Assessment of Programs Aimed to Decrease or Prevent Mistreatment of Medical Trainees

Abstract

Key Points Question What programmatic and curricular attempts have been reported to decrease the incidence of mistreatment of medical trainees? Findings After a systematic review of more than 3300 articles, only 10 peer-reviewed studies presented outcomes from an implemented program to prevent mistreatment. Overall, quality of included studies was low, and few studies reported any outcome data. Meaning There are very few published descriptions of programs attempting to decrease mistreatment of medical trainees, and there is a need for improved quantity and quality of such reports.

Why do few medical students report their experiences of mistreatment to administration?

“…Yale School of Medicine's annual 'Power Day' incorporates workshops, speakers and small group sessions to explore power dynamics and hidden curriculum in the health care environment, and has served as a springboard for broader faculty members wide interventions 33 . Further study examining efficacy of interventions to address mistreatment in formal, informal and hidden medical curricula is necessary, 34,35 and our findings relate to the central importance of organisational trust and clear communication indicate principles that may be useful in developing these programmes.…”

Association of Characteristics of the Learning Environment and US Medical Student Burnout, Empathy, and Career Regret

“…These findings also point to potential interventions. Although the most effective approaches to addressing mistreatment of learners remain elusive, 48 the frequency of mistreatment varies between educational programs, 20 suggesting there are likely to be levers within the control of the organization that adequate commitment, leadership, infrastructure, resources, and accountability can lead to a meaningful reduction in mistreatment. 49 Similarly, in a previous study of more than 4500 medical students attending 28 medical schools, the medical school campus explained the largest difference in MSLES scores.…”

“Toxic” bedside teaching: patient impact

“…The intent of this study 1 was to propose that attempts to fix the problem require a broad view of our conceptions of mistreatment by linking both the root cause/s of trainees’ mistreatment and proposed intervention to sociocultural theoretical framework. 3 Suggestions in more recent articles by Fleming and Smith 2 and Mazer et al 4 seem to be in line with this proposal.…”