeated in 2013 and then distributed during mandatory lectures (n=856). The questions used a behavioristic approach and asked about specific GH/SH experiences. Participation was voluntary and anonymous. The changes in prevalence over time were calculated by sampling weights in order to obtain comparable estimates, representative of both cohorts.ResultsThe response frequency was 55% (62% women) in 2002 and 81% (59% women) in 2013. The prevalence of GD tended to decrease for male and clinical students in comparison to female and pre-clinical peers. However, the prevalence of SH increased for female compared to male students. The ratio of SH for female pre-clinical students doubled in many instances; most often, the mistreatment occurred in the clinic. Medical doctors were indicated as perpetrators up to five times more often by all students in 2013.ConclusionOur results show a disproportional change in exposure to GD/SH between female and male medical students, resulting in a widening of the gender gap regarding prevalence of GD and SH between 2002 and 2013. In particular, personal experiences of SH increased for both sexes. It is proof that institutional efforts to fight mistreatment might be ineffective.

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Aligning perceptions of mistreatment among incoming medical trainees

Cited by 19 publications

References 33 publications

Systematic review of academic bullying in medical settings: dynamics and consequences

Systematic review of academic bullying in medical settings: dynamics and consequences

Perception of Medical Student Mistreatment: Does Specialty Matter?

Medical students’ self-reported gender discrimination and sexual harassment over time

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